|
HC LAB REF MORPHOMETRIC ANALYSIS IN SITU
|
Facility
|
OP
|
$64.90
|
|
|
Service Code
|
CPT 88368
|
| Hospital Charge Code |
900912796
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$11.75 |
| Max. Negotiated Rate |
$853.31 |
| Rate for Payer: Adventist Health Commercial |
$12.98
|
| Rate for Payer: Aetna of CA Gatekeeper |
$350.98
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$44.59
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$673.66
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$494.02
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$449.11
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$720.50
|
| Rate for Payer: Blue Shield of California Commercial |
$40.30
|
| Rate for Payer: Blue Shield of California EPN |
$38.10
|
| Rate for Payer: Cash Price |
$29.21
|
| Rate for Payer: Cash Price |
$29.21
|
| Rate for Payer: Cigna of CA HMO/PPO |
$42.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$673.66
|
| Rate for Payer: Dignity Health Medi-Cal |
$494.02
|
| Rate for Payer: Dignity Health Senior |
$449.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$42.18
|
| Rate for Payer: EPIC Health Plan Medicare |
$449.11
|
| Rate for Payer: Heritage Provider Network Commercial |
$40.17
|
| Rate for Payer: Heritage Provider Network Senior |
$40.17
|
| Rate for Payer: Humana Medicare |
$449.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$117.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$449.11
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$853.31
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$529.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.22
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$565.88
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$565.88
|
| Rate for Payer: Multiplan Commercial |
$48.68
|
| Rate for Payer: TriValley Medical Group Commercial |
$449.11
|
| Rate for Payer: TriValley Medical Group Senior |
$449.11
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$321.25
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$321.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$673.66
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$494.02
|
| Rate for Payer: Vantage Medical Group Senior |
$449.11
|
|
|
HC LAB REF MS PANEL IGG CSF
|
Facility
|
OP
|
$13.32
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
900910556
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.41 |
| Max. Negotiated Rate |
$72.61 |
| Rate for Payer: Adventist Health Commercial |
$2.66
|
| Rate for Payer: Aetna of CA Gatekeeper |
$19.07
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$9.15
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9.30
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$64.86
|
| Rate for Payer: Blue Shield of California Commercial |
$72.61
|
| Rate for Payer: Blue Shield of California EPN |
$56.77
|
| Rate for Payer: Cash Price |
$5.99
|
| Rate for Payer: Cash Price |
$5.99
|
| Rate for Payer: Cigna of CA HMO/PPO |
$8.66
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$10.23
|
| Rate for Payer: Dignity Health Senior |
$9.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.66
|
| Rate for Payer: EPIC Health Plan Medicare |
$9.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$8.25
|
| Rate for Payer: Heritage Provider Network Senior |
$8.25
|
| Rate for Payer: Humana Medicare |
$9.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$9.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$9.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$17.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.41
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.33
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11.72
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11.72
|
| Rate for Payer: Multiplan Commercial |
$9.99
|
| Rate for Payer: TriValley Medical Group Commercial |
$9.30
|
| Rate for Payer: TriValley Medical Group Senior |
$9.30
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$10.04
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$10.04
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.23
|
| Rate for Payer: Vantage Medical Group Senior |
$9.30
|
|
|
HC LAB REF MS PANEL IGG CSF
|
Facility
|
IP
|
$13.32
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
900910556
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.41 |
| Max. Negotiated Rate |
$9.99 |
| Rate for Payer: Adventist Health Commercial |
$2.66
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$9.15
|
| Rate for Payer: Cash Price |
$5.99
|
| Rate for Payer: Heritage Provider Network Commercial |
$9.02
|
| Rate for Payer: Heritage Provider Network Senior |
$9.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.33
|
| Rate for Payer: Multiplan Commercial |
$9.99
|
|
|
HC LAB REF MS PANEL IGG, SERUM
|
Facility
|
OP
|
$13.32
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
900912659
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.41 |
| Max. Negotiated Rate |
$72.61 |
| Rate for Payer: Adventist Health Commercial |
$2.66
|
| Rate for Payer: Aetna of CA Gatekeeper |
$19.07
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$9.15
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9.30
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$64.86
|
| Rate for Payer: Blue Shield of California Commercial |
$72.61
|
| Rate for Payer: Blue Shield of California EPN |
$56.77
|
| Rate for Payer: Cash Price |
$5.99
|
| Rate for Payer: Cash Price |
$5.99
|
| Rate for Payer: Cigna of CA HMO/PPO |
$8.66
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$10.23
|
| Rate for Payer: Dignity Health Senior |
$9.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.66
|
| Rate for Payer: EPIC Health Plan Medicare |
$9.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$8.25
|
| Rate for Payer: Heritage Provider Network Senior |
$8.25
|
| Rate for Payer: Humana Medicare |
$9.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$9.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$9.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$17.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.41
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.33
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11.72
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11.72
|
| Rate for Payer: Multiplan Commercial |
$9.99
|
| Rate for Payer: TriValley Medical Group Commercial |
$9.30
|
| Rate for Payer: TriValley Medical Group Senior |
$9.30
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$10.04
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$10.04
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.23
|
| Rate for Payer: Vantage Medical Group Senior |
$9.30
|
|
|
HC LAB REF MS PANEL IGG, SERUM
|
Facility
|
IP
|
$13.32
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
900912659
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.41 |
| Max. Negotiated Rate |
$9.99 |
| Rate for Payer: Adventist Health Commercial |
$2.66
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$9.15
|
| Rate for Payer: Cash Price |
$5.99
|
| Rate for Payer: Heritage Provider Network Commercial |
$9.02
|
| Rate for Payer: Heritage Provider Network Senior |
$9.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.33
|
| Rate for Payer: Multiplan Commercial |
$9.99
|
|
|
HC LAB REF MTHFR MUTATION
|
Facility
|
IP
|
$55.96
|
|
|
Service Code
|
CPT 81291
|
| Hospital Charge Code |
900912713
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$10.13 |
| Max. Negotiated Rate |
$41.97 |
| Rate for Payer: Adventist Health Commercial |
$11.19
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$38.44
|
| Rate for Payer: Cash Price |
$25.18
|
| Rate for Payer: Heritage Provider Network Commercial |
$37.88
|
| Rate for Payer: Heritage Provider Network Senior |
$37.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.99
|
| Rate for Payer: Multiplan Commercial |
$41.97
|
|
|
HC LAB REF MTHFR MUTATION
|
Facility
|
OP
|
$55.96
|
|
|
Service Code
|
CPT 81291
|
| Hospital Charge Code |
900912713
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$10.13 |
| Max. Negotiated Rate |
$382.68 |
| Rate for Payer: Adventist Health Commercial |
$11.19
|
| Rate for Payer: Aetna of CA Gatekeeper |
$113.10
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$38.44
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$98.01
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$71.87
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$65.34
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$382.68
|
| Rate for Payer: Blue Shield of California Commercial |
$34.75
|
| Rate for Payer: Blue Shield of California EPN |
$32.85
|
| Rate for Payer: Cash Price |
$25.18
|
| Rate for Payer: Cash Price |
$25.18
|
| Rate for Payer: Cigna of CA HMO/PPO |
$36.37
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$98.01
|
| Rate for Payer: Dignity Health Medi-Cal |
$71.87
|
| Rate for Payer: Dignity Health Senior |
$65.34
|
| Rate for Payer: EPIC Health Plan Commercial |
$36.37
|
| Rate for Payer: EPIC Health Plan Medicare |
$65.34
|
| Rate for Payer: Heritage Provider Network Commercial |
$34.64
|
| Rate for Payer: Heritage Provider Network Senior |
$34.64
|
| Rate for Payer: Humana Medicare |
$65.34
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$65.34
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$124.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10.13
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$77.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.99
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$82.33
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$82.33
|
| Rate for Payer: Multiplan Commercial |
$41.97
|
| Rate for Payer: TriValley Medical Group Commercial |
$65.34
|
| Rate for Payer: TriValley Medical Group Senior |
$65.34
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$70.57
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$70.57
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$98.01
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$71.87
|
| Rate for Payer: Vantage Medical Group Senior |
$65.34
|
|
|
HC LAB REF MUMPS AB IGG
|
Facility
|
OP
|
$18.69
|
|
|
Service Code
|
CPT 86735
|
| Hospital Charge Code |
900910544
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.38 |
| Max. Negotiated Rate |
$110.39 |
| Rate for Payer: Adventist Health Commercial |
$3.74
|
| Rate for Payer: Aetna of CA Gatekeeper |
$37.97
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$12.84
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19.58
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.36
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$110.39
|
| Rate for Payer: Blue Shield of California Commercial |
$101.91
|
| Rate for Payer: Blue Shield of California EPN |
$79.67
|
| Rate for Payer: Cash Price |
$8.41
|
| Rate for Payer: Cash Price |
$8.41
|
| Rate for Payer: Cigna of CA HMO/PPO |
$12.15
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.58
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.36
|
| Rate for Payer: Dignity Health Senior |
$13.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.15
|
| Rate for Payer: EPIC Health Plan Medicare |
$13.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$11.57
|
| Rate for Payer: Heritage Provider Network Senior |
$11.57
|
| Rate for Payer: Humana Medicare |
$13.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$18.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13.05
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$24.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.38
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.67
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16.44
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16.44
|
| Rate for Payer: Multiplan Commercial |
$14.02
|
| Rate for Payer: TriValley Medical Group Commercial |
$13.05
|
| Rate for Payer: TriValley Medical Group Senior |
$13.05
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$14.10
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$14.10
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.58
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.36
|
| Rate for Payer: Vantage Medical Group Senior |
$13.05
|
|
|
HC LAB REF MUMPS AB IGG
|
Facility
|
IP
|
$18.69
|
|
|
Service Code
|
CPT 86735
|
| Hospital Charge Code |
900910544
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.38 |
| Max. Negotiated Rate |
$14.02 |
| Rate for Payer: Adventist Health Commercial |
$3.74
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$12.84
|
| Rate for Payer: Cash Price |
$8.41
|
| Rate for Payer: Heritage Provider Network Commercial |
$12.65
|
| Rate for Payer: Heritage Provider Network Senior |
$12.65
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.67
|
| Rate for Payer: Multiplan Commercial |
$14.02
|
|
|
HC LAB REF MUMPS AB IGM
|
Facility
|
OP
|
$18.69
|
|
|
Service Code
|
CPT 86735
|
| Hospital Charge Code |
900912693
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.38 |
| Max. Negotiated Rate |
$110.39 |
| Rate for Payer: Adventist Health Commercial |
$3.74
|
| Rate for Payer: Aetna of CA Gatekeeper |
$37.97
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$12.84
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19.58
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.36
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$110.39
|
| Rate for Payer: Blue Shield of California Commercial |
$101.91
|
| Rate for Payer: Blue Shield of California EPN |
$79.67
|
| Rate for Payer: Cash Price |
$8.41
|
| Rate for Payer: Cash Price |
$8.41
|
| Rate for Payer: Cigna of CA HMO/PPO |
$12.15
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.58
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.36
|
| Rate for Payer: Dignity Health Senior |
$13.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.15
|
| Rate for Payer: EPIC Health Plan Medicare |
$13.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$11.57
|
| Rate for Payer: Heritage Provider Network Senior |
$11.57
|
| Rate for Payer: Humana Medicare |
$13.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$18.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13.05
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$24.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.38
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.67
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16.44
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16.44
|
| Rate for Payer: Multiplan Commercial |
$14.02
|
| Rate for Payer: TriValley Medical Group Commercial |
$13.05
|
| Rate for Payer: TriValley Medical Group Senior |
$13.05
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$14.10
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$14.10
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.58
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.36
|
| Rate for Payer: Vantage Medical Group Senior |
$13.05
|
|
|
HC LAB REF MUMPS AB IGM
|
Facility
|
IP
|
$18.69
|
|
|
Service Code
|
CPT 86735
|
| Hospital Charge Code |
900912693
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.38 |
| Max. Negotiated Rate |
$14.02 |
| Rate for Payer: Adventist Health Commercial |
$3.74
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$12.84
|
| Rate for Payer: Cash Price |
$8.41
|
| Rate for Payer: Heritage Provider Network Commercial |
$12.65
|
| Rate for Payer: Heritage Provider Network Senior |
$12.65
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.67
|
| Rate for Payer: Multiplan Commercial |
$14.02
|
|
|
HC LAB REF NEISSERIA GONORRHOEAE AB
|
Facility
|
IP
|
$89.31
|
|
|
Service Code
|
CPT 86609
|
| Hospital Charge Code |
900911592
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.17 |
| Max. Negotiated Rate |
$66.98 |
| Rate for Payer: Adventist Health Commercial |
$17.86
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$61.36
|
| Rate for Payer: Cash Price |
$40.19
|
| Rate for Payer: Heritage Provider Network Commercial |
$60.46
|
| Rate for Payer: Heritage Provider Network Senior |
$60.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$16.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.33
|
| Rate for Payer: Multiplan Commercial |
$66.98
|
|
|
HC LAB REF NEISSERIA GONORRHOEAE AB
|
Facility
|
OP
|
$89.31
|
|
|
Service Code
|
CPT 86609
|
| Hospital Charge Code |
900911592
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.88 |
| Max. Negotiated Rate |
$107.86 |
| Rate for Payer: Adventist Health Commercial |
$17.86
|
| Rate for Payer: Aetna of CA Gatekeeper |
$37.48
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$61.36
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19.32
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.17
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$107.86
|
| Rate for Payer: Blue Shield of California Commercial |
$100.62
|
| Rate for Payer: Blue Shield of California EPN |
$78.66
|
| Rate for Payer: Cash Price |
$40.19
|
| Rate for Payer: Cash Price |
$40.19
|
| Rate for Payer: Cigna of CA HMO/PPO |
$58.05
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.32
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.17
|
| Rate for Payer: Dignity Health Senior |
$12.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$58.05
|
| Rate for Payer: EPIC Health Plan Medicare |
$12.88
|
| Rate for Payer: Heritage Provider Network Commercial |
$55.28
|
| Rate for Payer: Heritage Provider Network Senior |
$55.28
|
| Rate for Payer: Humana Medicare |
$12.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$17.86
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$12.88
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$24.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$16.17
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.33
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16.23
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16.23
|
| Rate for Payer: Multiplan Commercial |
$66.98
|
| Rate for Payer: TriValley Medical Group Commercial |
$12.88
|
| Rate for Payer: TriValley Medical Group Senior |
$12.88
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$13.91
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$13.91
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.17
|
| Rate for Payer: Vantage Medical Group Senior |
$12.88
|
|
|
HC LAB REF NEUTROPHIL OXIDATIVE BURST
|
Facility
|
IP
|
$42.18
|
|
|
Service Code
|
CPT 82657
|
| Hospital Charge Code |
900912536
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.63 |
| Max. Negotiated Rate |
$31.64 |
| Rate for Payer: Adventist Health Commercial |
$8.44
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$28.98
|
| Rate for Payer: Cash Price |
$18.98
|
| Rate for Payer: Heritage Provider Network Commercial |
$28.56
|
| Rate for Payer: Heritage Provider Network Senior |
$28.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.54
|
| Rate for Payer: Multiplan Commercial |
$31.64
|
|
|
HC LAB REF NEUTROPHIL OXIDATIVE BURST
|
Facility
|
OP
|
$42.18
|
|
|
Service Code
|
CPT 82657
|
| Hospital Charge Code |
900912536
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.63 |
| Max. Negotiated Rate |
$150.51 |
| Rate for Payer: Adventist Health Commercial |
$8.44
|
| Rate for Payer: Aetna of CA Gatekeeper |
$52.54
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$28.98
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$33.26
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$24.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$22.17
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$150.51
|
| Rate for Payer: Blue Shield of California Commercial |
$141.04
|
| Rate for Payer: Blue Shield of California EPN |
$110.26
|
| Rate for Payer: Cash Price |
$18.98
|
| Rate for Payer: Cash Price |
$18.98
|
| Rate for Payer: Cigna of CA HMO/PPO |
$27.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$33.26
|
| Rate for Payer: Dignity Health Medi-Cal |
$24.39
|
| Rate for Payer: Dignity Health Senior |
$22.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$27.42
|
| Rate for Payer: EPIC Health Plan Medicare |
$22.17
|
| Rate for Payer: Heritage Provider Network Commercial |
$26.11
|
| Rate for Payer: Heritage Provider Network Senior |
$26.11
|
| Rate for Payer: Humana Medicare |
$22.17
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$27.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$22.17
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$42.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$26.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.54
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$27.93
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$27.93
|
| Rate for Payer: Multiplan Commercial |
$31.64
|
| Rate for Payer: TriValley Medical Group Commercial |
$22.17
|
| Rate for Payer: TriValley Medical Group Senior |
$22.17
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$23.94
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$23.94
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$33.26
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$24.39
|
| Rate for Payer: Vantage Medical Group Senior |
$22.17
|
|
|
HC LAB REF PARAINFLUENZA AB TYPE 1
|
Facility
|
OP
|
$25.83
|
|
|
Service Code
|
CPT 86790
|
| Hospital Charge Code |
900911773
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.68 |
| Max. Negotiated Rate |
$107.86 |
| Rate for Payer: Adventist Health Commercial |
$5.17
|
| Rate for Payer: Aetna of CA Gatekeeper |
$37.48
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$17.75
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19.32
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.17
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$107.86
|
| Rate for Payer: Blue Shield of California Commercial |
$100.62
|
| Rate for Payer: Blue Shield of California EPN |
$78.66
|
| Rate for Payer: Cash Price |
$11.62
|
| Rate for Payer: Cash Price |
$11.62
|
| Rate for Payer: Cigna of CA HMO/PPO |
$16.79
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.32
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.17
|
| Rate for Payer: Dignity Health Senior |
$12.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.79
|
| Rate for Payer: EPIC Health Plan Medicare |
$12.88
|
| Rate for Payer: Heritage Provider Network Commercial |
$15.99
|
| Rate for Payer: Heritage Provider Network Senior |
$15.99
|
| Rate for Payer: Humana Medicare |
$12.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$17.86
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$12.88
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$24.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.46
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16.23
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16.23
|
| Rate for Payer: Multiplan Commercial |
$19.37
|
| Rate for Payer: TriValley Medical Group Commercial |
$12.88
|
| Rate for Payer: TriValley Medical Group Senior |
$12.88
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$13.91
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$13.91
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.17
|
| Rate for Payer: Vantage Medical Group Senior |
$12.88
|
|
|
HC LAB REF PARAINFLUENZA AB TYPE 1
|
Facility
|
IP
|
$25.83
|
|
|
Service Code
|
CPT 86790
|
| Hospital Charge Code |
900911773
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.68 |
| Max. Negotiated Rate |
$19.37 |
| Rate for Payer: Adventist Health Commercial |
$5.17
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$17.75
|
| Rate for Payer: Cash Price |
$11.62
|
| Rate for Payer: Heritage Provider Network Commercial |
$17.49
|
| Rate for Payer: Heritage Provider Network Senior |
$17.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.46
|
| Rate for Payer: Multiplan Commercial |
$19.37
|
|
|
HC LAB REF PARAINFLUENZA AB TYPE 2
|
Facility
|
OP
|
$25.83
|
|
|
Service Code
|
CPT 86790
|
| Hospital Charge Code |
900912838
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.68 |
| Max. Negotiated Rate |
$107.86 |
| Rate for Payer: Adventist Health Commercial |
$5.17
|
| Rate for Payer: Aetna of CA Gatekeeper |
$37.48
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$17.75
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19.32
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.17
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$107.86
|
| Rate for Payer: Blue Shield of California Commercial |
$100.62
|
| Rate for Payer: Blue Shield of California EPN |
$78.66
|
| Rate for Payer: Cash Price |
$11.62
|
| Rate for Payer: Cash Price |
$11.62
|
| Rate for Payer: Cigna of CA HMO/PPO |
$16.79
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.32
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.17
|
| Rate for Payer: Dignity Health Senior |
$12.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.79
|
| Rate for Payer: EPIC Health Plan Medicare |
$12.88
|
| Rate for Payer: Heritage Provider Network Commercial |
$15.99
|
| Rate for Payer: Heritage Provider Network Senior |
$15.99
|
| Rate for Payer: Humana Medicare |
$12.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$17.86
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$12.88
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$24.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.46
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16.23
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16.23
|
| Rate for Payer: Multiplan Commercial |
$19.37
|
| Rate for Payer: TriValley Medical Group Commercial |
$12.88
|
| Rate for Payer: TriValley Medical Group Senior |
$12.88
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$13.91
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$13.91
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.17
|
| Rate for Payer: Vantage Medical Group Senior |
$12.88
|
|
|
HC LAB REF PARAINFLUENZA AB TYPE 2
|
Facility
|
IP
|
$25.83
|
|
|
Service Code
|
CPT 86790
|
| Hospital Charge Code |
900912838
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.68 |
| Max. Negotiated Rate |
$19.37 |
| Rate for Payer: Adventist Health Commercial |
$5.17
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$17.75
|
| Rate for Payer: Cash Price |
$11.62
|
| Rate for Payer: Heritage Provider Network Commercial |
$17.49
|
| Rate for Payer: Heritage Provider Network Senior |
$17.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.46
|
| Rate for Payer: Multiplan Commercial |
$19.37
|
|
|
HC LAB REF PARAINFLUENZA AB TYPE 3
|
Facility
|
IP
|
$25.84
|
|
|
Service Code
|
CPT 86790
|
| Hospital Charge Code |
900912839
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.68 |
| Max. Negotiated Rate |
$19.38 |
| Rate for Payer: Adventist Health Commercial |
$5.17
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$17.75
|
| Rate for Payer: Cash Price |
$11.63
|
| Rate for Payer: Heritage Provider Network Commercial |
$17.49
|
| Rate for Payer: Heritage Provider Network Senior |
$17.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.46
|
| Rate for Payer: Multiplan Commercial |
$19.38
|
|
|
HC LAB REF PARAINFLUENZA AB TYPE 3
|
Facility
|
OP
|
$25.84
|
|
|
Service Code
|
CPT 86790
|
| Hospital Charge Code |
900912839
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.68 |
| Max. Negotiated Rate |
$107.86 |
| Rate for Payer: Adventist Health Commercial |
$5.17
|
| Rate for Payer: Aetna of CA Gatekeeper |
$37.48
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$17.75
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19.32
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.17
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$107.86
|
| Rate for Payer: Blue Shield of California Commercial |
$100.62
|
| Rate for Payer: Blue Shield of California EPN |
$78.66
|
| Rate for Payer: Cash Price |
$11.63
|
| Rate for Payer: Cash Price |
$11.63
|
| Rate for Payer: Cigna of CA HMO/PPO |
$16.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.32
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.17
|
| Rate for Payer: Dignity Health Senior |
$12.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.80
|
| Rate for Payer: EPIC Health Plan Medicare |
$12.88
|
| Rate for Payer: Heritage Provider Network Commercial |
$15.99
|
| Rate for Payer: Heritage Provider Network Senior |
$15.99
|
| Rate for Payer: Humana Medicare |
$12.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$17.86
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$12.88
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$24.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.46
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16.23
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16.23
|
| Rate for Payer: Multiplan Commercial |
$19.38
|
| Rate for Payer: TriValley Medical Group Commercial |
$12.88
|
| Rate for Payer: TriValley Medical Group Senior |
$12.88
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$13.91
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$13.91
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.17
|
| Rate for Payer: Vantage Medical Group Senior |
$12.88
|
|
|
HC LAB REF PENTOBARBITAL
|
Facility
|
OP
|
$162.00
|
|
|
Service Code
|
CPT 80345
|
| Hospital Charge Code |
900911216
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$0.02 |
| Max. Negotiated Rate |
$137.70 |
| Rate for Payer: Adventist Health Commercial |
$32.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$0.02
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$111.29
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$137.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$89.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$121.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$91.96
|
| Rate for Payer: Cash Price |
$72.90
|
| Rate for Payer: Cash Price |
$72.90
|
| Rate for Payer: Cigna of CA HMO/PPO |
$105.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$137.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$137.70
|
| Rate for Payer: Dignity Health Senior |
$137.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$105.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$100.28
|
| Rate for Payer: Heritage Provider Network Senior |
$100.28
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$78.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$29.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$40.50
|
| Rate for Payer: Multiplan Commercial |
$121.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$137.70
|
| Rate for Payer: Vantage Medical Group Senior |
$137.70
|
|
|
HC LAB REF PENTOBARBITAL
|
Facility
|
IP
|
$162.00
|
|
|
Service Code
|
CPT 80345
|
| Hospital Charge Code |
900911216
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$29.32 |
| Max. Negotiated Rate |
$121.50 |
| Rate for Payer: Adventist Health Commercial |
$32.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$111.29
|
| Rate for Payer: Cash Price |
$72.90
|
| Rate for Payer: Heritage Provider Network Commercial |
$109.67
|
| Rate for Payer: Heritage Provider Network Senior |
$109.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$29.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$40.50
|
| Rate for Payer: Multiplan Commercial |
$121.50
|
|
|
HC LAB REF PHOSPHOTIDYLSERINE IGA
|
Facility
|
IP
|
$44.08
|
|
|
Service Code
|
CPT 86148
|
| Hospital Charge Code |
900911381
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.98 |
| Max. Negotiated Rate |
$33.06 |
| Rate for Payer: Adventist Health Commercial |
$8.82
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$30.28
|
| Rate for Payer: Cash Price |
$19.84
|
| Rate for Payer: Heritage Provider Network Commercial |
$29.84
|
| Rate for Payer: Heritage Provider Network Senior |
$29.84
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.02
|
| Rate for Payer: Multiplan Commercial |
$33.06
|
|
|
HC LAB REF PHOSPHOTIDYLSERINE IGA
|
Facility
|
OP
|
$44.08
|
|
|
Service Code
|
CPT 86148
|
| Hospital Charge Code |
900911381
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.98 |
| Max. Negotiated Rate |
$135.24 |
| Rate for Payer: Adventist Health Commercial |
$8.82
|
| Rate for Payer: Aetna of CA Gatekeeper |
$46.75
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$30.28
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$24.10
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$17.68
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$16.07
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$135.24
|
| Rate for Payer: Blue Shield of California Commercial |
$125.44
|
| Rate for Payer: Blue Shield of California EPN |
$98.06
|
| Rate for Payer: Cash Price |
$19.84
|
| Rate for Payer: Cash Price |
$19.84
|
| Rate for Payer: Cigna of CA HMO/PPO |
$28.65
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$24.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$17.68
|
| Rate for Payer: Dignity Health Senior |
$16.07
|
| Rate for Payer: EPIC Health Plan Commercial |
$28.65
|
| Rate for Payer: EPIC Health Plan Medicare |
$16.07
|
| Rate for Payer: Heritage Provider Network Commercial |
$27.29
|
| Rate for Payer: Heritage Provider Network Senior |
$27.29
|
| Rate for Payer: Humana Medicare |
$16.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$22.28
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$16.07
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$30.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.02
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$20.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$20.25
|
| Rate for Payer: Multiplan Commercial |
$33.06
|
| Rate for Payer: TriValley Medical Group Commercial |
$16.07
|
| Rate for Payer: TriValley Medical Group Senior |
$16.07
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$17.35
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$17.35
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$24.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$17.68
|
| Rate for Payer: Vantage Medical Group Senior |
$16.07
|
|
