|
HC DRSNG OPTIFOAM SA 6X6" BRDR
|
Facility
|
IP
|
$36.43
|
|
|
Service Code
|
CPT A6213
|
| Hospital Charge Code |
901698382
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.59 |
| Max. Negotiated Rate |
$27.32 |
| Rate for Payer: Adventist Health Commercial |
$7.29
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$23.46
|
| Rate for Payer: Cash Price |
$16.39
|
| Rate for Payer: Heritage Provider Network Commercial |
$24.66
|
| Rate for Payer: Heritage Provider Network Senior |
$24.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$6.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.11
|
| Rate for Payer: Multiplan Commercial |
$27.32
|
|
|
HC DRSNG OPTIFOAM SA 6X6" BRDR
|
Facility
|
OP
|
$36.43
|
|
|
Service Code
|
CPT A6213
|
| Hospital Charge Code |
901698382
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.59 |
| Max. Negotiated Rate |
$30.97 |
| Rate for Payer: Adventist Health Commercial |
$7.29
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$22.51
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$30.97
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$20.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$27.32
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$18.22
|
| Rate for Payer: Blue Shield of California Commercial |
$22.22
|
| Rate for Payer: Blue Shield of California EPN |
$17.78
|
| Rate for Payer: Cash Price |
$16.39
|
| Rate for Payer: Cigna of CA HMO/PPO |
$23.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$30.97
|
| Rate for Payer: Dignity Health Medi-Cal |
$30.97
|
| Rate for Payer: Dignity Health Medicare Advantage |
$30.97
|
| Rate for Payer: EPIC Health Plan Commercial |
$21.49
|
| Rate for Payer: Heritage Provider Network Commercial |
$22.55
|
| Rate for Payer: Heritage Provider Network Senior |
$22.55
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$17.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$6.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.11
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$25.50
|
| Rate for Payer: Multiplan Commercial |
$27.32
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$18.21
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$18.21
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$30.97
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$30.97
|
| Rate for Payer: Vantage Medical Group Senior |
$30.97
|
|
|
HC DRSNG TEGADERM 4-3/4X4IN FRAME STYLE 1626W
|
Facility
|
IP
|
$5.08
|
|
| Hospital Charge Code |
900101861
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.92 |
| Max. Negotiated Rate |
$3.81 |
| Rate for Payer: Cash Price |
$2.29
|
| Rate for Payer: Adventist Health Commercial |
$1.02
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3.27
|
| Rate for Payer: Heritage Provider Network Commercial |
$3.44
|
| Rate for Payer: Heritage Provider Network Senior |
$3.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.27
|
| Rate for Payer: Multiplan Commercial |
$3.81
|
|
|
HC DRSNG TEGADERM 4-3/4X4IN FRAME STYLE 1626W
|
Facility
|
OP
|
$5.08
|
|
| Hospital Charge Code |
900101861
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.92 |
| Max. Negotiated Rate |
$4.32 |
| Rate for Payer: Adventist Health Commercial |
$1.02
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3.14
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4.32
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2.79
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2.54
|
| Rate for Payer: Blue Shield of California Commercial |
$3.10
|
| Rate for Payer: Blue Shield of California EPN |
$2.48
|
| Rate for Payer: Cash Price |
$2.29
|
| Rate for Payer: Cigna of CA HMO/PPO |
$3.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4.32
|
| Rate for Payer: Dignity Health Medi-Cal |
$4.32
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4.32
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$3.14
|
| Rate for Payer: Heritage Provider Network Senior |
$3.14
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$2.42
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.27
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3.56
|
| Rate for Payer: Multiplan Commercial |
$3.81
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$2.54
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2.54
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4.32
|
| Rate for Payer: Vantage Medical Group Senior |
$4.32
|
|
|
HC DRUGS ABUSE SCREEN,URINE(7)COC
|
Facility
|
IP
|
$1,126.00
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
900912159
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$203.81 |
| Max. Negotiated Rate |
$844.50 |
| Rate for Payer: Adventist Health Commercial |
$225.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$725.14
|
| Rate for Payer: Cash Price |
$506.70
|
| Rate for Payer: Heritage Provider Network Commercial |
$762.30
|
| Rate for Payer: Heritage Provider Network Senior |
$762.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$203.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$281.50
|
| Rate for Payer: Multiplan Commercial |
$844.50
|
|
|
HC DRUGS ABUSE SCREEN,URINE(7)COC
|
Facility
|
OP
|
$242.00
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
900912159
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$43.80 |
| Max. Negotiated Rate |
$585.08 |
| Rate for Payer: Adventist Health Commercial |
$48.40
|
| Rate for Payer: Adventist Health Commercial |
$225.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$695.87
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$149.56
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$93.21
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$93.21
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$68.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$68.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$62.14
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$62.14
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$585.08
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$585.08
|
| Rate for Payer: Blue Shield of California Commercial |
$459.71
|
| Rate for Payer: Blue Shield of California Commercial |
$459.71
|
| Rate for Payer: Blue Shield of California EPN |
$368.72
|
| Rate for Payer: Blue Shield of California EPN |
$368.72
|
| Rate for Payer: Cash Price |
$108.90
|
| Rate for Payer: Cash Price |
$108.90
|
| Rate for Payer: Cash Price |
$506.70
|
| Rate for Payer: Cash Price |
$506.70
|
| Rate for Payer: Cigna of CA HMO/PPO |
$731.90
|
| Rate for Payer: Cigna of CA HMO/PPO |
$157.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$93.21
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$93.21
|
| Rate for Payer: Dignity Health Medi-Cal |
$68.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$68.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$62.14
|
| Rate for Payer: Dignity Health Medicare Advantage |
$62.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$142.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$664.34
|
| Rate for Payer: EPIC Health Plan Medicare |
$62.14
|
| Rate for Payer: EPIC Health Plan Medicare |
$62.14
|
| Rate for Payer: Heritage Provider Network Commercial |
$696.99
|
| Rate for Payer: Heritage Provider Network Commercial |
$149.80
|
| Rate for Payer: Heritage Provider Network Senior |
$696.99
|
| Rate for Payer: Heritage Provider Network Senior |
$149.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$62.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$62.14
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$537.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$115.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$203.81
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$43.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$71.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$71.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$60.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$281.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$83.27
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$83.27
|
| Rate for Payer: Multiplan Commercial |
$844.50
|
| Rate for Payer: Multiplan Commercial |
$181.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$62.14
|
| Rate for Payer: TriValley Medical Group Commercial |
$62.14
|
| Rate for Payer: TriValley Medical Group Senior |
$62.14
|
| Rate for Payer: TriValley Medical Group Senior |
$62.14
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$67.12
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$67.12
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$67.12
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$67.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$93.21
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$93.21
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$68.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$68.35
|
| Rate for Payer: Vantage Medical Group Senior |
$62.14
|
| Rate for Payer: Vantage Medical Group Senior |
$62.14
|
|
|
HC DRUG SCREEN AMPHETAMINES
|
Facility
|
OP
|
$278.00
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
900911077
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$50.32 |
| Max. Negotiated Rate |
$585.08 |
| Rate for Payer: Adventist Health Commercial |
$55.60
|
| Rate for Payer: Adventist Health Commercial |
$48.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$149.56
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$171.80
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$93.21
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$93.21
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$68.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$68.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$62.14
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$62.14
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$585.08
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$585.08
|
| Rate for Payer: Blue Shield of California Commercial |
$459.71
|
| Rate for Payer: Blue Shield of California Commercial |
$459.71
|
| Rate for Payer: Blue Shield of California EPN |
$368.72
|
| Rate for Payer: Blue Shield of California EPN |
$368.72
|
| Rate for Payer: Cash Price |
$125.10
|
| Rate for Payer: Cash Price |
$125.10
|
| Rate for Payer: Cash Price |
$108.90
|
| Rate for Payer: Cash Price |
$108.90
|
| Rate for Payer: Cigna of CA HMO/PPO |
$157.30
|
| Rate for Payer: Cigna of CA HMO/PPO |
$180.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$93.21
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$93.21
|
| Rate for Payer: Dignity Health Medi-Cal |
$68.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$68.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$62.14
|
| Rate for Payer: Dignity Health Medicare Advantage |
$62.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$164.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$142.78
|
| Rate for Payer: EPIC Health Plan Medicare |
$62.14
|
| Rate for Payer: EPIC Health Plan Medicare |
$62.14
|
| Rate for Payer: Heritage Provider Network Commercial |
$149.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$172.08
|
| Rate for Payer: Heritage Provider Network Senior |
$149.80
|
| Rate for Payer: Heritage Provider Network Senior |
$172.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$62.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$62.14
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$115.43
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$132.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$43.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$50.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$71.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$71.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$69.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$60.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$83.27
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$83.27
|
| Rate for Payer: Multiplan Commercial |
$181.50
|
| Rate for Payer: Multiplan Commercial |
$208.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$62.14
|
| Rate for Payer: TriValley Medical Group Commercial |
$62.14
|
| Rate for Payer: TriValley Medical Group Senior |
$62.14
|
| Rate for Payer: TriValley Medical Group Senior |
$62.14
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$67.12
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$67.12
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$67.12
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$67.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$93.21
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$93.21
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$68.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$68.35
|
| Rate for Payer: Vantage Medical Group Senior |
$62.14
|
| Rate for Payer: Vantage Medical Group Senior |
$62.14
|
|
|
HC DRUG SCREEN AMPHETAMINES
|
Facility
|
IP
|
$278.00
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
900911077
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$50.32 |
| Max. Negotiated Rate |
$208.50 |
| Rate for Payer: Adventist Health Commercial |
$55.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$179.03
|
| Rate for Payer: Cash Price |
$125.10
|
| Rate for Payer: Heritage Provider Network Commercial |
$188.21
|
| Rate for Payer: Heritage Provider Network Senior |
$188.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$50.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$69.50
|
| Rate for Payer: Multiplan Commercial |
$208.50
|
|
|
HC DRUG SCREEN BARBITUATES
|
Facility
|
OP
|
$278.00
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
900910325
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$50.32 |
| Max. Negotiated Rate |
$585.08 |
| Rate for Payer: Adventist Health Commercial |
$55.60
|
| Rate for Payer: Adventist Health Commercial |
$48.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$149.56
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$171.80
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$93.21
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$93.21
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$68.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$68.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$62.14
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$62.14
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$585.08
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$585.08
|
| Rate for Payer: Blue Shield of California Commercial |
$459.71
|
| Rate for Payer: Blue Shield of California Commercial |
$459.71
|
| Rate for Payer: Blue Shield of California EPN |
$368.72
|
| Rate for Payer: Blue Shield of California EPN |
$368.72
|
| Rate for Payer: Cash Price |
$125.10
|
| Rate for Payer: Cash Price |
$125.10
|
| Rate for Payer: Cash Price |
$108.90
|
| Rate for Payer: Cash Price |
$108.90
|
| Rate for Payer: Cigna of CA HMO/PPO |
$157.30
|
| Rate for Payer: Cigna of CA HMO/PPO |
$180.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$93.21
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$93.21
|
| Rate for Payer: Dignity Health Medi-Cal |
$68.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$68.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$62.14
|
| Rate for Payer: Dignity Health Medicare Advantage |
$62.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$164.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$142.78
|
| Rate for Payer: EPIC Health Plan Medicare |
$62.14
|
| Rate for Payer: EPIC Health Plan Medicare |
$62.14
|
| Rate for Payer: Heritage Provider Network Commercial |
$149.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$172.08
|
| Rate for Payer: Heritage Provider Network Senior |
$149.80
|
| Rate for Payer: Heritage Provider Network Senior |
$172.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$62.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$62.14
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$115.43
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$132.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$43.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$50.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$71.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$71.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$69.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$60.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$83.27
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$83.27
|
| Rate for Payer: Multiplan Commercial |
$181.50
|
| Rate for Payer: Multiplan Commercial |
$208.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$62.14
|
| Rate for Payer: TriValley Medical Group Commercial |
$62.14
|
| Rate for Payer: TriValley Medical Group Senior |
$62.14
|
| Rate for Payer: TriValley Medical Group Senior |
$62.14
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$67.12
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$67.12
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$67.12
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$67.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$93.21
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$93.21
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$68.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$68.35
|
| Rate for Payer: Vantage Medical Group Senior |
$62.14
|
| Rate for Payer: Vantage Medical Group Senior |
$62.14
|
|
|
HC DRUG SCREEN BARBITUATES
|
Facility
|
IP
|
$278.00
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
900910325
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$50.32 |
| Max. Negotiated Rate |
$208.50 |
| Rate for Payer: Adventist Health Commercial |
$55.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$179.03
|
| Rate for Payer: Cash Price |
$125.10
|
| Rate for Payer: Heritage Provider Network Commercial |
$188.21
|
| Rate for Payer: Heritage Provider Network Senior |
$188.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$50.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$69.50
|
| Rate for Payer: Multiplan Commercial |
$208.50
|
|
|
HC DRUG SCREEN BENZODIAZPINES
|
Facility
|
IP
|
$278.00
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
900911101
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$50.32 |
| Max. Negotiated Rate |
$208.50 |
| Rate for Payer: Adventist Health Commercial |
$55.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$179.03
|
| Rate for Payer: Cash Price |
$125.10
|
| Rate for Payer: Heritage Provider Network Commercial |
$188.21
|
| Rate for Payer: Heritage Provider Network Senior |
$188.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$50.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$69.50
|
| Rate for Payer: Multiplan Commercial |
$208.50
|
|
|
HC DRUG SCREEN BENZODIAZPINES
|
Facility
|
OP
|
$278.00
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
900911101
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$50.32 |
| Max. Negotiated Rate |
$585.08 |
| Rate for Payer: Adventist Health Commercial |
$55.60
|
| Rate for Payer: Adventist Health Commercial |
$48.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$149.56
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$171.80
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$93.21
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$93.21
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$68.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$68.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$62.14
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$62.14
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$585.08
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$585.08
|
| Rate for Payer: Blue Shield of California Commercial |
$459.71
|
| Rate for Payer: Blue Shield of California Commercial |
$459.71
|
| Rate for Payer: Blue Shield of California EPN |
$368.72
|
| Rate for Payer: Blue Shield of California EPN |
$368.72
|
| Rate for Payer: Cash Price |
$125.10
|
| Rate for Payer: Cash Price |
$125.10
|
| Rate for Payer: Cash Price |
$108.90
|
| Rate for Payer: Cash Price |
$108.90
|
| Rate for Payer: Cigna of CA HMO/PPO |
$157.30
|
| Rate for Payer: Cigna of CA HMO/PPO |
$180.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$93.21
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$93.21
|
| Rate for Payer: Dignity Health Medi-Cal |
$68.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$68.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$62.14
|
| Rate for Payer: Dignity Health Medicare Advantage |
$62.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$164.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$142.78
|
| Rate for Payer: EPIC Health Plan Medicare |
$62.14
|
| Rate for Payer: EPIC Health Plan Medicare |
$62.14
|
| Rate for Payer: Heritage Provider Network Commercial |
$149.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$172.08
|
| Rate for Payer: Heritage Provider Network Senior |
$149.80
|
| Rate for Payer: Heritage Provider Network Senior |
$172.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$62.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$62.14
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$115.43
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$132.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$43.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$50.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$71.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$71.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$69.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$60.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$83.27
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$83.27
|
| Rate for Payer: Multiplan Commercial |
$181.50
|
| Rate for Payer: Multiplan Commercial |
$208.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$62.14
|
| Rate for Payer: TriValley Medical Group Commercial |
$62.14
|
| Rate for Payer: TriValley Medical Group Senior |
$62.14
|
| Rate for Payer: TriValley Medical Group Senior |
$62.14
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$67.12
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$67.12
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$67.12
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$67.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$93.21
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$93.21
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$68.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$68.35
|
| Rate for Payer: Vantage Medical Group Senior |
$62.14
|
| Rate for Payer: Vantage Medical Group Senior |
$62.14
|
|
|
HC DRUG SCREEN CANNABINOIDS
|
Facility
|
IP
|
$278.00
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
900911238
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$50.32 |
| Max. Negotiated Rate |
$208.50 |
| Rate for Payer: Adventist Health Commercial |
$55.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$179.03
|
| Rate for Payer: Cash Price |
$125.10
|
| Rate for Payer: Heritage Provider Network Commercial |
$188.21
|
| Rate for Payer: Heritage Provider Network Senior |
$188.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$50.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$69.50
|
| Rate for Payer: Multiplan Commercial |
$208.50
|
|
|
HC DRUG SCREEN CANNABINOIDS
|
Facility
|
OP
|
$278.00
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
900911238
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$50.32 |
| Max. Negotiated Rate |
$585.08 |
| Rate for Payer: Adventist Health Commercial |
$55.60
|
| Rate for Payer: Adventist Health Commercial |
$48.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$149.56
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$171.80
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$93.21
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$93.21
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$68.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$68.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$62.14
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$62.14
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$585.08
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$585.08
|
| Rate for Payer: Blue Shield of California Commercial |
$459.71
|
| Rate for Payer: Blue Shield of California Commercial |
$459.71
|
| Rate for Payer: Blue Shield of California EPN |
$368.72
|
| Rate for Payer: Blue Shield of California EPN |
$368.72
|
| Rate for Payer: Cash Price |
$125.10
|
| Rate for Payer: Cash Price |
$125.10
|
| Rate for Payer: Cash Price |
$108.90
|
| Rate for Payer: Cash Price |
$108.90
|
| Rate for Payer: Cigna of CA HMO/PPO |
$157.30
|
| Rate for Payer: Cigna of CA HMO/PPO |
$180.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$93.21
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$93.21
|
| Rate for Payer: Dignity Health Medi-Cal |
$68.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$68.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$62.14
|
| Rate for Payer: Dignity Health Medicare Advantage |
$62.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$164.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$142.78
|
| Rate for Payer: EPIC Health Plan Medicare |
$62.14
|
| Rate for Payer: EPIC Health Plan Medicare |
$62.14
|
| Rate for Payer: Heritage Provider Network Commercial |
$149.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$172.08
|
| Rate for Payer: Heritage Provider Network Senior |
$149.80
|
| Rate for Payer: Heritage Provider Network Senior |
$172.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$62.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$62.14
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$115.43
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$132.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$43.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$50.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$71.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$71.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$69.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$60.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$83.27
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$83.27
|
| Rate for Payer: Multiplan Commercial |
$181.50
|
| Rate for Payer: Multiplan Commercial |
$208.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$62.14
|
| Rate for Payer: TriValley Medical Group Commercial |
$62.14
|
| Rate for Payer: TriValley Medical Group Senior |
$62.14
|
| Rate for Payer: TriValley Medical Group Senior |
$62.14
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$67.12
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$67.12
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$67.12
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$67.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$93.21
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$93.21
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$68.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$68.35
|
| Rate for Payer: Vantage Medical Group Senior |
$62.14
|
| Rate for Payer: Vantage Medical Group Senior |
$62.14
|
|
|
HC DRUG SCREEN COCAINE
|
Facility
|
IP
|
$278.00
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
900910390
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$50.32 |
| Max. Negotiated Rate |
$208.50 |
| Rate for Payer: Adventist Health Commercial |
$55.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$179.03
|
| Rate for Payer: Cash Price |
$125.10
|
| Rate for Payer: Heritage Provider Network Commercial |
$188.21
|
| Rate for Payer: Heritage Provider Network Senior |
$188.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$50.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$69.50
|
| Rate for Payer: Multiplan Commercial |
$208.50
|
|
|
HC DRUG SCREEN COCAINE
|
Facility
|
OP
|
$278.00
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
900910390
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$50.32 |
| Max. Negotiated Rate |
$585.08 |
| Rate for Payer: Adventist Health Commercial |
$55.60
|
| Rate for Payer: Adventist Health Commercial |
$48.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$149.56
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$171.80
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$93.21
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$93.21
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$68.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$68.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$62.14
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$62.14
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$585.08
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$585.08
|
| Rate for Payer: Blue Shield of California Commercial |
$459.71
|
| Rate for Payer: Blue Shield of California Commercial |
$459.71
|
| Rate for Payer: Blue Shield of California EPN |
$368.72
|
| Rate for Payer: Blue Shield of California EPN |
$368.72
|
| Rate for Payer: Cash Price |
$125.10
|
| Rate for Payer: Cash Price |
$125.10
|
| Rate for Payer: Cash Price |
$108.90
|
| Rate for Payer: Cash Price |
$108.90
|
| Rate for Payer: Cigna of CA HMO/PPO |
$157.30
|
| Rate for Payer: Cigna of CA HMO/PPO |
$180.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$93.21
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$93.21
|
| Rate for Payer: Dignity Health Medi-Cal |
$68.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$68.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$62.14
|
| Rate for Payer: Dignity Health Medicare Advantage |
$62.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$164.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$142.78
|
| Rate for Payer: EPIC Health Plan Medicare |
$62.14
|
| Rate for Payer: EPIC Health Plan Medicare |
$62.14
|
| Rate for Payer: Heritage Provider Network Commercial |
$149.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$172.08
|
| Rate for Payer: Heritage Provider Network Senior |
$149.80
|
| Rate for Payer: Heritage Provider Network Senior |
$172.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$62.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$62.14
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$115.43
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$132.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$43.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$50.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$71.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$71.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$69.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$60.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$83.27
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$83.27
|
| Rate for Payer: Multiplan Commercial |
$181.50
|
| Rate for Payer: Multiplan Commercial |
$208.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$62.14
|
| Rate for Payer: TriValley Medical Group Commercial |
$62.14
|
| Rate for Payer: TriValley Medical Group Senior |
$62.14
|
| Rate for Payer: TriValley Medical Group Senior |
$62.14
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$67.12
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$67.12
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$67.12
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$67.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$93.21
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$93.21
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$68.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$68.35
|
| Rate for Payer: Vantage Medical Group Senior |
$62.14
|
| Rate for Payer: Vantage Medical Group Senior |
$62.14
|
|
|
HC DRUG SCREEN OPIATES
|
Facility
|
IP
|
$278.00
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
900911145
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$50.32 |
| Max. Negotiated Rate |
$208.50 |
| Rate for Payer: Adventist Health Commercial |
$55.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$179.03
|
| Rate for Payer: Cash Price |
$125.10
|
| Rate for Payer: Heritage Provider Network Commercial |
$188.21
|
| Rate for Payer: Heritage Provider Network Senior |
$188.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$50.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$69.50
|
| Rate for Payer: Multiplan Commercial |
$208.50
|
|
|
HC DRUG SCREEN OPIATES
|
Facility
|
OP
|
$278.00
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
900911145
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$50.32 |
| Max. Negotiated Rate |
$585.08 |
| Rate for Payer: Adventist Health Commercial |
$55.60
|
| Rate for Payer: Adventist Health Commercial |
$48.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$149.56
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$171.80
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$93.21
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$93.21
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$68.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$68.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$62.14
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$62.14
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$585.08
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$585.08
|
| Rate for Payer: Blue Shield of California Commercial |
$459.71
|
| Rate for Payer: Blue Shield of California Commercial |
$459.71
|
| Rate for Payer: Blue Shield of California EPN |
$368.72
|
| Rate for Payer: Blue Shield of California EPN |
$368.72
|
| Rate for Payer: Cash Price |
$125.10
|
| Rate for Payer: Cash Price |
$125.10
|
| Rate for Payer: Cash Price |
$108.90
|
| Rate for Payer: Cash Price |
$108.90
|
| Rate for Payer: Cigna of CA HMO/PPO |
$157.30
|
| Rate for Payer: Cigna of CA HMO/PPO |
$180.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$93.21
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$93.21
|
| Rate for Payer: Dignity Health Medi-Cal |
$68.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$68.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$62.14
|
| Rate for Payer: Dignity Health Medicare Advantage |
$62.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$164.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$142.78
|
| Rate for Payer: EPIC Health Plan Medicare |
$62.14
|
| Rate for Payer: EPIC Health Plan Medicare |
$62.14
|
| Rate for Payer: Heritage Provider Network Commercial |
$149.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$172.08
|
| Rate for Payer: Heritage Provider Network Senior |
$149.80
|
| Rate for Payer: Heritage Provider Network Senior |
$172.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$62.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$62.14
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$115.43
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$132.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$43.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$50.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$71.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$71.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$69.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$60.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$83.27
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$83.27
|
| Rate for Payer: Multiplan Commercial |
$181.50
|
| Rate for Payer: Multiplan Commercial |
$208.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$62.14
|
| Rate for Payer: TriValley Medical Group Commercial |
$62.14
|
| Rate for Payer: TriValley Medical Group Senior |
$62.14
|
| Rate for Payer: TriValley Medical Group Senior |
$62.14
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$67.12
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$67.12
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$67.12
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$67.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$93.21
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$93.21
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$68.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$68.35
|
| Rate for Payer: Vantage Medical Group Senior |
$62.14
|
| Rate for Payer: Vantage Medical Group Senior |
$62.14
|
|
|
HC DRUG SCREEN PHENCYCLIDINE
|
Facility
|
IP
|
$278.00
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
900911147
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$50.32 |
| Max. Negotiated Rate |
$208.50 |
| Rate for Payer: Adventist Health Commercial |
$55.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$179.03
|
| Rate for Payer: Cash Price |
$125.10
|
| Rate for Payer: Heritage Provider Network Commercial |
$188.21
|
| Rate for Payer: Heritage Provider Network Senior |
$188.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$50.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$69.50
|
| Rate for Payer: Multiplan Commercial |
$208.50
|
|
|
HC DRUG SCREEN PHENCYCLIDINE
|
Facility
|
OP
|
$278.00
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
900911147
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$50.32 |
| Max. Negotiated Rate |
$585.08 |
| Rate for Payer: Blue Shield of California EPN |
$368.72
|
| Rate for Payer: Blue Shield of California EPN |
$368.72
|
| Rate for Payer: Adventist Health Commercial |
$55.60
|
| Rate for Payer: Adventist Health Commercial |
$48.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$149.56
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$171.80
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$93.21
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$93.21
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$68.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$68.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$62.14
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$62.14
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$585.08
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$585.08
|
| Rate for Payer: Blue Shield of California Commercial |
$459.71
|
| Rate for Payer: Blue Shield of California Commercial |
$459.71
|
| Rate for Payer: Cash Price |
$125.10
|
| Rate for Payer: Cash Price |
$125.10
|
| Rate for Payer: Cash Price |
$108.90
|
| Rate for Payer: Cash Price |
$108.90
|
| Rate for Payer: Cigna of CA HMO/PPO |
$157.30
|
| Rate for Payer: Cigna of CA HMO/PPO |
$180.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$93.21
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$93.21
|
| Rate for Payer: Dignity Health Medi-Cal |
$68.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$68.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$62.14
|
| Rate for Payer: Dignity Health Medicare Advantage |
$62.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$164.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$142.78
|
| Rate for Payer: EPIC Health Plan Medicare |
$62.14
|
| Rate for Payer: EPIC Health Plan Medicare |
$62.14
|
| Rate for Payer: Heritage Provider Network Commercial |
$149.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$172.08
|
| Rate for Payer: Heritage Provider Network Senior |
$149.80
|
| Rate for Payer: Heritage Provider Network Senior |
$172.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$62.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$62.14
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$115.43
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$132.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$43.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$50.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$71.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$71.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$69.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$60.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$83.27
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$83.27
|
| Rate for Payer: Multiplan Commercial |
$181.50
|
| Rate for Payer: Multiplan Commercial |
$208.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$62.14
|
| Rate for Payer: TriValley Medical Group Commercial |
$62.14
|
| Rate for Payer: TriValley Medical Group Senior |
$62.14
|
| Rate for Payer: TriValley Medical Group Senior |
$62.14
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$67.12
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$67.12
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$67.12
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$67.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$93.21
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$93.21
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$68.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$68.35
|
| Rate for Payer: Vantage Medical Group Senior |
$62.14
|
| Rate for Payer: Vantage Medical Group Senior |
$62.14
|
|
|
HC DRUG SCREEN, PRE-EMPLOYMENT
|
Facility
|
IP
|
$1,126.00
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
900912158
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$203.81 |
| Max. Negotiated Rate |
$844.50 |
| Rate for Payer: Adventist Health Commercial |
$225.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$725.14
|
| Rate for Payer: Cash Price |
$506.70
|
| Rate for Payer: Heritage Provider Network Commercial |
$762.30
|
| Rate for Payer: Heritage Provider Network Senior |
$762.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$203.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$281.50
|
| Rate for Payer: Multiplan Commercial |
$844.50
|
|
|
HC DRUG SCREEN, PRE-EMPLOYMENT
|
Facility
|
OP
|
$242.00
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
900912158
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$43.80 |
| Max. Negotiated Rate |
$585.08 |
| Rate for Payer: Adventist Health Commercial |
$48.40
|
| Rate for Payer: Adventist Health Commercial |
$225.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$695.87
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$149.56
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$93.21
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$93.21
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$68.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$68.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$62.14
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$62.14
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$585.08
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$585.08
|
| Rate for Payer: Blue Shield of California Commercial |
$459.71
|
| Rate for Payer: Blue Shield of California Commercial |
$459.71
|
| Rate for Payer: Blue Shield of California EPN |
$368.72
|
| Rate for Payer: Blue Shield of California EPN |
$368.72
|
| Rate for Payer: Cash Price |
$108.90
|
| Rate for Payer: Cash Price |
$108.90
|
| Rate for Payer: Cash Price |
$506.70
|
| Rate for Payer: Cash Price |
$506.70
|
| Rate for Payer: Cigna of CA HMO/PPO |
$731.90
|
| Rate for Payer: Cigna of CA HMO/PPO |
$157.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$93.21
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$93.21
|
| Rate for Payer: Dignity Health Medi-Cal |
$68.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$68.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$62.14
|
| Rate for Payer: Dignity Health Medicare Advantage |
$62.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$142.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$664.34
|
| Rate for Payer: EPIC Health Plan Medicare |
$62.14
|
| Rate for Payer: EPIC Health Plan Medicare |
$62.14
|
| Rate for Payer: Heritage Provider Network Commercial |
$696.99
|
| Rate for Payer: Heritage Provider Network Commercial |
$149.80
|
| Rate for Payer: Heritage Provider Network Senior |
$696.99
|
| Rate for Payer: Heritage Provider Network Senior |
$149.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$62.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$62.14
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$537.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$115.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$203.81
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$43.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$71.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$71.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$60.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$281.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$83.27
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$83.27
|
| Rate for Payer: Multiplan Commercial |
$844.50
|
| Rate for Payer: Multiplan Commercial |
$181.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$62.14
|
| Rate for Payer: TriValley Medical Group Commercial |
$62.14
|
| Rate for Payer: TriValley Medical Group Senior |
$62.14
|
| Rate for Payer: TriValley Medical Group Senior |
$62.14
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$67.12
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$67.12
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$67.12
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$67.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$93.21
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$93.21
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$68.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$68.35
|
| Rate for Payer: Vantage Medical Group Senior |
$62.14
|
| Rate for Payer: Vantage Medical Group Senior |
$62.14
|
|
|
HC DRUGS OF ABUSE SCREEN,URINE(5)
|
Facility
|
OP
|
$310.00
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
900912160
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$56.11 |
| Max. Negotiated Rate |
$585.08 |
| Rate for Payer: Adventist Health Commercial |
$62.00
|
| Rate for Payer: Adventist Health Commercial |
$48.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$149.56
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$191.58
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$93.21
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$93.21
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$68.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$68.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$62.14
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$62.14
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$585.08
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$585.08
|
| Rate for Payer: Blue Shield of California Commercial |
$459.71
|
| Rate for Payer: Blue Shield of California Commercial |
$459.71
|
| Rate for Payer: Blue Shield of California EPN |
$368.72
|
| Rate for Payer: Blue Shield of California EPN |
$368.72
|
| Rate for Payer: Cash Price |
$139.50
|
| Rate for Payer: Cash Price |
$139.50
|
| Rate for Payer: Cash Price |
$108.90
|
| Rate for Payer: Cash Price |
$108.90
|
| Rate for Payer: Cigna of CA HMO/PPO |
$157.30
|
| Rate for Payer: Cigna of CA HMO/PPO |
$201.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$93.21
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$93.21
|
| Rate for Payer: Dignity Health Medi-Cal |
$68.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$68.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$62.14
|
| Rate for Payer: Dignity Health Medicare Advantage |
$62.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$182.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$142.78
|
| Rate for Payer: EPIC Health Plan Medicare |
$62.14
|
| Rate for Payer: EPIC Health Plan Medicare |
$62.14
|
| Rate for Payer: Heritage Provider Network Commercial |
$149.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$191.89
|
| Rate for Payer: Heritage Provider Network Senior |
$149.80
|
| Rate for Payer: Heritage Provider Network Senior |
$191.89
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$62.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$62.14
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$115.43
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$147.87
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$43.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$56.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$71.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$71.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$77.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$60.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$83.27
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$83.27
|
| Rate for Payer: Multiplan Commercial |
$181.50
|
| Rate for Payer: Multiplan Commercial |
$232.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$62.14
|
| Rate for Payer: TriValley Medical Group Commercial |
$62.14
|
| Rate for Payer: TriValley Medical Group Senior |
$62.14
|
| Rate for Payer: TriValley Medical Group Senior |
$62.14
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$67.12
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$67.12
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$67.12
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$67.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$93.21
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$93.21
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$68.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$68.35
|
| Rate for Payer: Vantage Medical Group Senior |
$62.14
|
| Rate for Payer: Vantage Medical Group Senior |
$62.14
|
|
|
HC DRUGS OF ABUSE SCREEN,URINE(5)
|
Facility
|
IP
|
$310.00
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
900912160
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$56.11 |
| Max. Negotiated Rate |
$232.50 |
| Rate for Payer: Adventist Health Commercial |
$62.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$199.64
|
| Rate for Payer: Cash Price |
$139.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$209.87
|
| Rate for Payer: Heritage Provider Network Senior |
$209.87
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$56.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$77.50
|
| Rate for Payer: Multiplan Commercial |
$232.50
|
|
|
HC DRUGS OF ABUSE SCREEN,URINE(7)
|
Facility
|
OP
|
$242.00
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
900912161
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$43.80 |
| Max. Negotiated Rate |
$585.08 |
| Rate for Payer: Adventist Health Commercial |
$48.40
|
| Rate for Payer: Adventist Health Commercial |
$225.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$695.87
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$149.56
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$93.21
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$93.21
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$68.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$68.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$62.14
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$62.14
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$585.08
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$585.08
|
| Rate for Payer: Blue Shield of California Commercial |
$459.71
|
| Rate for Payer: Blue Shield of California Commercial |
$459.71
|
| Rate for Payer: Blue Shield of California EPN |
$368.72
|
| Rate for Payer: Blue Shield of California EPN |
$368.72
|
| Rate for Payer: Cash Price |
$108.90
|
| Rate for Payer: Cash Price |
$108.90
|
| Rate for Payer: Cash Price |
$506.70
|
| Rate for Payer: Cash Price |
$506.70
|
| Rate for Payer: Cigna of CA HMO/PPO |
$731.90
|
| Rate for Payer: Cigna of CA HMO/PPO |
$157.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$93.21
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$93.21
|
| Rate for Payer: Dignity Health Medi-Cal |
$68.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$68.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$62.14
|
| Rate for Payer: Dignity Health Medicare Advantage |
$62.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$142.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$664.34
|
| Rate for Payer: EPIC Health Plan Medicare |
$62.14
|
| Rate for Payer: EPIC Health Plan Medicare |
$62.14
|
| Rate for Payer: Heritage Provider Network Commercial |
$696.99
|
| Rate for Payer: Heritage Provider Network Commercial |
$149.80
|
| Rate for Payer: Heritage Provider Network Senior |
$696.99
|
| Rate for Payer: Heritage Provider Network Senior |
$149.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$62.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$62.14
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$537.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$115.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$203.81
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$43.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$71.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$71.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$60.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$281.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$83.27
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$83.27
|
| Rate for Payer: Multiplan Commercial |
$844.50
|
| Rate for Payer: Multiplan Commercial |
$181.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$62.14
|
| Rate for Payer: TriValley Medical Group Commercial |
$62.14
|
| Rate for Payer: TriValley Medical Group Senior |
$62.14
|
| Rate for Payer: TriValley Medical Group Senior |
$62.14
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$67.12
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$67.12
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$67.12
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$67.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$93.21
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$93.21
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$68.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$68.35
|
| Rate for Payer: Vantage Medical Group Senior |
$62.14
|
| Rate for Payer: Vantage Medical Group Senior |
$62.14
|
|
