|
HC LAB REF BK VIRUS BY PCR
|
Facility
|
IP
|
$50.27
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
900912606
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$9.10 |
| Max. Negotiated Rate |
$37.70 |
| Rate for Payer: Adventist Health Commercial |
$10.05
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$34.54
|
| Rate for Payer: Cash Price |
$22.62
|
| Rate for Payer: Heritage Provider Network Commercial |
$34.03
|
| Rate for Payer: Heritage Provider Network Senior |
$34.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.57
|
| Rate for Payer: Multiplan Commercial |
$37.70
|
|
|
HC LAB REF BK VIRUS BY PCR
|
Facility
|
OP
|
$50.27
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
900912606
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$9.10 |
| Max. Negotiated Rate |
$284.23 |
| Rate for Payer: Adventist Health Commercial |
$10.05
|
| Rate for Payer: Aetna of CA Gatekeeper |
$102.11
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$34.54
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$52.64
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$38.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$35.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$284.23
|
| Rate for Payer: Blue Shield of California Commercial |
$274.13
|
| Rate for Payer: Blue Shield of California EPN |
$214.30
|
| Rate for Payer: Cash Price |
$22.62
|
| Rate for Payer: Cash Price |
$22.62
|
| Rate for Payer: Cigna of CA HMO/PPO |
$32.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$52.64
|
| Rate for Payer: Dignity Health Medi-Cal |
$38.60
|
| Rate for Payer: Dignity Health Senior |
$35.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$32.68
|
| Rate for Payer: EPIC Health Plan Medicare |
$35.09
|
| Rate for Payer: Heritage Provider Network Commercial |
$31.12
|
| Rate for Payer: Heritage Provider Network Senior |
$31.12
|
| Rate for Payer: Humana Medicare |
$35.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$47.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$35.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$66.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$41.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.57
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$44.21
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$44.21
|
| Rate for Payer: Multiplan Commercial |
$37.70
|
| Rate for Payer: TriValley Medical Group Commercial |
$35.09
|
| Rate for Payer: TriValley Medical Group Senior |
$35.09
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$37.90
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$37.90
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$52.64
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$38.60
|
| Rate for Payer: Vantage Medical Group Senior |
$35.09
|
|
|
HC LAB REF BK VIRUS QUANT PCR, URINE
|
Facility
|
OP
|
$61.35
|
|
|
Service Code
|
CPT 87799
|
| Hospital Charge Code |
900912695
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.10 |
| Max. Negotiated Rate |
$334.56 |
| Rate for Payer: Adventist Health Commercial |
$12.27
|
| Rate for Payer: Aetna of CA Gatekeeper |
$124.63
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$42.15
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$64.26
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$47.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$42.84
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$216.56
|
| Rate for Payer: Blue Shield of California Commercial |
$334.56
|
| Rate for Payer: Blue Shield of California EPN |
$261.54
|
| Rate for Payer: Cash Price |
$27.61
|
| Rate for Payer: Cash Price |
$27.61
|
| Rate for Payer: Cigna of CA HMO/PPO |
$39.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$64.26
|
| Rate for Payer: Dignity Health Medi-Cal |
$47.12
|
| Rate for Payer: Dignity Health Senior |
$42.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$39.88
|
| Rate for Payer: EPIC Health Plan Medicare |
$42.84
|
| Rate for Payer: Heritage Provider Network Commercial |
$37.98
|
| Rate for Payer: Heritage Provider Network Senior |
$37.98
|
| Rate for Payer: Humana Medicare |
$42.84
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$59.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$42.84
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$81.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$50.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.34
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$53.98
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$53.98
|
| Rate for Payer: Multiplan Commercial |
$46.01
|
| Rate for Payer: TriValley Medical Group Commercial |
$42.84
|
| Rate for Payer: TriValley Medical Group Senior |
$42.84
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$46.27
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$46.27
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$64.26
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$47.12
|
| Rate for Payer: Vantage Medical Group Senior |
$42.84
|
|
|
HC LAB REF BK VIRUS QUANT PCR, URINE
|
Facility
|
IP
|
$61.35
|
|
|
Service Code
|
CPT 87799
|
| Hospital Charge Code |
900912695
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.10 |
| Max. Negotiated Rate |
$46.01 |
| Rate for Payer: Adventist Health Commercial |
$12.27
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$42.15
|
| Rate for Payer: Cash Price |
$27.61
|
| Rate for Payer: Heritage Provider Network Commercial |
$41.53
|
| Rate for Payer: Heritage Provider Network Senior |
$41.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.34
|
| Rate for Payer: Multiplan Commercial |
$46.01
|
|
|
HC LAB REF CALCIUM RANDOM URINE
|
Facility
|
IP
|
$8.64
|
|
|
Service Code
|
CPT 82340
|
| Hospital Charge Code |
900912784
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$1.56 |
| Max. Negotiated Rate |
$6.48 |
| Rate for Payer: Adventist Health Commercial |
$1.73
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$5.94
|
| Rate for Payer: Cash Price |
$3.89
|
| Rate for Payer: Heritage Provider Network Commercial |
$5.85
|
| Rate for Payer: Heritage Provider Network Senior |
$5.85
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.16
|
| Rate for Payer: Multiplan Commercial |
$6.48
|
|
|
HC LAB REF CALCIUM RANDOM URINE
|
Facility
|
OP
|
$8.64
|
|
|
Service Code
|
CPT 82340
|
| Hospital Charge Code |
900912784
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$1.56 |
| Max. Negotiated Rate |
$50.49 |
| Rate for Payer: Adventist Health Commercial |
$1.73
|
| Rate for Payer: Aetna of CA Gatekeeper |
$17.56
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$5.94
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$9.04
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6.63
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6.03
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$50.49
|
| Rate for Payer: Blue Shield of California Commercial |
$47.12
|
| Rate for Payer: Blue Shield of California EPN |
$36.84
|
| Rate for Payer: Cash Price |
$3.89
|
| Rate for Payer: Cash Price |
$3.89
|
| Rate for Payer: Cigna of CA HMO/PPO |
$5.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9.04
|
| Rate for Payer: Dignity Health Medi-Cal |
$6.63
|
| Rate for Payer: Dignity Health Senior |
$6.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.62
|
| Rate for Payer: EPIC Health Plan Medicare |
$6.03
|
| Rate for Payer: Heritage Provider Network Commercial |
$5.35
|
| Rate for Payer: Heritage Provider Network Senior |
$5.35
|
| Rate for Payer: Humana Medicare |
$6.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$8.36
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6.03
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$11.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.56
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$7.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$7.60
|
| Rate for Payer: Multiplan Commercial |
$6.48
|
| Rate for Payer: TriValley Medical Group Commercial |
$6.03
|
| Rate for Payer: TriValley Medical Group Senior |
$6.03
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$6.52
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$6.52
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$9.04
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6.63
|
| Rate for Payer: Vantage Medical Group Senior |
$6.03
|
|
|
HC LAB REF CALCIUM URINE
|
Facility
|
OP
|
$8.64
|
|
|
Service Code
|
CPT 82340
|
| Hospital Charge Code |
900910213
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$1.56 |
| Max. Negotiated Rate |
$50.49 |
| Rate for Payer: Adventist Health Commercial |
$1.73
|
| Rate for Payer: Aetna of CA Gatekeeper |
$17.56
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$5.94
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$9.04
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6.63
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6.03
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$50.49
|
| Rate for Payer: Blue Shield of California Commercial |
$47.12
|
| Rate for Payer: Blue Shield of California EPN |
$36.84
|
| Rate for Payer: Cash Price |
$3.89
|
| Rate for Payer: Cash Price |
$3.89
|
| Rate for Payer: Cigna of CA HMO/PPO |
$5.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9.04
|
| Rate for Payer: Dignity Health Medi-Cal |
$6.63
|
| Rate for Payer: Dignity Health Senior |
$6.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.62
|
| Rate for Payer: EPIC Health Plan Medicare |
$6.03
|
| Rate for Payer: Heritage Provider Network Commercial |
$5.35
|
| Rate for Payer: Heritage Provider Network Senior |
$5.35
|
| Rate for Payer: Humana Medicare |
$6.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$8.36
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6.03
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$11.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.56
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$7.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$7.60
|
| Rate for Payer: Multiplan Commercial |
$6.48
|
| Rate for Payer: TriValley Medical Group Commercial |
$6.03
|
| Rate for Payer: TriValley Medical Group Senior |
$6.03
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$6.52
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$6.52
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$9.04
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6.63
|
| Rate for Payer: Vantage Medical Group Senior |
$6.03
|
|
|
HC LAB REF CALCIUM URINE
|
Facility
|
IP
|
$8.64
|
|
|
Service Code
|
CPT 82340
|
| Hospital Charge Code |
900910213
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$1.56 |
| Max. Negotiated Rate |
$6.48 |
| Rate for Payer: Adventist Health Commercial |
$1.73
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$5.94
|
| Rate for Payer: Cash Price |
$3.89
|
| Rate for Payer: Heritage Provider Network Commercial |
$5.85
|
| Rate for Payer: Heritage Provider Network Senior |
$5.85
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.16
|
| Rate for Payer: Multiplan Commercial |
$6.48
|
|
|
HC LAB REF CALIFORNIA ENCEPH AB IGG
|
Facility
|
IP
|
$18.75
|
|
|
Service Code
|
CPT 86651
|
| Hospital Charge Code |
900911466
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.39 |
| Max. Negotiated Rate |
$14.06 |
| Rate for Payer: Adventist Health Commercial |
$3.75
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$12.88
|
| Rate for Payer: Cash Price |
$8.44
|
| Rate for Payer: Heritage Provider Network Commercial |
$12.69
|
| Rate for Payer: Heritage Provider Network Senior |
$12.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.69
|
| Rate for Payer: Multiplan Commercial |
$14.06
|
|
|
HC LAB REF CALIFORNIA ENCEPH AB IGG
|
Facility
|
OP
|
$18.75
|
|
|
Service Code
|
CPT 86651
|
| Hospital Charge Code |
900911466
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.39 |
| Max. Negotiated Rate |
$110.39 |
| Rate for Payer: Adventist Health Commercial |
$3.75
|
| Rate for Payer: Aetna of CA Gatekeeper |
$38.38
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$12.88
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19.78
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.51
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13.19
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$110.39
|
| Rate for Payer: Blue Shield of California Commercial |
$103.02
|
| Rate for Payer: Blue Shield of California EPN |
$80.54
|
| Rate for Payer: Cash Price |
$8.44
|
| Rate for Payer: Cash Price |
$8.44
|
| Rate for Payer: Cigna of CA HMO/PPO |
$12.19
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.78
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.51
|
| Rate for Payer: Dignity Health Senior |
$13.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.19
|
| Rate for Payer: EPIC Health Plan Medicare |
$13.19
|
| Rate for Payer: Heritage Provider Network Commercial |
$11.61
|
| Rate for Payer: Heritage Provider Network Senior |
$11.61
|
| Rate for Payer: Humana Medicare |
$13.19
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$18.28
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13.19
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$25.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.39
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.69
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16.62
|
| Rate for Payer: Multiplan Commercial |
$14.06
|
| Rate for Payer: TriValley Medical Group Commercial |
$13.19
|
| Rate for Payer: TriValley Medical Group Senior |
$13.19
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$14.24
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$14.24
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.51
|
| Rate for Payer: Vantage Medical Group Senior |
$13.19
|
|
|
HC LAB REF CALIFORNIA ENCEPH AB IGM
|
Facility
|
OP
|
$18.75
|
|
|
Service Code
|
CPT 86651
|
| Hospital Charge Code |
900912654
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.39 |
| Max. Negotiated Rate |
$110.39 |
| Rate for Payer: Adventist Health Commercial |
$3.75
|
| Rate for Payer: Aetna of CA Gatekeeper |
$38.38
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$12.88
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19.78
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.51
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13.19
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$110.39
|
| Rate for Payer: Blue Shield of California Commercial |
$103.02
|
| Rate for Payer: Blue Shield of California EPN |
$80.54
|
| Rate for Payer: Cash Price |
$8.44
|
| Rate for Payer: Cash Price |
$8.44
|
| Rate for Payer: Cigna of CA HMO/PPO |
$12.19
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.78
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.51
|
| Rate for Payer: Dignity Health Senior |
$13.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.19
|
| Rate for Payer: EPIC Health Plan Medicare |
$13.19
|
| Rate for Payer: Heritage Provider Network Commercial |
$11.61
|
| Rate for Payer: Heritage Provider Network Senior |
$11.61
|
| Rate for Payer: Humana Medicare |
$13.19
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$18.28
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13.19
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$25.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.39
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.69
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16.62
|
| Rate for Payer: Multiplan Commercial |
$14.06
|
| Rate for Payer: TriValley Medical Group Commercial |
$13.19
|
| Rate for Payer: TriValley Medical Group Senior |
$13.19
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$14.24
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$14.24
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.51
|
| Rate for Payer: Vantage Medical Group Senior |
$13.19
|
|
|
HC LAB REF CALIFORNIA ENCEPH AB IGM
|
Facility
|
IP
|
$18.75
|
|
|
Service Code
|
CPT 86651
|
| Hospital Charge Code |
900912654
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.39 |
| Max. Negotiated Rate |
$14.06 |
| Rate for Payer: Adventist Health Commercial |
$3.75
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$12.88
|
| Rate for Payer: Cash Price |
$8.44
|
| Rate for Payer: Heritage Provider Network Commercial |
$12.69
|
| Rate for Payer: Heritage Provider Network Senior |
$12.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.69
|
| Rate for Payer: Multiplan Commercial |
$14.06
|
|
|
HC LAB REF CHLAMYDIA PNEUMONIA
|
Facility
|
IP
|
$74.20
|
|
|
Service Code
|
CPT 87486
|
| Hospital Charge Code |
900912516
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$13.43 |
| Max. Negotiated Rate |
$55.65 |
| Rate for Payer: Adventist Health Commercial |
$14.84
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$50.98
|
| Rate for Payer: Cash Price |
$33.39
|
| Rate for Payer: Heritage Provider Network Commercial |
$50.23
|
| Rate for Payer: Heritage Provider Network Senior |
$50.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18.55
|
| Rate for Payer: Multiplan Commercial |
$55.65
|
|
|
HC LAB REF CHLAMYDIA PNEUMONIA
|
Facility
|
OP
|
$74.20
|
|
|
Service Code
|
CPT 87486
|
| Hospital Charge Code |
900912516
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$13.43 |
| Max. Negotiated Rate |
$284.23 |
| Rate for Payer: Adventist Health Commercial |
$14.84
|
| Rate for Payer: Aetna of CA Gatekeeper |
$102.11
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$50.98
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$52.64
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$38.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$35.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$284.23
|
| Rate for Payer: Blue Shield of California Commercial |
$274.13
|
| Rate for Payer: Blue Shield of California EPN |
$214.30
|
| Rate for Payer: Cash Price |
$33.39
|
| Rate for Payer: Cash Price |
$33.39
|
| Rate for Payer: Cigna of CA HMO/PPO |
$48.23
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$52.64
|
| Rate for Payer: Dignity Health Medi-Cal |
$38.60
|
| Rate for Payer: Dignity Health Senior |
$35.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$48.23
|
| Rate for Payer: EPIC Health Plan Medicare |
$35.09
|
| Rate for Payer: Heritage Provider Network Commercial |
$45.93
|
| Rate for Payer: Heritage Provider Network Senior |
$45.93
|
| Rate for Payer: Humana Medicare |
$35.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$48.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$35.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$66.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13.43
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$41.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18.55
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$44.21
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$44.21
|
| Rate for Payer: Multiplan Commercial |
$55.65
|
| Rate for Payer: TriValley Medical Group Commercial |
$35.09
|
| Rate for Payer: TriValley Medical Group Senior |
$35.09
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$37.90
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$37.90
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$52.64
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$38.60
|
| Rate for Payer: Vantage Medical Group Senior |
$35.09
|
|
|
HC LAB REF CHORIONIC VILLUS
|
Facility
|
OP
|
$257.48
|
|
|
Service Code
|
CPT 88267
|
| Hospital Charge Code |
900912555
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$46.60 |
| Max. Negotiated Rate |
$1,504.68 |
| Rate for Payer: Adventist Health Commercial |
$51.50
|
| Rate for Payer: Aetna of CA Gatekeeper |
$523.02
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$176.89
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$282.86
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$207.43
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$188.57
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,504.68
|
| Rate for Payer: Blue Shield of California Commercial |
$1,404.04
|
| Rate for Payer: Blue Shield of California EPN |
$1,097.61
|
| Rate for Payer: Cash Price |
$115.87
|
| Rate for Payer: Cash Price |
$115.87
|
| Rate for Payer: Cigna of CA HMO/PPO |
$167.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$282.86
|
| Rate for Payer: Dignity Health Medi-Cal |
$207.43
|
| Rate for Payer: Dignity Health Senior |
$188.57
|
| Rate for Payer: EPIC Health Plan Commercial |
$167.36
|
| Rate for Payer: EPIC Health Plan Medicare |
$188.57
|
| Rate for Payer: Heritage Provider Network Commercial |
$159.38
|
| Rate for Payer: Heritage Provider Network Senior |
$159.38
|
| Rate for Payer: Humana Medicare |
$188.57
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$249.29
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$188.57
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$358.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$46.60
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$222.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$64.37
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$237.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$237.60
|
| Rate for Payer: Multiplan Commercial |
$193.11
|
| Rate for Payer: TriValley Medical Group Commercial |
$188.57
|
| Rate for Payer: TriValley Medical Group Senior |
$188.57
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$203.65
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$203.65
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$282.86
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$207.43
|
| Rate for Payer: Vantage Medical Group Senior |
$188.57
|
|
|
HC LAB REF CHORIONIC VILLUS
|
Facility
|
IP
|
$257.48
|
|
|
Service Code
|
CPT 88267
|
| Hospital Charge Code |
900912555
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$46.60 |
| Max. Negotiated Rate |
$193.11 |
| Rate for Payer: Adventist Health Commercial |
$51.50
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$176.89
|
| Rate for Payer: Cash Price |
$115.87
|
| Rate for Payer: Heritage Provider Network Commercial |
$174.31
|
| Rate for Payer: Heritage Provider Network Senior |
$174.31
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$46.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$64.37
|
| Rate for Payer: Multiplan Commercial |
$193.11
|
|
|
HC LAB REF CHROMOSOMAL IN SITU HYBRIDIZAT
|
Facility
|
IP
|
$292.62
|
|
|
Service Code
|
CPT 88273
|
| Hospital Charge Code |
900912581
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$52.96 |
| Max. Negotiated Rate |
$219.46 |
| Rate for Payer: Adventist Health Commercial |
$58.52
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$201.03
|
| Rate for Payer: Cash Price |
$131.68
|
| Rate for Payer: Heritage Provider Network Commercial |
$198.10
|
| Rate for Payer: Heritage Provider Network Senior |
$198.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$52.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$73.16
|
| Rate for Payer: Multiplan Commercial |
$219.46
|
|
|
HC LAB REF CHROMOSOMAL IN SITU HYBRIDIZAT
|
Facility
|
OP
|
$292.62
|
|
|
Service Code
|
CPT 88273
|
| Hospital Charge Code |
900912581
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$34.81 |
| Max. Negotiated Rate |
$1,590.45 |
| Rate for Payer: Adventist Health Commercial |
$58.52
|
| Rate for Payer: Aetna of CA Gatekeeper |
$93.47
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$201.03
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$52.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$38.29
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$34.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,590.45
|
| Rate for Payer: Blue Shield of California Commercial |
$250.94
|
| Rate for Payer: Blue Shield of California EPN |
$196.17
|
| Rate for Payer: Cash Price |
$131.68
|
| Rate for Payer: Cash Price |
$131.68
|
| Rate for Payer: Cigna of CA HMO/PPO |
$190.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$52.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$38.29
|
| Rate for Payer: Dignity Health Senior |
$34.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$190.20
|
| Rate for Payer: EPIC Health Plan Medicare |
$34.81
|
| Rate for Payer: Heritage Provider Network Commercial |
$181.13
|
| Rate for Payer: Heritage Provider Network Senior |
$181.13
|
| Rate for Payer: Humana Medicare |
$34.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$44.55
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$34.81
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$66.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$52.96
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$41.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$73.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$43.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$43.86
|
| Rate for Payer: Multiplan Commercial |
$219.46
|
| Rate for Payer: TriValley Medical Group Commercial |
$34.81
|
| Rate for Payer: TriValley Medical Group Senior |
$34.81
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$37.60
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$37.60
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$52.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$38.29
|
| Rate for Payer: Vantage Medical Group Senior |
$34.81
|
|
|
HC LAB REF CHROMOSOME ANALYSIS 20-25 CELL
|
Facility
|
OP
|
$115.00
|
|
|
Service Code
|
CPT 88299
|
| Hospital Charge Code |
900912794
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$20.82 |
| Max. Negotiated Rate |
$128.63 |
| Rate for Payer: Adventist Health Commercial |
$23.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$61.47
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$79.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$101.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$74.47
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$67.70
|
| Rate for Payer: Blue Shield of California Commercial |
$71.42
|
| Rate for Payer: Blue Shield of California EPN |
$67.50
|
| Rate for Payer: Cash Price |
$51.75
|
| Rate for Payer: Cash Price |
$51.75
|
| Rate for Payer: Cigna of CA HMO/PPO |
$74.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$101.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$74.47
|
| Rate for Payer: Dignity Health Senior |
$67.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$74.75
|
| Rate for Payer: EPIC Health Plan Medicare |
$67.70
|
| Rate for Payer: Heritage Provider Network Commercial |
$71.18
|
| Rate for Payer: Heritage Provider Network Senior |
$71.18
|
| Rate for Payer: Humana Medicare |
$67.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$67.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$128.63
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$20.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$79.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$28.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$85.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$85.30
|
| Rate for Payer: Multiplan Commercial |
$86.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$67.70
|
| Rate for Payer: TriValley Medical Group Senior |
$67.70
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$54.82
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$54.82
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$101.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$74.47
|
| Rate for Payer: Vantage Medical Group Senior |
$67.70
|
|
|
HC LAB REF CHROMOSOME ANALYSIS 20-25 CELL
|
Facility
|
IP
|
$115.00
|
|
|
Service Code
|
CPT 88299
|
| Hospital Charge Code |
900912794
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$20.82 |
| Max. Negotiated Rate |
$86.25 |
| Rate for Payer: Adventist Health Commercial |
$23.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$79.00
|
| Rate for Payer: Cash Price |
$51.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$77.86
|
| Rate for Payer: Heritage Provider Network Senior |
$77.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$20.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$28.75
|
| Rate for Payer: Multiplan Commercial |
$86.25
|
|
|
HC LAB REF CHROMOSOME IN SITU HYB 10-30 C
|
Facility
|
OP
|
$46.02
|
|
|
Service Code
|
CPT 88273
|
| Hospital Charge Code |
900912795
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$8.33 |
| Max. Negotiated Rate |
$1,590.45 |
| Rate for Payer: Adventist Health Commercial |
$9.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$93.47
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$31.62
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$52.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$38.29
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$34.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,590.45
|
| Rate for Payer: Blue Shield of California Commercial |
$250.94
|
| Rate for Payer: Blue Shield of California EPN |
$196.17
|
| Rate for Payer: Cash Price |
$20.71
|
| Rate for Payer: Cash Price |
$20.71
|
| Rate for Payer: Cigna of CA HMO/PPO |
$29.91
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$52.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$38.29
|
| Rate for Payer: Dignity Health Senior |
$34.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$29.91
|
| Rate for Payer: EPIC Health Plan Medicare |
$34.81
|
| Rate for Payer: Heritage Provider Network Commercial |
$28.49
|
| Rate for Payer: Heritage Provider Network Senior |
$28.49
|
| Rate for Payer: Humana Medicare |
$34.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$44.55
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$34.81
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$66.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.33
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$41.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$43.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$43.86
|
| Rate for Payer: Multiplan Commercial |
$34.52
|
| Rate for Payer: TriValley Medical Group Commercial |
$34.81
|
| Rate for Payer: TriValley Medical Group Senior |
$34.81
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$37.60
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$37.60
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$52.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$38.29
|
| Rate for Payer: Vantage Medical Group Senior |
$34.81
|
|
|
HC LAB REF CHROMOSOME IN SITU HYB 10-30 C
|
Facility
|
IP
|
$46.02
|
|
|
Service Code
|
CPT 88273
|
| Hospital Charge Code |
900912795
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$8.33 |
| Max. Negotiated Rate |
$34.52 |
| Rate for Payer: Adventist Health Commercial |
$9.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$31.62
|
| Rate for Payer: Cash Price |
$20.71
|
| Rate for Payer: Heritage Provider Network Commercial |
$31.16
|
| Rate for Payer: Heritage Provider Network Senior |
$31.16
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.50
|
| Rate for Payer: Multiplan Commercial |
$34.52
|
|
|
HC LAB REF CHROMOSOME INTERP & REPORT
|
Facility
|
OP
|
$334.70
|
|
|
Service Code
|
CPT 88291
|
| Hospital Charge Code |
900910747
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$21.25 |
| Max. Negotiated Rate |
$284.50 |
| Rate for Payer: Adventist Health Commercial |
$66.94
|
| Rate for Payer: Aetna of CA Gatekeeper |
$61.73
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$229.94
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$284.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$184.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$251.02
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$156.37
|
| Rate for Payer: Blue Shield of California Commercial |
$207.85
|
| Rate for Payer: Blue Shield of California EPN |
$196.47
|
| Rate for Payer: Cash Price |
$150.62
|
| Rate for Payer: Cash Price |
$150.62
|
| Rate for Payer: Cigna of CA HMO/PPO |
$217.56
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$284.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$284.50
|
| Rate for Payer: Dignity Health Senior |
$284.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$217.56
|
| Rate for Payer: Heritage Provider Network Commercial |
$207.18
|
| Rate for Payer: Heritage Provider Network Senior |
$207.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$21.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$161.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$60.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$83.68
|
| Rate for Payer: Multiplan Commercial |
$251.02
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$36.25
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$36.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$284.50
|
| Rate for Payer: Vantage Medical Group Senior |
$284.50
|
|
|
HC LAB REF CHROMOSOME INTERP & REPORT
|
Facility
|
IP
|
$334.70
|
|
|
Service Code
|
CPT 88291
|
| Hospital Charge Code |
900910747
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$60.58 |
| Max. Negotiated Rate |
$251.02 |
| Rate for Payer: Adventist Health Commercial |
$66.94
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$229.94
|
| Rate for Payer: Cash Price |
$150.62
|
| Rate for Payer: Heritage Provider Network Commercial |
$226.59
|
| Rate for Payer: Heritage Provider Network Senior |
$226.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$60.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$83.68
|
| Rate for Payer: Multiplan Commercial |
$251.02
|
|
|
HC LAB REF CHROMOSOMES SCE
|
Facility
|
OP
|
$505.28
|
|
|
Service Code
|
CPT 88291
|
| Hospital Charge Code |
900915261
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$21.25 |
| Max. Negotiated Rate |
$429.49 |
| Rate for Payer: Adventist Health Commercial |
$101.06
|
| Rate for Payer: Aetna of CA Gatekeeper |
$61.73
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$347.13
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$429.49
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$277.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$378.96
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$156.37
|
| Rate for Payer: Blue Shield of California Commercial |
$313.78
|
| Rate for Payer: Blue Shield of California EPN |
$296.60
|
| Rate for Payer: Cash Price |
$227.38
|
| Rate for Payer: Cash Price |
$227.38
|
| Rate for Payer: Cigna of CA HMO/PPO |
$328.43
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$429.49
|
| Rate for Payer: Dignity Health Medi-Cal |
$429.49
|
| Rate for Payer: Dignity Health Senior |
$429.49
|
| Rate for Payer: EPIC Health Plan Commercial |
$328.43
|
| Rate for Payer: Heritage Provider Network Commercial |
$312.77
|
| Rate for Payer: Heritage Provider Network Senior |
$312.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$21.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$243.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$91.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$126.32
|
| Rate for Payer: Multiplan Commercial |
$378.96
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$36.25
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$36.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$429.49
|
| Rate for Payer: Vantage Medical Group Senior |
$429.49
|
|
