|
HC HIGH FREQUENCY VENT SUB
|
Facility
|
OP
|
$3,400.00
|
|
|
Service Code
|
CPT 94003
|
| Hospital Charge Code |
900800016
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$100.00 |
| Max. Negotiated Rate |
$2,550.00 |
| Rate for Payer: Adventist Health Commercial |
$680.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,101.20
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,191.87
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$874.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$794.58
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$347.00
|
| Rate for Payer: Blue Shield of California Commercial |
$354.00
|
| Rate for Payer: Blue Shield of California EPN |
$284.00
|
| Rate for Payer: Cash Price |
$1,530.00
|
| Rate for Payer: Cash Price |
$1,530.00
|
| Rate for Payer: Cash Price |
$1,530.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,210.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,191.87
|
| Rate for Payer: Dignity Health Medi-Cal |
$874.04
|
| Rate for Payer: Dignity Health Medicare Advantage |
$794.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,210.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$794.58
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,104.60
|
| Rate for Payer: Heritage Provider Network Senior |
$2,104.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$794.58
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$1,621.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$615.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$913.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$850.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,064.74
|
| Rate for Payer: Multiplan Commercial |
$2,550.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$100.00
|
| Rate for Payer: TriValley Medical Group Senior |
$100.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$376.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$319.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,191.87
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$874.04
|
| Rate for Payer: Vantage Medical Group Senior |
$794.58
|
|
|
HC HIGH FREQUENCY VENT SUB
|
Facility
|
IP
|
$3,400.00
|
|
|
Service Code
|
CPT 94003
|
| Hospital Charge Code |
900800016
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$615.40 |
| Max. Negotiated Rate |
$2,550.00 |
| Rate for Payer: Adventist Health Commercial |
$680.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,189.60
|
| Rate for Payer: Cash Price |
$1,530.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,301.80
|
| Rate for Payer: Heritage Provider Network Senior |
$2,301.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$615.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$850.00
|
| Rate for Payer: Multiplan Commercial |
$2,550.00
|
|
|
HC HIP ARTHROGRAPHY INJECTION
|
Facility
|
OP
|
$651.00
|
|
|
Service Code
|
CPT 27093
|
| Hospital Charge Code |
909000116
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$117.83 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$130.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$402.32
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$553.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$358.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$488.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,672.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Cash Price |
$292.95
|
| Rate for Payer: Cash Price |
$292.95
|
| Rate for Payer: Cigna of CA HMO/PPO |
$423.15
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$553.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$553.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$553.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$402.97
|
| Rate for Payer: Heritage Provider Network Senior |
$402.97
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$310.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$117.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$162.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$455.70
|
| Rate for Payer: Multiplan Commercial |
$488.25
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,093.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$553.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$553.35
|
| Rate for Payer: Vantage Medical Group Senior |
$553.35
|
|
|
HC HIP ARTHROGRAPHY INJECTION
|
Facility
|
IP
|
$651.00
|
|
|
Service Code
|
CPT 27093
|
| Hospital Charge Code |
909000116
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$117.83 |
| Max. Negotiated Rate |
$488.25 |
| Rate for Payer: Adventist Health Commercial |
$130.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$419.24
|
| Rate for Payer: Cash Price |
$292.95
|
| Rate for Payer: Heritage Provider Network Commercial |
$440.73
|
| Rate for Payer: Heritage Provider Network Senior |
$440.73
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$117.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$162.75
|
| Rate for Payer: Multiplan Commercial |
$488.25
|
|
|
HC HISTOCHEM STAIN/MUSCLE BIOPSY
|
Facility
|
IP
|
$1,056.00
|
|
|
Service Code
|
CPT 88319
|
| Hospital Charge Code |
903800040
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$191.14 |
| Max. Negotiated Rate |
$792.00 |
| Rate for Payer: Adventist Health Commercial |
$211.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$680.06
|
| Rate for Payer: Cash Price |
$475.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$714.91
|
| Rate for Payer: Heritage Provider Network Senior |
$714.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$191.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$264.00
|
| Rate for Payer: Multiplan Commercial |
$792.00
|
|
|
HC HISTOCHEM STAIN/MUSCLE BIOPSY
|
Facility
|
OP
|
$348.00
|
|
|
Service Code
|
CPT 88319
|
| Hospital Charge Code |
903800040
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$62.99 |
| Max. Negotiated Rate |
$1,554.36 |
| Rate for Payer: Adventist Health Commercial |
$69.60
|
| Rate for Payer: Adventist Health Commercial |
$211.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$652.61
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$215.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,554.36
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,554.36
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,139.86
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,139.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,036.24
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,036.24
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$68.08
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$68.08
|
| Rate for Payer: Blue Shield of California Commercial |
$338.21
|
| Rate for Payer: Blue Shield of California Commercial |
$338.21
|
| Rate for Payer: Blue Shield of California EPN |
$271.98
|
| Rate for Payer: Blue Shield of California EPN |
$271.98
|
| Rate for Payer: Cash Price |
$156.60
|
| Rate for Payer: Cash Price |
$156.60
|
| Rate for Payer: Cash Price |
$475.20
|
| Rate for Payer: Cash Price |
$475.20
|
| Rate for Payer: Cigna of CA HMO/PPO |
$686.40
|
| Rate for Payer: Cigna of CA HMO/PPO |
$226.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,554.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,554.36
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,139.86
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,139.86
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,036.24
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,036.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$226.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$686.40
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,036.24
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,036.24
|
| Rate for Payer: Heritage Provider Network Commercial |
$653.66
|
| Rate for Payer: Heritage Provider Network Commercial |
$215.41
|
| Rate for Payer: Heritage Provider Network Senior |
$653.66
|
| Rate for Payer: Heritage Provider Network Senior |
$215.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,036.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,036.24
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$503.71
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$166.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$191.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$62.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,191.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,191.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$87.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$264.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,388.56
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,388.56
|
| Rate for Payer: Multiplan Commercial |
$792.00
|
| Rate for Payer: Multiplan Commercial |
$261.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$1,036.24
|
| Rate for Payer: TriValley Medical Group Commercial |
$1,036.24
|
| Rate for Payer: TriValley Medical Group Senior |
$1,036.24
|
| Rate for Payer: TriValley Medical Group Senior |
$1,036.24
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$722.83
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$722.83
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$722.83
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$722.83
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,554.36
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,554.36
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,139.86
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,139.86
|
| Rate for Payer: Vantage Medical Group Senior |
$1,036.24
|
| Rate for Payer: Vantage Medical Group Senior |
$1,036.24
|
|
|
HC HISTONE AUTO AB
|
Facility
|
OP
|
$64.00
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
900913528
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.58 |
| Max. Negotiated Rate |
$114.48 |
| Rate for Payer: Adventist Health Commercial |
$12.80
|
| Rate for Payer: Adventist Health Commercial |
$37.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$114.95
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$39.55
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$18.07
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$18.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13.26
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$114.48
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$114.48
|
| Rate for Payer: Blue Shield of California Commercial |
$97.00
|
| Rate for Payer: Blue Shield of California Commercial |
$97.00
|
| Rate for Payer: Blue Shield of California EPN |
$77.80
|
| Rate for Payer: Blue Shield of California EPN |
$77.80
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Cash Price |
$83.70
|
| Rate for Payer: Cash Price |
$83.70
|
| Rate for Payer: Cigna of CA HMO/PPO |
$120.90
|
| Rate for Payer: Cigna of CA HMO/PPO |
$41.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$18.07
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$18.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.26
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.26
|
| Rate for Payer: Dignity Health Medicare Advantage |
$12.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$12.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$37.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$109.74
|
| Rate for Payer: EPIC Health Plan Medicare |
$12.05
|
| Rate for Payer: EPIC Health Plan Medicare |
$12.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$115.13
|
| Rate for Payer: Heritage Provider Network Commercial |
$39.62
|
| Rate for Payer: Heritage Provider Network Senior |
$115.13
|
| Rate for Payer: Heritage Provider Network Senior |
$39.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$12.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$12.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$88.72
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$30.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$33.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$11.58
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$13.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$13.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$46.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$16.15
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$16.15
|
| Rate for Payer: Multiplan Commercial |
$139.50
|
| Rate for Payer: Multiplan Commercial |
$48.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$12.05
|
| Rate for Payer: TriValley Medical Group Commercial |
$12.05
|
| Rate for Payer: TriValley Medical Group Senior |
$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 All Other HMO/non HMO |
$13.02
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$13.02
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$13.02
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$18.07
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$18.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.26
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.26
|
| Rate for Payer: Vantage Medical Group Senior |
$12.05
|
| Rate for Payer: Vantage Medical Group Senior |
$12.05
|
|
|
HC HISTONE AUTO AB
|
Facility
|
IP
|
$186.00
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
900913528
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$33.67 |
| Max. Negotiated Rate |
$139.50 |
| Rate for Payer: Adventist Health Commercial |
$37.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$119.78
|
| Rate for Payer: Cash Price |
$83.70
|
| Rate for Payer: Heritage Provider Network Commercial |
$125.92
|
| Rate for Payer: Heritage Provider Network Senior |
$125.92
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$33.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$46.50
|
| Rate for Payer: Multiplan Commercial |
$139.50
|
|
|
HC HIT SCREEN PF4 H AB
|
Facility
|
IP
|
$116.00
|
|
|
Service Code
|
CPT 86023
|
| Hospital Charge Code |
900912035
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$21.00 |
| Max. Negotiated Rate |
$87.00 |
| Rate for Payer: Adventist Health Commercial |
$23.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$74.70
|
| Rate for Payer: Cash Price |
$52.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$78.53
|
| Rate for Payer: Heritage Provider Network Senior |
$78.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$21.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$29.00
|
| Rate for Payer: Multiplan Commercial |
$87.00
|
|
|
HC HIT SCREEN PF4 H AB
|
Facility
|
OP
|
$97.00
|
|
|
Service Code
|
CPT 86023
|
| Hospital Charge Code |
900912035
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.46 |
| Max. Negotiated Rate |
$101.96 |
| Rate for Payer: Adventist Health Commercial |
$19.40
|
| Rate for Payer: Adventist Health Commercial |
$23.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$71.69
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$59.95
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$18.69
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$18.69
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13.71
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13.71
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12.46
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12.46
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$101.96
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$101.96
|
| Rate for Payer: Blue Shield of California Commercial |
$100.22
|
| Rate for Payer: Blue Shield of California Commercial |
$100.22
|
| Rate for Payer: Blue Shield of California EPN |
$80.39
|
| Rate for Payer: Blue Shield of California EPN |
$80.39
|
| Rate for Payer: Cash Price |
$43.65
|
| Rate for Payer: Cash Price |
$43.65
|
| Rate for Payer: Cash Price |
$52.20
|
| Rate for Payer: Cash Price |
$52.20
|
| Rate for Payer: Cigna of CA HMO/PPO |
$75.40
|
| Rate for Payer: Cigna of CA HMO/PPO |
$63.05
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$18.69
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$18.69
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.71
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.71
|
| Rate for Payer: Dignity Health Medicare Advantage |
$12.46
|
| Rate for Payer: Dignity Health Medicare Advantage |
$12.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$57.23
|
| Rate for Payer: EPIC Health Plan Commercial |
$68.44
|
| Rate for Payer: EPIC Health Plan Medicare |
$12.46
|
| Rate for Payer: EPIC Health Plan Medicare |
$12.46
|
| Rate for Payer: Heritage Provider Network Commercial |
$71.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$60.04
|
| Rate for Payer: Heritage Provider Network Senior |
$71.80
|
| Rate for Payer: Heritage Provider Network Senior |
$60.04
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$12.46
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$12.46
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$55.33
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$46.27
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$21.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$17.56
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$14.33
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$14.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$29.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$16.70
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$16.70
|
| Rate for Payer: Multiplan Commercial |
$87.00
|
| Rate for Payer: Multiplan Commercial |
$72.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$12.46
|
| Rate for Payer: TriValley Medical Group Commercial |
$12.46
|
| Rate for Payer: TriValley Medical Group Senior |
$12.46
|
| Rate for Payer: TriValley Medical Group Senior |
$12.46
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$13.45
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$13.45
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$13.45
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$13.45
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$18.69
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$18.69
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.71
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.71
|
| Rate for Payer: Vantage Medical Group Senior |
$12.46
|
| Rate for Payer: Vantage Medical Group Senior |
$12.46
|
|
|
HC HIV 1 2 AB CONFIRMATION
|
Facility
|
IP
|
$255.00
|
|
|
Service Code
|
CPT 86703
|
| Hospital Charge Code |
900913681
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$46.16 |
| Max. Negotiated Rate |
$191.25 |
| Rate for Payer: Adventist Health Commercial |
$51.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$164.22
|
| Rate for Payer: Cash Price |
$114.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$172.63
|
| Rate for Payer: Heritage Provider Network Senior |
$172.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$46.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$63.75
|
| Rate for Payer: Multiplan Commercial |
$191.25
|
|
|
HC HIV 1 2 AB CONFIRMATION
|
Facility
|
OP
|
$255.00
|
|
|
Service Code
|
CPT 86703
|
| Hospital Charge Code |
900913681
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.71 |
| Max. Negotiated Rate |
$191.25 |
| Rate for Payer: Adventist Health Commercial |
$51.00
|
| Rate for Payer: Adventist Health Commercial |
$30.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$93.32
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$157.59
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20.57
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15.08
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13.71
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13.71
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$134.17
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$134.17
|
| Rate for Payer: Blue Shield of California Commercial |
$110.42
|
| Rate for Payer: Blue Shield of California Commercial |
$110.42
|
| Rate for Payer: Blue Shield of California EPN |
$88.57
|
| Rate for Payer: Blue Shield of California EPN |
$88.57
|
| Rate for Payer: Cash Price |
$114.75
|
| Rate for Payer: Cash Price |
$114.75
|
| Rate for Payer: Cash Price |
$67.95
|
| Rate for Payer: Cash Price |
$67.95
|
| Rate for Payer: Cigna of CA HMO/PPO |
$98.15
|
| Rate for Payer: Cigna of CA HMO/PPO |
$165.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20.57
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20.57
|
| Rate for Payer: Dignity Health Medi-Cal |
$15.08
|
| Rate for Payer: Dignity Health Medi-Cal |
$15.08
|
| Rate for Payer: Dignity Health Medicare Advantage |
$13.71
|
| Rate for Payer: Dignity Health Medicare Advantage |
$13.71
|
| Rate for Payer: EPIC Health Plan Commercial |
$150.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$89.09
|
| Rate for Payer: EPIC Health Plan Medicare |
$13.71
|
| Rate for Payer: EPIC Health Plan Medicare |
$13.71
|
| Rate for Payer: Heritage Provider Network Commercial |
$93.47
|
| Rate for Payer: Heritage Provider Network Commercial |
$157.84
|
| Rate for Payer: Heritage Provider Network Senior |
$93.47
|
| Rate for Payer: Heritage Provider Network Senior |
$157.84
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13.71
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13.71
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$72.03
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$121.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$27.33
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$46.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$15.77
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$15.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$63.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$37.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$18.37
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$18.37
|
| Rate for Payer: Multiplan Commercial |
$113.25
|
| Rate for Payer: Multiplan Commercial |
$191.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$13.71
|
| Rate for Payer: TriValley Medical Group Commercial |
$13.71
|
| Rate for Payer: TriValley Medical Group Senior |
$13.71
|
| Rate for Payer: TriValley Medical Group Senior |
$13.71
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$14.81
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$14.81
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$14.81
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$14.81
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20.57
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15.08
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15.08
|
| Rate for Payer: Vantage Medical Group Senior |
$13.71
|
| Rate for Payer: Vantage Medical Group Senior |
$13.71
|
|
|
HC HIV 1/2 AG AB
|
Facility
|
OP
|
$29.00
|
|
|
Service Code
|
CPT G0475 QW
|
| Hospital Charge Code |
900912044
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.25 |
| Max. Negotiated Rate |
$141.01 |
| Rate for Payer: Adventist Health Commercial |
$5.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$17.92
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$36.12
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$26.49
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$24.08
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$141.01
|
| Rate for Payer: Cash Price |
$13.05
|
| Rate for Payer: Cash Price |
$13.05
|
| Rate for Payer: Cigna of CA HMO/PPO |
$18.85
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$36.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$26.49
|
| Rate for Payer: Dignity Health Medicare Advantage |
$24.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$17.11
|
| Rate for Payer: EPIC Health Plan Medicare |
$24.08
|
| Rate for Payer: Heritage Provider Network Commercial |
$17.95
|
| Rate for Payer: Heritage Provider Network Senior |
$17.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$24.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$13.83
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$5.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$27.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$32.27
|
| Rate for Payer: Multiplan Commercial |
$21.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$24.08
|
| Rate for Payer: TriValley Medical Group Senior |
$24.08
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$26.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$26.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$36.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$26.49
|
| Rate for Payer: Vantage Medical Group Senior |
$24.08
|
|
|
HC HIV 1/2 AG AB
|
Facility
|
IP
|
$29.00
|
|
|
Service Code
|
CPT G0475 QW
|
| Hospital Charge Code |
900912044
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.25 |
| Max. Negotiated Rate |
$21.75 |
| Rate for Payer: Adventist Health Commercial |
$5.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$18.68
|
| Rate for Payer: Cash Price |
$13.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$19.63
|
| Rate for Payer: Heritage Provider Network Senior |
$19.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$5.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.25
|
| Rate for Payer: Multiplan Commercial |
$21.75
|
|
|
HC HIV-1,2 AG AB SCREEN
|
Facility
|
IP
|
$113.00
|
|
|
Service Code
|
CPT 87389
|
| Hospital Charge Code |
900913626
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$20.45 |
| Max. Negotiated Rate |
$84.75 |
| Rate for Payer: Adventist Health Commercial |
$22.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$72.77
|
| Rate for Payer: Cash Price |
$50.85
|
| Rate for Payer: Heritage Provider Network Commercial |
$76.50
|
| Rate for Payer: Heritage Provider Network Senior |
$76.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$20.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$28.25
|
| Rate for Payer: Multiplan Commercial |
$84.75
|
|
|
HC HIV-1,2 AG AB SCREEN
|
Facility
|
OP
|
$54.00
|
|
|
Service Code
|
CPT 87389
|
| Hospital Charge Code |
900913626
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.77 |
| Max. Negotiated Rate |
$196.53 |
| Rate for Payer: Adventist Health Commercial |
$10.80
|
| Rate for Payer: Adventist Health Commercial |
$22.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$69.83
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$33.37
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$36.12
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$36.12
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$26.49
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$26.49
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$24.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$24.08
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$186.65
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$186.65
|
| Rate for Payer: Blue Shield of California Commercial |
$196.53
|
| Rate for Payer: Blue Shield of California Commercial |
$196.53
|
| Rate for Payer: Blue Shield of California EPN |
$157.63
|
| Rate for Payer: Blue Shield of California EPN |
$157.63
|
| Rate for Payer: Cash Price |
$24.30
|
| Rate for Payer: Cash Price |
$24.30
|
| Rate for Payer: Cash Price |
$50.85
|
| Rate for Payer: Cash Price |
$50.85
|
| Rate for Payer: Cigna of CA HMO/PPO |
$73.45
|
| Rate for Payer: Cigna of CA HMO/PPO |
$35.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$36.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$36.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$26.49
|
| Rate for Payer: Dignity Health Medi-Cal |
$26.49
|
| Rate for Payer: Dignity Health Medicare Advantage |
$24.08
|
| Rate for Payer: Dignity Health Medicare Advantage |
$24.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$31.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$66.67
|
| Rate for Payer: EPIC Health Plan Medicare |
$24.08
|
| Rate for Payer: EPIC Health Plan Medicare |
$24.08
|
| Rate for Payer: Heritage Provider Network Commercial |
$69.95
|
| Rate for Payer: Heritage Provider Network Commercial |
$33.43
|
| Rate for Payer: Heritage Provider Network Senior |
$69.95
|
| Rate for Payer: Heritage Provider Network Senior |
$33.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$24.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$24.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$53.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$25.76
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$20.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$9.77
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$27.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$27.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$28.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$32.27
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$32.27
|
| Rate for Payer: Multiplan Commercial |
$84.75
|
| Rate for Payer: Multiplan Commercial |
$40.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$24.08
|
| Rate for Payer: TriValley Medical Group Commercial |
$24.08
|
| Rate for Payer: TriValley Medical Group Senior |
$24.08
|
| Rate for Payer: TriValley Medical Group Senior |
$24.08
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$26.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$26.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$26.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$26.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$36.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$36.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$26.49
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$26.49
|
| Rate for Payer: Vantage Medical Group Senior |
$24.08
|
| Rate for Payer: Vantage Medical Group Senior |
$24.08
|
|
|
HC HIV 1 ANTIBODY
|
Facility
|
IP
|
$109.00
|
|
|
Service Code
|
CPT 86701
|
| Hospital Charge Code |
900913682
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$19.73 |
| Max. Negotiated Rate |
$81.75 |
| Rate for Payer: Adventist Health Commercial |
$21.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$70.20
|
| Rate for Payer: Cash Price |
$49.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$73.79
|
| Rate for Payer: Heritage Provider Network Senior |
$73.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$19.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27.25
|
| Rate for Payer: Multiplan Commercial |
$81.75
|
|
|
HC HIV 1 ANTIBODY
|
Facility
|
OP
|
$95.00
|
|
|
Service Code
|
CPT 86701
|
| Hospital Charge Code |
900913682
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.89 |
| Max. Negotiated Rate |
$84.31 |
| Rate for Payer: Blue Shield of California EPN |
$57.33
|
| Rate for Payer: Blue Shield of California EPN |
$57.33
|
| Rate for Payer: Adventist Health Commercial |
$19.00
|
| Rate for Payer: Adventist Health Commercial |
$21.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$67.36
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$58.71
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13.34
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13.34
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9.78
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9.78
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.89
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.89
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$84.31
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$84.31
|
| Rate for Payer: Blue Shield of California Commercial |
$71.48
|
| Rate for Payer: Blue Shield of California Commercial |
$71.48
|
| Rate for Payer: Cash Price |
$42.75
|
| Rate for Payer: Cash Price |
$42.75
|
| Rate for Payer: Cash Price |
$49.05
|
| Rate for Payer: Cash Price |
$49.05
|
| Rate for Payer: Cigna of CA HMO/PPO |
$70.85
|
| Rate for Payer: Cigna of CA HMO/PPO |
$61.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13.34
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.78
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.78
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8.89
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8.89
|
| Rate for Payer: EPIC Health Plan Commercial |
$56.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$64.31
|
| Rate for Payer: EPIC Health Plan Medicare |
$8.89
|
| Rate for Payer: EPIC Health Plan Medicare |
$8.89
|
| Rate for Payer: Heritage Provider Network Commercial |
$67.47
|
| Rate for Payer: Heritage Provider Network Commercial |
$58.80
|
| Rate for Payer: Heritage Provider Network Senior |
$67.47
|
| Rate for Payer: Heritage Provider Network Senior |
$58.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.89
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.89
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$51.99
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$45.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$19.73
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$17.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10.22
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$11.91
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$11.91
|
| Rate for Payer: Multiplan Commercial |
$81.75
|
| Rate for Payer: Multiplan Commercial |
$71.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$8.89
|
| Rate for Payer: TriValley Medical Group Commercial |
$8.89
|
| Rate for Payer: TriValley Medical Group Senior |
$8.89
|
| Rate for Payer: TriValley Medical Group Senior |
$8.89
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$9.60
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$9.60
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$9.60
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$9.60
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13.34
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13.34
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.78
|
| Rate for Payer: Vantage Medical Group Senior |
$8.89
|
| Rate for Payer: Vantage Medical Group Senior |
$8.89
|
|
|
HC HIV 1 P24 ANTIGEN
|
Facility
|
IP
|
$174.00
|
|
|
Service Code
|
CPT 87390
|
| Hospital Charge Code |
900913684
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$31.49 |
| Max. Negotiated Rate |
$130.50 |
| Rate for Payer: Adventist Health Commercial |
$34.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$112.06
|
| Rate for Payer: Cash Price |
$78.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$117.80
|
| Rate for Payer: Heritage Provider Network Senior |
$117.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$31.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$43.50
|
| Rate for Payer: Multiplan Commercial |
$130.50
|
|
|
HC HIV 1 P24 ANTIGEN
|
Facility
|
OP
|
$174.00
|
|
|
Service Code
|
CPT 87390
|
| Hospital Charge Code |
900913684
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$24.06 |
| Max. Negotiated Rate |
$162.11 |
| Rate for Payer: Adventist Health Commercial |
$34.80
|
| Rate for Payer: Adventist Health Commercial |
$27.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$83.43
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$107.53
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$36.09
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$36.09
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$26.47
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$26.47
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$24.06
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$24.06
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$162.11
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$162.11
|
| Rate for Payer: Blue Shield of California Commercial |
$141.98
|
| Rate for Payer: Blue Shield of California Commercial |
$141.98
|
| Rate for Payer: Blue Shield of California EPN |
$113.88
|
| Rate for Payer: Blue Shield of California EPN |
$113.88
|
| Rate for Payer: Cash Price |
$78.30
|
| Rate for Payer: Cash Price |
$78.30
|
| Rate for Payer: Cash Price |
$60.75
|
| Rate for Payer: Cash Price |
$60.75
|
| Rate for Payer: Cigna of CA HMO/PPO |
$87.75
|
| Rate for Payer: Cigna of CA HMO/PPO |
$113.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$36.09
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$36.09
|
| Rate for Payer: Dignity Health Medi-Cal |
$26.47
|
| Rate for Payer: Dignity Health Medi-Cal |
$26.47
|
| Rate for Payer: Dignity Health Medicare Advantage |
$24.06
|
| Rate for Payer: Dignity Health Medicare Advantage |
$24.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$102.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$79.65
|
| Rate for Payer: EPIC Health Plan Medicare |
$24.06
|
| Rate for Payer: EPIC Health Plan Medicare |
$24.06
|
| Rate for Payer: Heritage Provider Network Commercial |
$83.56
|
| Rate for Payer: Heritage Provider Network Commercial |
$107.71
|
| Rate for Payer: Heritage Provider Network Senior |
$83.56
|
| Rate for Payer: Heritage Provider Network Senior |
$107.71
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$24.06
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$24.06
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$64.39
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$83.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$24.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$31.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$27.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$27.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$43.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$33.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$32.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$32.24
|
| Rate for Payer: Multiplan Commercial |
$101.25
|
| Rate for Payer: Multiplan Commercial |
$130.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$24.06
|
| Rate for Payer: TriValley Medical Group Commercial |
$24.06
|
| Rate for Payer: TriValley Medical Group Senior |
$24.06
|
| Rate for Payer: TriValley Medical Group Senior |
$24.06
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$25.98
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$25.98
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$25.98
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$25.98
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$36.09
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$36.09
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$26.47
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$26.47
|
| Rate for Payer: Vantage Medical Group Senior |
$24.06
|
| Rate for Payer: Vantage Medical Group Senior |
$24.06
|
|
|
HC HIV 2 ANTIBODY
|
Facility
|
OP
|
$140.00
|
|
|
Service Code
|
CPT 86702
|
| Hospital Charge Code |
900913683
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.52 |
| Max. Negotiated Rate |
$130.40 |
| Rate for Payer: Adventist Health Commercial |
$28.00
|
| Rate for Payer: Adventist Health Commercial |
$27.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$83.43
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$86.52
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20.28
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20.28
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.87
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.87
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13.52
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13.52
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$130.40
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$130.40
|
| Rate for Payer: Blue Shield of California Commercial |
$108.75
|
| Rate for Payer: Blue Shield of California Commercial |
$108.75
|
| Rate for Payer: Blue Shield of California EPN |
$87.23
|
| Rate for Payer: Blue Shield of California EPN |
$87.23
|
| Rate for Payer: Cash Price |
$63.00
|
| Rate for Payer: Cash Price |
$63.00
|
| Rate for Payer: Cash Price |
$60.75
|
| Rate for Payer: Cash Price |
$60.75
|
| Rate for Payer: Cigna of CA HMO/PPO |
$87.75
|
| Rate for Payer: Cigna of CA HMO/PPO |
$91.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20.28
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.87
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.87
|
| Rate for Payer: Dignity Health Medicare Advantage |
$13.52
|
| Rate for Payer: Dignity Health Medicare Advantage |
$13.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$82.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$79.65
|
| Rate for Payer: EPIC Health Plan Medicare |
$13.52
|
| Rate for Payer: EPIC Health Plan Medicare |
$13.52
|
| Rate for Payer: Heritage Provider Network Commercial |
$83.56
|
| Rate for Payer: Heritage Provider Network Commercial |
$86.66
|
| Rate for Payer: Heritage Provider Network Senior |
$83.56
|
| Rate for Payer: Heritage Provider Network Senior |
$86.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13.52
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13.52
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$64.39
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$66.78
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$24.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$25.34
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$15.55
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$15.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$35.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$33.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$18.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$18.12
|
| Rate for Payer: Multiplan Commercial |
$101.25
|
| Rate for Payer: Multiplan Commercial |
$105.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$13.52
|
| Rate for Payer: TriValley Medical Group Commercial |
$13.52
|
| Rate for Payer: TriValley Medical Group Senior |
$13.52
|
| Rate for Payer: TriValley Medical Group Senior |
$13.52
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$14.60
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$14.60
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$14.60
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$14.60
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20.28
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20.28
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.87
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.87
|
| Rate for Payer: Vantage Medical Group Senior |
$13.52
|
| Rate for Payer: Vantage Medical Group Senior |
$13.52
|
|
|
HC HIV 2 ANTIBODY
|
Facility
|
IP
|
$140.00
|
|
|
Service Code
|
CPT 86702
|
| Hospital Charge Code |
900913683
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$25.34 |
| Max. Negotiated Rate |
$105.00 |
| Rate for Payer: Adventist Health Commercial |
$28.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$90.16
|
| Rate for Payer: Cash Price |
$63.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$94.78
|
| Rate for Payer: Heritage Provider Network Senior |
$94.78
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$25.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$35.00
|
| Rate for Payer: Multiplan Commercial |
$105.00
|
|
|
HC HIV ANTIGEN, ANTIBODY
|
Facility
|
IP
|
$57.00
|
|
|
Service Code
|
CPT 87389
|
| Hospital Charge Code |
900913662
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.32 |
| Max. Negotiated Rate |
$42.75 |
| Rate for Payer: Adventist Health Commercial |
$11.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$36.71
|
| Rate for Payer: Cash Price |
$25.65
|
| Rate for Payer: Heritage Provider Network Commercial |
$38.59
|
| Rate for Payer: Heritage Provider Network Senior |
$38.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$10.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.25
|
| Rate for Payer: Multiplan Commercial |
$42.75
|
|
|
HC HIV ANTIGEN, ANTIBODY
|
Facility
|
OP
|
$57.00
|
|
|
Service Code
|
CPT 87389
|
| Hospital Charge Code |
900913662
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.32 |
| Max. Negotiated Rate |
$196.53 |
| Rate for Payer: Adventist Health Commercial |
$11.40
|
| Rate for Payer: Adventist Health Commercial |
$8.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$25.96
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$35.23
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$36.12
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$36.12
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$26.49
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$26.49
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$24.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$24.08
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$186.65
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$186.65
|
| Rate for Payer: Blue Shield of California Commercial |
$196.53
|
| Rate for Payer: Blue Shield of California Commercial |
$196.53
|
| Rate for Payer: Blue Shield of California EPN |
$157.63
|
| Rate for Payer: Blue Shield of California EPN |
$157.63
|
| Rate for Payer: Cash Price |
$25.65
|
| Rate for Payer: Cash Price |
$25.65
|
| Rate for Payer: Cash Price |
$18.90
|
| Rate for Payer: Cash Price |
$18.90
|
| Rate for Payer: Cigna of CA HMO/PPO |
$27.30
|
| Rate for Payer: Cigna of CA HMO/PPO |
$37.05
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$36.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$36.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$26.49
|
| Rate for Payer: Dignity Health Medi-Cal |
$26.49
|
| Rate for Payer: Dignity Health Medicare Advantage |
$24.08
|
| Rate for Payer: Dignity Health Medicare Advantage |
$24.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$33.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$24.78
|
| Rate for Payer: EPIC Health Plan Medicare |
$24.08
|
| Rate for Payer: EPIC Health Plan Medicare |
$24.08
|
| Rate for Payer: Heritage Provider Network Commercial |
$26.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$35.28
|
| Rate for Payer: Heritage Provider Network Senior |
$26.00
|
| Rate for Payer: Heritage Provider Network Senior |
$35.28
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$24.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$24.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$20.03
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$27.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$7.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$10.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$27.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$27.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$32.27
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$32.27
|
| Rate for Payer: Multiplan Commercial |
$31.50
|
| Rate for Payer: Multiplan Commercial |
$42.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$24.08
|
| Rate for Payer: TriValley Medical Group Commercial |
$24.08
|
| Rate for Payer: TriValley Medical Group Senior |
$24.08
|
| Rate for Payer: TriValley Medical Group Senior |
$24.08
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$26.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$26.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$26.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$26.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$36.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$36.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$26.49
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$26.49
|
| Rate for Payer: Vantage Medical Group Senior |
$24.08
|
| Rate for Payer: Vantage Medical Group Senior |
$24.08
|
|
|
HC HIV RAPID TESTING
|
Facility
|
OP
|
$270.00
|
|
|
Service Code
|
CPT 86703
|
| Hospital Charge Code |
900912325
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.71 |
| Max. Negotiated Rate |
$202.50 |
| Rate for Payer: Adventist Health Commercial |
$54.00
|
| Rate for Payer: Adventist Health Commercial |
$25.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$77.87
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$166.86
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20.57
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15.08
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13.71
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13.71
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$134.17
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$134.17
|
| Rate for Payer: Blue Shield of California Commercial |
$110.42
|
| Rate for Payer: Blue Shield of California Commercial |
$110.42
|
| Rate for Payer: Blue Shield of California EPN |
$88.57
|
| Rate for Payer: Blue Shield of California EPN |
$88.57
|
| Rate for Payer: Cash Price |
$121.50
|
| Rate for Payer: Cash Price |
$121.50
|
| Rate for Payer: Cash Price |
$56.70
|
| Rate for Payer: Cash Price |
$56.70
|
| Rate for Payer: Cigna of CA HMO/PPO |
$81.90
|
| Rate for Payer: Cigna of CA HMO/PPO |
$175.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20.57
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20.57
|
| Rate for Payer: Dignity Health Medi-Cal |
$15.08
|
| Rate for Payer: Dignity Health Medi-Cal |
$15.08
|
| Rate for Payer: Dignity Health Medicare Advantage |
$13.71
|
| Rate for Payer: Dignity Health Medicare Advantage |
$13.71
|
| Rate for Payer: EPIC Health Plan Commercial |
$159.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$74.34
|
| Rate for Payer: EPIC Health Plan Medicare |
$13.71
|
| Rate for Payer: EPIC Health Plan Medicare |
$13.71
|
| Rate for Payer: Heritage Provider Network Commercial |
$77.99
|
| Rate for Payer: Heritage Provider Network Commercial |
$167.13
|
| Rate for Payer: Heritage Provider Network Senior |
$77.99
|
| Rate for Payer: Heritage Provider Network Senior |
$167.13
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13.71
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13.71
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$60.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$128.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$22.81
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$48.87
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$15.77
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$15.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$67.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$31.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$18.37
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$18.37
|
| Rate for Payer: Multiplan Commercial |
$94.50
|
| Rate for Payer: Multiplan Commercial |
$202.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$13.71
|
| Rate for Payer: TriValley Medical Group Commercial |
$13.71
|
| Rate for Payer: TriValley Medical Group Senior |
$13.71
|
| Rate for Payer: TriValley Medical Group Senior |
$13.71
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$14.81
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$14.81
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$14.81
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$14.81
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20.57
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15.08
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15.08
|
| Rate for Payer: Vantage Medical Group Senior |
$13.71
|
| Rate for Payer: Vantage Medical Group Senior |
$13.71
|
|
