|
HC HEMOGLOBIN PLASMA
|
Facility
IP
|
$244.00
|
|
|
Service Code
|
CPT 83051
|
| Hospital Charge Code |
900912162
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$44.16 |
| Max. Negotiated Rate |
$183.00 |
| Rate for Payer: Adventist Health Commercial |
$48.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$167.63
|
| Rate for Payer: Cash Price |
$109.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$165.19
|
| Rate for Payer: Heritage Provider Network Senior |
$165.19
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$44.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$61.00
|
| Rate for Payer: Multiplan Commercial |
$183.00
|
|
|
HC HEMOGLOBIN PLASMA
|
Facility
OP
|
$26.00
|
|
|
Service Code
|
CPT 83051
|
| Hospital Charge Code |
900912162
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.71 |
| Max. Negotiated Rate |
$61.14 |
| Rate for Payer: Adventist Health Commercial |
$5.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$21.28
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$17.86
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$10.96
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$8.04
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$7.31
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$61.14
|
| Rate for Payer: Blue Shield of California Commercial |
$57.07
|
| Rate for Payer: Blue Shield of California EPN |
$44.62
|
| Rate for Payer: Cash Price |
$11.70
|
| Rate for Payer: Cash Price |
$11.70
|
| Rate for Payer: Cigna of CA HMO/PPO |
$16.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.96
|
| Rate for Payer: Dignity Health Medi-Cal |
$8.04
|
| Rate for Payer: Dignity Health Senior |
$7.31
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.90
|
| Rate for Payer: EPIC Health Plan Medicare |
$7.31
|
| Rate for Payer: Heritage Provider Network Commercial |
$16.09
|
| Rate for Payer: Heritage Provider Network Senior |
$16.09
|
| Rate for Payer: Humana Medicare |
$7.31
|
| Rate for Payer: IEHP Medi-Cal |
$10.14
|
| Rate for Payer: IEHP Medicare Advantage |
$7.31
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$13.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.71
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9.21
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9.21
|
| Rate for Payer: Multiplan Commercial |
$19.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$7.31
|
| Rate for Payer: TriValley Medical Group Senior |
$7.31
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$7.90
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$7.90
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.04
|
| Rate for Payer: Vantage Medical Group Senior |
$7.31
|
|
|
HC HEMOGLOBIN (POC)
|
Facility
OP
|
$100.00
|
|
|
Service Code
|
CPT 85018
|
| Hospital Charge Code |
900912023
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$2.37 |
| Max. Negotiated Rate |
$75.00 |
| Rate for Payer: Adventist Health Commercial |
$20.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$6.88
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$68.70
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$3.56
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2.61
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$2.37
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$19.78
|
| Rate for Payer: Blue Shield of California Commercial |
$18.50
|
| Rate for Payer: Blue Shield of California EPN |
$14.46
|
| Rate for Payer: Cash Price |
$45.00
|
| Rate for Payer: Cash Price |
$45.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$65.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3.56
|
| Rate for Payer: Dignity Health Medi-Cal |
$2.61
|
| Rate for Payer: Dignity Health Senior |
$2.37
|
| Rate for Payer: EPIC Health Plan Commercial |
$65.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$2.37
|
| Rate for Payer: Heritage Provider Network Commercial |
$61.90
|
| Rate for Payer: Heritage Provider Network Senior |
$61.90
|
| Rate for Payer: Humana Medicare |
$2.37
|
| Rate for Payer: IEHP Medi-Cal |
$3.23
|
| Rate for Payer: IEHP Medicare Advantage |
$2.37
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$4.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$18.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2.99
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2.99
|
| Rate for Payer: Multiplan Commercial |
$75.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$2.37
|
| Rate for Payer: TriValley Medical Group Senior |
$2.37
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$2.56
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2.56
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3.56
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2.61
|
| Rate for Payer: Vantage Medical Group Senior |
$2.37
|
|
|
HC HEMOGLOBIN (POC)
|
Facility
IP
|
$100.00
|
|
|
Service Code
|
CPT 85018
|
| Hospital Charge Code |
900912023
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$18.10 |
| Max. Negotiated Rate |
$75.00 |
| Rate for Payer: Adventist Health Commercial |
$20.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$68.70
|
| Rate for Payer: Cash Price |
$45.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$67.70
|
| Rate for Payer: Heritage Provider Network Senior |
$67.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$18.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.00
|
| Rate for Payer: Multiplan Commercial |
$75.00
|
|
|
HC HEMOSTASIS TEST FOR QUANTRA
|
Facility
OP
|
$179.00
|
|
|
Service Code
|
CPT 85396
|
| Hospital Charge Code |
900912041
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$21.31 |
| Max. Negotiated Rate |
$152.15 |
| Rate for Payer: Adventist Health Commercial |
$35.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$39.67
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$122.97
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$152.15
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$98.45
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$134.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$134.23
|
| Rate for Payer: Blue Shield of California Commercial |
$111.16
|
| Rate for Payer: Blue Shield of California EPN |
$105.07
|
| Rate for Payer: Cash Price |
$80.55
|
| Rate for Payer: Cash Price |
$80.55
|
| Rate for Payer: Cigna of CA HMO/PPO |
$116.35
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$152.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$152.15
|
| Rate for Payer: Dignity Health Senior |
$152.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$116.35
|
| Rate for Payer: Heritage Provider Network Commercial |
$110.80
|
| Rate for Payer: Heritage Provider Network Senior |
$110.80
|
| Rate for Payer: IEHP Medi-Cal |
$27.66
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$86.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$32.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$44.75
|
| Rate for Payer: Multiplan Commercial |
$134.25
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$21.31
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$21.31
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$152.15
|
| Rate for Payer: Vantage Medical Group Senior |
$152.15
|
|
|
HC HEMOSTASIS TEST FOR QUANTRA
|
Facility
IP
|
$251.00
|
|
|
Service Code
|
CPT 85396
|
| Hospital Charge Code |
900912041
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$45.43 |
| Max. Negotiated Rate |
$188.25 |
| Rate for Payer: Adventist Health Commercial |
$50.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$172.44
|
| Rate for Payer: Cash Price |
$112.95
|
| Rate for Payer: Heritage Provider Network Commercial |
$169.93
|
| Rate for Payer: Heritage Provider Network Senior |
$169.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$45.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$62.75
|
| Rate for Payer: Multiplan Commercial |
$188.25
|
|
|
HC HEMOSTATIC VALVE
|
Facility
IP
|
$60.50
|
|
| Hospital Charge Code |
909081232
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10.95 |
| Max. Negotiated Rate |
$45.38 |
| Rate for Payer: Adventist Health Commercial |
$12.10
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$41.56
|
| Rate for Payer: Cash Price |
$27.23
|
| Rate for Payer: Heritage Provider Network Commercial |
$40.96
|
| Rate for Payer: Heritage Provider Network Senior |
$40.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.12
|
| Rate for Payer: Multiplan Commercial |
$45.38
|
|
|
HC HEMOSTATIC VALVE
|
Facility
OP
|
$60.50
|
|
| Hospital Charge Code |
909081232
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10.95 |
| Max. Negotiated Rate |
$51.42 |
| Rate for Payer: Adventist Health Commercial |
$12.10
|
| Rate for Payer: Aetna of CA Gatekeeper |
$32.34
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$41.56
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$51.42
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$33.28
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$45.38
|
| Rate for Payer: Blue Shield of California Commercial |
$37.57
|
| Rate for Payer: Blue Shield of California EPN |
$35.51
|
| Rate for Payer: Cash Price |
$27.23
|
| Rate for Payer: Cigna of CA HMO/PPO |
$39.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$51.42
|
| Rate for Payer: Dignity Health Medi-Cal |
$51.42
|
| Rate for Payer: Dignity Health Senior |
$51.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$39.32
|
| Rate for Payer: Heritage Provider Network Commercial |
$37.45
|
| Rate for Payer: Heritage Provider Network Senior |
$37.45
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$29.16
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.12
|
| Rate for Payer: Multiplan Commercial |
$45.38
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$51.42
|
| Rate for Payer: Vantage Medical Group Senior |
$51.42
|
|
|
HC HEPARIN NEUTRALIZED PT/PTT
|
Facility
OP
|
$24.00
|
|
|
Service Code
|
CPT 85525
|
| Hospital Charge Code |
900910094
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$4.34 |
| Max. Negotiated Rate |
$72.56 |
| Rate for Payer: Adventist Health Commercial |
$4.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$27.02
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$16.49
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$17.76
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$13.02
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$11.84
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$71.90
|
| Rate for Payer: Blue Shield of California Commercial |
$72.56
|
| Rate for Payer: Blue Shield of California EPN |
$56.72
|
| Rate for Payer: Cash Price |
$10.80
|
| Rate for Payer: Cash Price |
$10.80
|
| Rate for Payer: Cigna of CA HMO/PPO |
$15.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$17.76
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.02
|
| Rate for Payer: Dignity Health Senior |
$11.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.60
|
| Rate for Payer: EPIC Health Plan Medicare |
$11.84
|
| Rate for Payer: Heritage Provider Network Commercial |
$14.86
|
| Rate for Payer: Heritage Provider Network Senior |
$14.86
|
| Rate for Payer: Humana Medicare |
$11.84
|
| Rate for Payer: IEHP Medi-Cal |
$15.76
|
| Rate for Payer: IEHP Medicare Advantage |
$11.84
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$22.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$14.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14.92
|
| Rate for Payer: Multiplan Commercial |
$18.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$11.84
|
| Rate for Payer: TriValley Medical Group Senior |
$11.84
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$12.79
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$12.79
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$17.76
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.02
|
| Rate for Payer: Vantage Medical Group Senior |
$11.84
|
|
|
HC HEPARIN NEUTRALIZED PT/PTT
|
Facility
IP
|
$204.00
|
|
|
Service Code
|
CPT 85525
|
| Hospital Charge Code |
900910094
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$36.92 |
| Max. Negotiated Rate |
$153.00 |
| Rate for Payer: Adventist Health Commercial |
$40.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$140.15
|
| Rate for Payer: Cash Price |
$91.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$138.11
|
| Rate for Payer: Heritage Provider Network Senior |
$138.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$36.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$51.00
|
| Rate for Payer: Multiplan Commercial |
$153.00
|
|
|
HC HEPATIC FUNCTION PANEL
|
Facility
OP
|
$19.00
|
|
|
Service Code
|
CPT 80076
|
| Hospital Charge Code |
900912166
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.44 |
| Max. Negotiated Rate |
$68.41 |
| Rate for Payer: Adventist Health Commercial |
$3.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$23.76
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$13.05
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$12.26
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$8.99
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$8.17
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$68.41
|
| Rate for Payer: Blue Shield of California Commercial |
$63.84
|
| Rate for Payer: Blue Shield of California EPN |
$49.91
|
| Rate for Payer: Cash Price |
$8.55
|
| Rate for Payer: Cash Price |
$8.55
|
| Rate for Payer: Cigna of CA HMO/PPO |
$12.35
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.26
|
| Rate for Payer: Dignity Health Medi-Cal |
$8.99
|
| Rate for Payer: Dignity Health Senior |
$8.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.35
|
| Rate for Payer: EPIC Health Plan Medicare |
$8.17
|
| Rate for Payer: Heritage Provider Network Commercial |
$11.76
|
| Rate for Payer: Heritage Provider Network Senior |
$11.76
|
| Rate for Payer: Humana Medicare |
$8.17
|
| Rate for Payer: IEHP Medi-Cal |
$9.95
|
| Rate for Payer: IEHP Medicare Advantage |
$8.17
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$15.52
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.29
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10.29
|
| Rate for Payer: Multiplan Commercial |
$14.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$8.17
|
| Rate for Payer: TriValley Medical Group Senior |
$8.17
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$8.82
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$8.82
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.26
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.99
|
| Rate for Payer: Vantage Medical Group Senior |
$8.17
|
|
|
HC HEPATIC FUNCTION PANEL
|
Facility
IP
|
$431.00
|
|
|
Service Code
|
CPT 80076
|
| Hospital Charge Code |
900912166
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$78.01 |
| Max. Negotiated Rate |
$323.25 |
| Rate for Payer: Adventist Health Commercial |
$86.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$296.10
|
| Rate for Payer: Cash Price |
$193.95
|
| Rate for Payer: Heritage Provider Network Commercial |
$291.79
|
| Rate for Payer: Heritage Provider Network Senior |
$291.79
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$78.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$107.75
|
| Rate for Payer: Multiplan Commercial |
$323.25
|
|
|
HC HEPATIC W/HEMODYNAMI
|
Facility
IP
|
$9,032.00
|
|
|
Service Code
|
CPT 75889
|
| Hospital Charge Code |
909081643
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,634.79 |
| Max. Negotiated Rate |
$6,774.00 |
| Rate for Payer: Adventist Health Commercial |
$1,806.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$6,204.98
|
| Rate for Payer: Cash Price |
$4,064.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,114.66
|
| Rate for Payer: Heritage Provider Network Senior |
$6,114.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,634.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,258.00
|
| Rate for Payer: Multiplan Commercial |
$6,774.00
|
|
|
HC HEPATIC W/HEMODYNAMI
|
Facility
OP
|
$9,032.00
|
|
|
Service Code
|
CPT 75889
|
| Hospital Charge Code |
909081643
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$341.91 |
| Max. Negotiated Rate |
$7,566.84 |
| Rate for Payer: Adventist Health Commercial |
$1,806.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$341.91
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$6,204.98
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$3,982.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,017.54
|
| Rate for Payer: Blue Shield of California Commercial |
$2,569.94
|
| Rate for Payer: Blue Shield of California EPN |
$1,461.45
|
| Rate for Payer: Cash Price |
$4,064.40
|
| Rate for Payer: Cash Price |
$4,064.40
|
| Rate for Payer: Cigna of CA HMO/PPO |
$5,870.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,380.80
|
| Rate for Payer: Dignity Health Senior |
$3,982.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,870.80
|
| Rate for Payer: EPIC Health Plan Medicare |
$3,982.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,590.81
|
| Rate for Payer: Heritage Provider Network Senior |
$5,590.81
|
| Rate for Payer: Humana Medicare |
$3,982.55
|
| Rate for Payer: IEHP Medicare Advantage |
$3,982.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$7,566.84
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,634.79
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,699.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,258.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,018.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,018.01
|
| Rate for Payer: Multiplan Commercial |
$6,774.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$3,982.55
|
| Rate for Payer: TriValley Medical Group Senior |
$3,982.55
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,338.61
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$3,338.61
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: Vantage Medical Group Senior |
$3,982.55
|
|
|
HC HEPATIC W/O HEMODYNA
|
Facility
OP
|
$9,032.00
|
|
|
Service Code
|
CPT 75891
|
| Hospital Charge Code |
909081662
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$342.66 |
| Max. Negotiated Rate |
$7,566.84 |
| Rate for Payer: Adventist Health Commercial |
$1,806.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$342.66
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$6,204.98
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$3,982.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,017.54
|
| Rate for Payer: Blue Shield of California Commercial |
$2,569.94
|
| Rate for Payer: Blue Shield of California EPN |
$1,461.45
|
| Rate for Payer: Cash Price |
$4,064.40
|
| Rate for Payer: Cash Price |
$4,064.40
|
| Rate for Payer: Cigna of CA HMO/PPO |
$5,870.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,380.80
|
| Rate for Payer: Dignity Health Senior |
$3,982.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,870.80
|
| Rate for Payer: EPIC Health Plan Medicare |
$3,982.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,590.81
|
| Rate for Payer: Heritage Provider Network Senior |
$5,590.81
|
| Rate for Payer: Humana Medicare |
$3,982.55
|
| Rate for Payer: IEHP Medicare Advantage |
$3,982.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$7,566.84
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,634.79
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,699.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,258.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,018.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,018.01
|
| Rate for Payer: Multiplan Commercial |
$6,774.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$3,982.55
|
| Rate for Payer: TriValley Medical Group Senior |
$3,982.55
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,338.61
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$3,338.61
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: Vantage Medical Group Senior |
$3,982.55
|
|
|
HC HEPATIC W/O HEMODYNA
|
Facility
IP
|
$9,032.00
|
|
|
Service Code
|
CPT 75891
|
| Hospital Charge Code |
909081662
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,634.79 |
| Max. Negotiated Rate |
$6,774.00 |
| Rate for Payer: Adventist Health Commercial |
$1,806.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$6,204.98
|
| Rate for Payer: Cash Price |
$4,064.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,114.66
|
| Rate for Payer: Heritage Provider Network Senior |
$6,114.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,634.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,258.00
|
| Rate for Payer: Multiplan Commercial |
$6,774.00
|
|
|
HC HEPATITIS A AB IGM
|
Facility
IP
|
$39.00
|
|
|
Service Code
|
CPT 86709
|
| Hospital Charge Code |
900913613
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.06 |
| Max. Negotiated Rate |
$29.25 |
| Rate for Payer: Adventist Health Commercial |
$7.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$26.79
|
| Rate for Payer: Cash Price |
$17.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$26.40
|
| Rate for Payer: Heritage Provider Network Senior |
$26.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.75
|
| Rate for Payer: Multiplan Commercial |
$29.25
|
|
|
HC HEPATITIS A AB IGM
|
Facility
OP
|
$28.00
|
|
|
Service Code
|
CPT 86709
|
| Hospital Charge Code |
900913613
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.07 |
| Max. Negotiated Rate |
$91.12 |
| Rate for Payer: Adventist Health Commercial |
$5.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$32.74
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$19.24
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$16.89
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$12.39
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$11.26
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$91.12
|
| Rate for Payer: Blue Shield of California Commercial |
$87.93
|
| Rate for Payer: Blue Shield of California EPN |
$68.74
|
| Rate for Payer: Cash Price |
$12.60
|
| Rate for Payer: Cash Price |
$12.60
|
| Rate for Payer: Cigna of CA HMO/PPO |
$18.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$16.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$12.39
|
| Rate for Payer: Dignity Health Senior |
$11.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$18.20
|
| Rate for Payer: EPIC Health Plan Medicare |
$11.26
|
| Rate for Payer: Heritage Provider Network Commercial |
$17.33
|
| Rate for Payer: Heritage Provider Network Senior |
$17.33
|
| Rate for Payer: Humana Medicare |
$11.26
|
| Rate for Payer: IEHP Medi-Cal |
$15.46
|
| Rate for Payer: IEHP Medicare Advantage |
$11.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$21.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.07
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$14.19
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14.19
|
| Rate for Payer: Multiplan Commercial |
$21.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$11.26
|
| Rate for Payer: TriValley Medical Group Senior |
$11.26
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$12.16
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$12.16
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$16.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$12.39
|
| Rate for Payer: Vantage Medical Group Senior |
$11.26
|
|
|
HC HEPATITIS A AB IGM INDIVIDUAL
|
Facility
OP
|
$43.00
|
|
|
Service Code
|
CPT 86709
|
| Hospital Charge Code |
900913617
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.78 |
| Max. Negotiated Rate |
$91.12 |
| Rate for Payer: Adventist Health Commercial |
$8.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$32.74
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$29.54
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$16.89
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$12.39
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$11.26
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$91.12
|
| Rate for Payer: Blue Shield of California Commercial |
$87.93
|
| Rate for Payer: Blue Shield of California EPN |
$68.74
|
| Rate for Payer: Cash Price |
$19.35
|
| Rate for Payer: Cash Price |
$19.35
|
| Rate for Payer: Cigna of CA HMO/PPO |
$27.95
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$16.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$12.39
|
| Rate for Payer: Dignity Health Senior |
$11.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$27.95
|
| Rate for Payer: EPIC Health Plan Medicare |
$11.26
|
| Rate for Payer: Heritage Provider Network Commercial |
$26.62
|
| Rate for Payer: Heritage Provider Network Senior |
$26.62
|
| Rate for Payer: Humana Medicare |
$11.26
|
| Rate for Payer: IEHP Medi-Cal |
$15.46
|
| Rate for Payer: IEHP Medicare Advantage |
$11.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$21.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$14.19
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14.19
|
| Rate for Payer: Multiplan Commercial |
$32.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$11.26
|
| Rate for Payer: TriValley Medical Group Senior |
$11.26
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$12.16
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$12.16
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$16.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$12.39
|
| Rate for Payer: Vantage Medical Group Senior |
$11.26
|
|
|
HC HEPATITIS A AB IGM INDIVIDUAL
|
Facility
IP
|
$304.00
|
|
|
Service Code
|
CPT 86709
|
| Hospital Charge Code |
900913617
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$55.02 |
| Max. Negotiated Rate |
$228.00 |
| Rate for Payer: Adventist Health Commercial |
$60.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$208.85
|
| Rate for Payer: Cash Price |
$136.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$205.81
|
| Rate for Payer: Heritage Provider Network Senior |
$205.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$55.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$76.00
|
| Rate for Payer: Multiplan Commercial |
$228.00
|
|
|
HC HEPATITIS A AB TOTAL
|
Facility
OP
|
$22.00
|
|
|
Service Code
|
CPT 86708
|
| Hospital Charge Code |
900913612
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.98 |
| Max. Negotiated Rate |
$100.30 |
| Rate for Payer: Adventist Health Commercial |
$4.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$36.05
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$15.11
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$18.58
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$13.63
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$12.39
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$100.30
|
| Rate for Payer: Blue Shield of California Commercial |
$96.76
|
| Rate for Payer: Blue Shield of California EPN |
$75.64
|
| Rate for Payer: Cash Price |
$9.90
|
| Rate for Payer: Cash Price |
$9.90
|
| Rate for Payer: Cigna of CA HMO/PPO |
$14.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$18.58
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.63
|
| Rate for Payer: Dignity Health Senior |
$12.39
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.30
|
| Rate for Payer: EPIC Health Plan Medicare |
$12.39
|
| Rate for Payer: Heritage Provider Network Commercial |
$13.62
|
| Rate for Payer: Heritage Provider Network Senior |
$13.62
|
| Rate for Payer: Humana Medicare |
$12.39
|
| Rate for Payer: IEHP Medi-Cal |
$17.18
|
| Rate for Payer: IEHP Medicare Advantage |
$12.39
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$23.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$15.61
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$15.61
|
| Rate for Payer: Multiplan Commercial |
$16.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$12.39
|
| Rate for Payer: TriValley Medical Group Senior |
$12.39
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$13.38
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$13.38
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$18.58
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.63
|
| Rate for Payer: Vantage Medical Group Senior |
$12.39
|
|
|
HC HEPATITIS A AB TOTAL
|
Facility
IP
|
$32.00
|
|
|
Service Code
|
CPT 86708
|
| Hospital Charge Code |
900913612
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.79 |
| Max. Negotiated Rate |
$24.00 |
| Rate for Payer: Adventist Health Commercial |
$6.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$21.98
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$21.66
|
| Rate for Payer: Heritage Provider Network Senior |
$21.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.00
|
| Rate for Payer: Multiplan Commercial |
$24.00
|
|
|
HC HEPATITIS B CORE AB
|
Facility
IP
|
$23.00
|
|
|
Service Code
|
CPT 86704
|
| Hospital Charge Code |
900913614
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.16 |
| Max. Negotiated Rate |
$17.25 |
| Rate for Payer: Adventist Health Commercial |
$4.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$15.80
|
| Rate for Payer: Cash Price |
$10.35
|
| Rate for Payer: Heritage Provider Network Commercial |
$15.57
|
| Rate for Payer: Heritage Provider Network Senior |
$15.57
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.75
|
| Rate for Payer: Multiplan Commercial |
$17.25
|
|
|
HC HEPATITIS B CORE AB
|
Facility
OP
|
$17.00
|
|
|
Service Code
|
CPT 86704
|
| Hospital Charge Code |
900913614
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.08 |
| Max. Negotiated Rate |
$97.66 |
| Rate for Payer: Adventist Health Commercial |
$3.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$35.07
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$11.68
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$18.08
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$13.26
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$12.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$97.66
|
| Rate for Payer: Blue Shield of California Commercial |
$94.14
|
| Rate for Payer: Blue Shield of California EPN |
$73.59
|
| Rate for Payer: Cash Price |
$7.65
|
| Rate for Payer: Cash Price |
$7.65
|
| Rate for Payer: Cigna of CA HMO/PPO |
$11.05
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$18.08
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.26
|
| Rate for Payer: Dignity Health Senior |
$12.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.05
|
| Rate for Payer: EPIC Health Plan Medicare |
$12.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$10.52
|
| Rate for Payer: Heritage Provider Network Senior |
$10.52
|
| Rate for Payer: Humana Medicare |
$12.05
|
| Rate for Payer: IEHP Medi-Cal |
$16.71
|
| Rate for Payer: IEHP Medicare Advantage |
$12.05
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$22.90
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.08
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$15.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$15.18
|
| Rate for Payer: Multiplan Commercial |
$12.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$12.05
|
| Rate for Payer: TriValley Medical Group Senior |
$12.05
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$13.02
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$13.02
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$18.08
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.26
|
| Rate for Payer: Vantage Medical Group Senior |
$12.05
|
|
|
HC HEPATITIS B CORE AB IGM
|
Facility
OP
|
$22.00
|
|
|
Service Code
|
CPT 86705
|
| Hospital Charge Code |
900913615
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.98 |
| Max. Negotiated Rate |
$95.35 |
| Rate for Payer: Adventist Health Commercial |
$4.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$34.25
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$15.11
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$17.66
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$12.95
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$11.77
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$95.35
|
| Rate for Payer: Blue Shield of California Commercial |
$91.90
|
| Rate for Payer: Blue Shield of California EPN |
$71.84
|
| Rate for Payer: Cash Price |
$9.90
|
| Rate for Payer: Cash Price |
$9.90
|
| Rate for Payer: Cigna of CA HMO/PPO |
$14.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$17.66
|
| Rate for Payer: Dignity Health Medi-Cal |
$12.95
|
| Rate for Payer: Dignity Health Senior |
$11.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.30
|
| Rate for Payer: EPIC Health Plan Medicare |
$11.77
|
| Rate for Payer: Heritage Provider Network Commercial |
$13.62
|
| Rate for Payer: Heritage Provider Network Senior |
$13.62
|
| Rate for Payer: Humana Medicare |
$11.77
|
| Rate for Payer: IEHP Medi-Cal |
$16.18
|
| Rate for Payer: IEHP Medicare Advantage |
$11.77
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$22.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$14.83
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14.83
|
| Rate for Payer: Multiplan Commercial |
$16.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$11.77
|
| Rate for Payer: TriValley Medical Group Senior |
$11.77
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$12.71
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$12.71
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$17.66
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$12.95
|
| Rate for Payer: Vantage Medical Group Senior |
$11.77
|
|
