|
HC LAB REF RETICULIN AB
|
Facility
|
OP
|
$14.00
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
900910788
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.53 |
| Max. Negotiated Rate |
$110.08 |
| Rate for Payer: Adventist Health Commercial |
$2.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$7.48
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$9.62
|
| 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 Medicare Advantage/Dual Product |
$12.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$110.08
|
| Rate for Payer: Blue Shield of California Commercial |
$97.00
|
| Rate for Payer: Blue Shield of California EPN |
$77.80
|
| Rate for Payer: Cash Price |
$7.70
|
| Rate for Payer: Cash Price |
$7.70
|
| Rate for Payer: Cigna of CA HMO/PPO |
$9.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$18.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.26
|
| Rate for Payer: Dignity Health Senior |
$12.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.10
|
| Rate for Payer: EPIC Health Plan Medicare |
$12.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$8.67
|
| Rate for Payer: Heritage Provider Network Senior |
$8.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$13.98
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$12.05
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$6.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.50
|
| 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 |
$10.50
|
| 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 |
$18.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.26
|
| Rate for Payer: Vantage Medical Group Senior |
$12.05
|
|
|
HC LAB REF RETICULIN AB
|
Facility
|
IP
|
$14.00
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
900910788
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.53 |
| Max. Negotiated Rate |
$10.50 |
| Rate for Payer: Adventist Health Commercial |
$2.80
|
| Rate for Payer: Cash Price |
$7.70
|
| Rate for Payer: Heritage Provider Network Commercial |
$9.48
|
| Rate for Payer: Heritage Provider Network Senior |
$9.48
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.50
|
| Rate for Payer: Multiplan Commercial |
$10.50
|
|
|
HC LAB REF RIFAMPIN
|
Facility
|
IP
|
$137.00
|
|
|
Service Code
|
CPT 80299
|
| Hospital Charge Code |
900911389
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$24.80 |
| Max. Negotiated Rate |
$102.75 |
| Rate for Payer: Adventist Health Commercial |
$27.40
|
| Rate for Payer: Cash Price |
$75.35
|
| Rate for Payer: Heritage Provider Network Commercial |
$92.75
|
| Rate for Payer: Heritage Provider Network Senior |
$92.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$24.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$34.25
|
| Rate for Payer: Multiplan Commercial |
$102.75
|
|
|
HC LAB REF RIFAMPIN
|
Facility
|
OP
|
$137.00
|
|
|
Service Code
|
CPT 80299
|
| Hospital Charge Code |
900911389
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$18.64 |
| Max. Negotiated Rate |
$132.94 |
| Rate for Payer: Adventist Health Commercial |
$27.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$73.23
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$94.12
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$27.96
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$20.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$18.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$132.94
|
| Rate for Payer: Blue Shield of California Commercial |
$110.19
|
| Rate for Payer: Blue Shield of California EPN |
$88.38
|
| Rate for Payer: Cash Price |
$75.35
|
| Rate for Payer: Cash Price |
$75.35
|
| Rate for Payer: Cigna of CA HMO/PPO |
$89.05
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$27.96
|
| Rate for Payer: Dignity Health Medi-Cal |
$20.50
|
| Rate for Payer: Dignity Health Senior |
$18.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$89.05
|
| Rate for Payer: EPIC Health Plan Medicare |
$18.64
|
| Rate for Payer: Heritage Provider Network Commercial |
$84.80
|
| Rate for Payer: Heritage Provider Network Senior |
$84.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$20.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$18.64
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$65.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$24.80
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$34.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$23.49
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$23.49
|
| Rate for Payer: Multiplan Commercial |
$102.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$18.64
|
| Rate for Payer: TriValley Medical Group Senior |
$18.64
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$20.14
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$20.14
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$27.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$20.50
|
| Rate for Payer: Vantage Medical Group Senior |
$18.64
|
|
|
HC LAB REF ST LOUIS ENCEPH AB IGM
|
Facility
|
OP
|
$21.00
|
|
|
Service Code
|
CPT 86653
|
| Hospital Charge Code |
900912652
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.80 |
| Max. Negotiated Rate |
$120.41 |
| Rate for Payer: Adventist Health Commercial |
$4.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$11.22
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$14.43
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19.79
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.51
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13.19
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$120.41
|
| Rate for Payer: Blue Shield of California Commercial |
$106.16
|
| Rate for Payer: Blue Shield of California EPN |
$85.15
|
| Rate for Payer: Cash Price |
$11.55
|
| Rate for Payer: Cash Price |
$11.55
|
| Rate for Payer: Cigna of CA HMO/PPO |
$13.65
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.79
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.51
|
| Rate for Payer: Dignity Health Senior |
$13.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.65
|
| Rate for Payer: EPIC Health Plan Medicare |
$13.19
|
| Rate for Payer: Heritage Provider Network Commercial |
$13.00
|
| Rate for Payer: Heritage Provider Network Senior |
$13.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$18.99
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13.19
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$10.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.80
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16.62
|
| Rate for Payer: Multiplan Commercial |
$15.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$13.19
|
| Rate for Payer: TriValley Medical Group Senior |
$13.19
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$14.24
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$14.24
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.79
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.51
|
| Rate for Payer: Vantage Medical Group Senior |
$13.19
|
|
|
HC LAB REF ST LOUIS ENCEPH AB IGM
|
Facility
|
IP
|
$21.00
|
|
|
Service Code
|
CPT 86653
|
| Hospital Charge Code |
900912652
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.80 |
| Max. Negotiated Rate |
$15.75 |
| Rate for Payer: Adventist Health Commercial |
$4.20
|
| Rate for Payer: Cash Price |
$11.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$14.22
|
| Rate for Payer: Heritage Provider Network Senior |
$14.22
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.25
|
| Rate for Payer: Multiplan Commercial |
$15.75
|
|
|
HC LAB REF STRIATIONAL ABS
|
Facility
|
IP
|
$21.00
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
900912585
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.80 |
| Max. Negotiated Rate |
$15.75 |
| Rate for Payer: Adventist Health Commercial |
$4.20
|
| Rate for Payer: Cash Price |
$11.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$14.22
|
| Rate for Payer: Heritage Provider Network Senior |
$14.22
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.25
|
| Rate for Payer: Multiplan Commercial |
$15.75
|
|
|
HC LAB REF STRIATIONAL ABS
|
Facility
|
OP
|
$21.00
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
900912585
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.80 |
| Max. Negotiated Rate |
$118.19 |
| Rate for Payer: Adventist Health Commercial |
$4.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$11.22
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$14.43
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$25.91
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$17.27
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$118.19
|
| Rate for Payer: Blue Shield of California Commercial |
$104.20
|
| Rate for Payer: Blue Shield of California EPN |
$83.58
|
| Rate for Payer: Cash Price |
$11.55
|
| Rate for Payer: Cash Price |
$11.55
|
| Rate for Payer: Cigna of CA HMO/PPO |
$13.65
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$25.91
|
| Rate for Payer: Dignity Health Medi-Cal |
$19.00
|
| Rate for Payer: Dignity Health Senior |
$17.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.65
|
| Rate for Payer: EPIC Health Plan Medicare |
$17.27
|
| Rate for Payer: Heritage Provider Network Commercial |
$13.00
|
| Rate for Payer: Heritage Provider Network Senior |
$13.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$16.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$17.27
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$10.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.80
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$19.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$21.76
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$21.76
|
| Rate for Payer: Multiplan Commercial |
$15.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$17.27
|
| Rate for Payer: TriValley Medical Group Senior |
$17.27
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$18.65
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$18.65
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$25.91
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.00
|
| Rate for Payer: Vantage Medical Group Senior |
$17.27
|
|
|
HC LAB REF SULFHEMOGLOBIN
|
Facility
|
OP
|
$10.00
|
|
|
Service Code
|
CPT 83060
|
| Hospital Charge Code |
900910299
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$1.81 |
| Max. Negotiated Rate |
$75.48 |
| Rate for Payer: Adventist Health Commercial |
$2.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$5.34
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$6.87
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9.68
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$75.48
|
| Rate for Payer: Blue Shield of California Commercial |
$66.59
|
| Rate for Payer: Blue Shield of California EPN |
$53.41
|
| Rate for Payer: Cash Price |
$5.50
|
| Rate for Payer: Cash Price |
$5.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$6.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.68
|
| Rate for Payer: Dignity Health Senior |
$8.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.50
|
| Rate for Payer: EPIC Health Plan Medicare |
$8.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$6.19
|
| Rate for Payer: Heritage Provider Network Senior |
$6.19
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$11.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$4.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11.09
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11.09
|
| Rate for Payer: Multiplan Commercial |
$7.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$8.80
|
| Rate for Payer: TriValley Medical Group Senior |
$8.80
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$9.50
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$9.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.68
|
| Rate for Payer: Vantage Medical Group Senior |
$8.80
|
|
|
HC LAB REF SULFHEMOGLOBIN
|
Facility
|
IP
|
$10.00
|
|
|
Service Code
|
CPT 83060
|
| Hospital Charge Code |
900910299
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$1.81 |
| Max. Negotiated Rate |
$7.50 |
| Rate for Payer: Adventist Health Commercial |
$2.00
|
| Rate for Payer: Cash Price |
$5.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$6.77
|
| Rate for Payer: Heritage Provider Network Senior |
$6.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.50
|
| Rate for Payer: Multiplan Commercial |
$7.50
|
|
|
HC LAB REF T3 UPTAKE
|
Facility
|
IP
|
$10.00
|
|
|
Service Code
|
CPT 84479
|
| Hospital Charge Code |
900910792
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$1.81 |
| Max. Negotiated Rate |
$7.50 |
| Rate for Payer: Adventist Health Commercial |
$2.00
|
| Rate for Payer: Cash Price |
$5.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$6.77
|
| Rate for Payer: Heritage Provider Network Senior |
$6.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.50
|
| Rate for Payer: Multiplan Commercial |
$7.50
|
|
|
HC LAB REF T3 UPTAKE
|
Facility
|
OP
|
$10.00
|
|
|
Service Code
|
CPT 84479
|
| Hospital Charge Code |
900910792
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$1.81 |
| Max. Negotiated Rate |
$59.07 |
| Rate for Payer: Adventist Health Commercial |
$2.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$5.34
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$6.87
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$9.71
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6.47
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$59.07
|
| Rate for Payer: Blue Shield of California Commercial |
$52.07
|
| Rate for Payer: Blue Shield of California EPN |
$41.76
|
| Rate for Payer: Cash Price |
$5.50
|
| Rate for Payer: Cash Price |
$5.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$6.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9.71
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.12
|
| Rate for Payer: Dignity Health Senior |
$6.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.50
|
| Rate for Payer: EPIC Health Plan Medicare |
$6.47
|
| Rate for Payer: Heritage Provider Network Commercial |
$6.19
|
| Rate for Payer: Heritage Provider Network Senior |
$6.19
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$9.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6.47
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$4.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8.15
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8.15
|
| Rate for Payer: Multiplan Commercial |
$7.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$6.47
|
| Rate for Payer: TriValley Medical Group Senior |
$6.47
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$6.98
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$6.98
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$9.71
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.12
|
| Rate for Payer: Vantage Medical Group Senior |
$6.47
|
|
|
HC LAB REF TISSUE CULT OTHER SOLID TISSUE
|
Facility
|
IP
|
$75.00
|
|
|
Service Code
|
CPT 88291
|
| Hospital Charge Code |
900910776
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$13.57 |
| Max. Negotiated Rate |
$56.25 |
| Rate for Payer: Adventist Health Commercial |
$15.00
|
| Rate for Payer: Cash Price |
$41.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$50.77
|
| Rate for Payer: Heritage Provider Network Senior |
$50.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18.75
|
| Rate for Payer: Multiplan Commercial |
$56.25
|
|
|
HC LAB REF TISSUE CULT OTHER SOLID TISSUE
|
Facility
|
OP
|
$75.00
|
|
|
Service Code
|
CPT 88291
|
| Hospital Charge Code |
900910776
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$13.57 |
| Max. Negotiated Rate |
$170.56 |
| Rate for Payer: Adventist Health Commercial |
$15.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$40.09
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$51.52
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$63.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$41.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$56.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$170.56
|
| Rate for Payer: Blue Shield of California Commercial |
$37.25
|
| Rate for Payer: Blue Shield of California EPN |
$29.95
|
| Rate for Payer: Cash Price |
$41.25
|
| Rate for Payer: Cash Price |
$41.25
|
| Rate for Payer: Cigna of CA HMO/PPO |
$48.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$63.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$63.75
|
| Rate for Payer: Dignity Health Senior |
$63.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$48.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$46.42
|
| Rate for Payer: Heritage Provider Network Senior |
$46.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$22.06
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$35.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$52.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$52.50
|
| Rate for Payer: Multiplan Commercial |
$56.25
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$36.25
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$36.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$63.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$63.75
|
| Rate for Payer: Vantage Medical Group Senior |
$63.75
|
|
|
HC LAB REF TISSUE CULTURE LYMPHOCYTE NON
|
Facility
|
IP
|
$101.00
|
|
|
Service Code
|
CPT 88230
|
| Hospital Charge Code |
900910686
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$18.28 |
| Max. Negotiated Rate |
$75.75 |
| Rate for Payer: Adventist Health Commercial |
$20.20
|
| Rate for Payer: Cash Price |
$55.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$68.38
|
| Rate for Payer: Heritage Provider Network Senior |
$68.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$18.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.25
|
| Rate for Payer: Multiplan Commercial |
$75.75
|
|
|
HC LAB REF TISSUE CULTURE LYMPHOCYTE NON
|
Facility
|
OP
|
$101.00
|
|
|
Service Code
|
CPT 88230
|
| Hospital Charge Code |
900910686
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$18.28 |
| Max. Negotiated Rate |
$937.56 |
| Rate for Payer: Adventist Health Commercial |
$20.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$53.98
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$69.39
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$174.74
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$128.14
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$116.49
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$902.95
|
| Rate for Payer: Blue Shield of California Commercial |
$937.56
|
| Rate for Payer: Blue Shield of California EPN |
$752.00
|
| Rate for Payer: Cash Price |
$55.55
|
| Rate for Payer: Cash Price |
$55.55
|
| Rate for Payer: Cigna of CA HMO/PPO |
$65.65
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$174.74
|
| Rate for Payer: Dignity Health Medi-Cal |
$128.14
|
| Rate for Payer: Dignity Health Senior |
$116.49
|
| Rate for Payer: EPIC Health Plan Commercial |
$65.65
|
| Rate for Payer: EPIC Health Plan Medicare |
$116.49
|
| Rate for Payer: Heritage Provider Network Commercial |
$62.52
|
| Rate for Payer: Heritage Provider Network Senior |
$62.52
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$163.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$116.49
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$48.18
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$18.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$133.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$146.78
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$146.78
|
| Rate for Payer: Multiplan Commercial |
$75.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$116.49
|
| Rate for Payer: TriValley Medical Group Senior |
$116.49
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$125.81
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$125.81
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$174.74
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$128.14
|
| Rate for Payer: Vantage Medical Group Senior |
$116.49
|
|
|
HC LAB REF TISSUE CULTURE NEO BLOOD/BONE
|
Facility
|
OP
|
$203.00
|
|
|
Service Code
|
CPT 88237
|
| Hospital Charge Code |
900912791
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$36.74 |
| Max. Negotiated Rate |
$1,016.47 |
| Rate for Payer: Adventist Health Commercial |
$40.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$108.50
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$139.46
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$215.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$158.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$143.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$978.92
|
| Rate for Payer: Blue Shield of California Commercial |
$1,016.47
|
| Rate for Payer: Blue Shield of California EPN |
$815.29
|
| Rate for Payer: Cash Price |
$111.65
|
| Rate for Payer: Cash Price |
$111.65
|
| Rate for Payer: Cigna of CA HMO/PPO |
$131.95
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$215.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$158.12
|
| Rate for Payer: Dignity Health Senior |
$143.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$131.95
|
| Rate for Payer: EPIC Health Plan Medicare |
$143.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$125.66
|
| Rate for Payer: Heritage Provider Network Senior |
$125.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$161.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$143.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$96.83
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$36.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$165.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$50.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$181.12
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$181.12
|
| Rate for Payer: Multiplan Commercial |
$152.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$143.75
|
| Rate for Payer: TriValley Medical Group Senior |
$143.75
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$155.26
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$155.26
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$215.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$158.12
|
| Rate for Payer: Vantage Medical Group Senior |
$143.75
|
|
|
HC LAB REF TISSUE CULTURE NEO BLOOD/BONE
|
Facility
|
IP
|
$203.00
|
|
|
Service Code
|
CPT 88237
|
| Hospital Charge Code |
900912791
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$36.74 |
| Max. Negotiated Rate |
$152.25 |
| Rate for Payer: Adventist Health Commercial |
$40.60
|
| Rate for Payer: Cash Price |
$111.65
|
| Rate for Payer: Heritage Provider Network Commercial |
$137.43
|
| Rate for Payer: Heritage Provider Network Senior |
$137.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$36.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$50.75
|
| Rate for Payer: Multiplan Commercial |
$152.25
|
|
|
HC LAB REF TISSUE CULTURE NEO SOLID TUMOR
|
Facility
|
IP
|
$237.00
|
|
|
Service Code
|
CPT 88239
|
| Hospital Charge Code |
900912792
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$42.90 |
| Max. Negotiated Rate |
$177.75 |
| Rate for Payer: Adventist Health Commercial |
$47.40
|
| Rate for Payer: Cash Price |
$130.35
|
| Rate for Payer: Heritage Provider Network Commercial |
$160.45
|
| Rate for Payer: Heritage Provider Network Senior |
$160.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$42.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$59.25
|
| Rate for Payer: Multiplan Commercial |
$177.75
|
|
|
HC LAB REF TISSUE CULTURE NEO SOLID TUMOR
|
Facility
|
OP
|
$237.00
|
|
|
Service Code
|
CPT 88239
|
| Hospital Charge Code |
900912792
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$42.90 |
| Max. Negotiated Rate |
$1,303.26 |
| Rate for Payer: Adventist Health Commercial |
$47.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$126.68
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$162.82
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$221.28
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$162.27
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$147.52
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,303.26
|
| Rate for Payer: Blue Shield of California Commercial |
$1,187.25
|
| Rate for Payer: Blue Shield of California EPN |
$952.27
|
| Rate for Payer: Cash Price |
$130.35
|
| Rate for Payer: Cash Price |
$130.35
|
| Rate for Payer: Cigna of CA HMO/PPO |
$154.05
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$221.28
|
| Rate for Payer: Dignity Health Medi-Cal |
$162.27
|
| Rate for Payer: Dignity Health Senior |
$147.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$154.05
|
| Rate for Payer: EPIC Health Plan Medicare |
$147.52
|
| Rate for Payer: Heritage Provider Network Commercial |
$146.70
|
| Rate for Payer: Heritage Provider Network Senior |
$146.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$212.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$147.52
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$113.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$42.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$169.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$59.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$185.88
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$185.88
|
| Rate for Payer: Multiplan Commercial |
$177.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$147.52
|
| Rate for Payer: TriValley Medical Group Senior |
$147.52
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$159.32
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$159.32
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$221.28
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$162.27
|
| Rate for Payer: Vantage Medical Group Senior |
$147.52
|
|
|
HC LAB REF TISSUE CULTURE SKIN/SOLID TISS
|
Facility
|
IP
|
$151.00
|
|
|
Service Code
|
CPT 88233
|
| Hospital Charge Code |
900912790
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$27.33 |
| Max. Negotiated Rate |
$113.25 |
| Rate for Payer: Adventist Health Commercial |
$30.20
|
| Rate for Payer: Cash Price |
$83.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$102.23
|
| Rate for Payer: Heritage Provider Network Senior |
$102.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$27.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$37.75
|
| Rate for Payer: Multiplan Commercial |
$113.25
|
|
|
HC LAB REF TISSUE CULTURE SKIN/SOLID TISS
|
Facility
|
OP
|
$151.00
|
|
|
Service Code
|
CPT 88233
|
| Hospital Charge Code |
900912790
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$27.33 |
| Max. Negotiated Rate |
$1,132.59 |
| Rate for Payer: Adventist Health Commercial |
$30.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$80.71
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$103.74
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$211.09
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$154.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$140.73
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,090.66
|
| Rate for Payer: Blue Shield of California Commercial |
$1,132.59
|
| Rate for Payer: Blue Shield of California EPN |
$908.43
|
| Rate for Payer: Cash Price |
$83.05
|
| Rate for Payer: Cash Price |
$83.05
|
| Rate for Payer: Cigna of CA HMO/PPO |
$98.15
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$211.09
|
| Rate for Payer: Dignity Health Medi-Cal |
$154.80
|
| Rate for Payer: Dignity Health Senior |
$140.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$98.15
|
| Rate for Payer: EPIC Health Plan Medicare |
$140.73
|
| Rate for Payer: Heritage Provider Network Commercial |
$93.47
|
| Rate for Payer: Heritage Provider Network Senior |
$93.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$202.63
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$140.73
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$72.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$27.33
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$161.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$37.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$177.32
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$177.32
|
| Rate for Payer: Multiplan Commercial |
$113.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$140.73
|
| Rate for Payer: TriValley Medical Group Senior |
$140.73
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$151.99
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$151.99
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$211.09
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$154.80
|
| Rate for Payer: Vantage Medical Group Senior |
$140.73
|
|
|
HC LAB REF TISSUE INSITU INTERP & REPORT
|
Facility
|
IP
|
$54.00
|
|
|
Service Code
|
CPT 88365
|
| Hospital Charge Code |
900910703
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$9.77 |
| Max. Negotiated Rate |
$40.50 |
| Rate for Payer: Adventist Health Commercial |
$10.80
|
| Rate for Payer: Cash Price |
$29.70
|
| Rate for Payer: Heritage Provider Network Commercial |
$36.56
|
| Rate for Payer: Heritage Provider Network Senior |
$36.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.50
|
| Rate for Payer: Multiplan Commercial |
$40.50
|
|
|
HC LAB REF TISSUE INSITU INTERP & REPORT
|
Facility
|
OP
|
$54.00
|
|
|
Service Code
|
CPT 88365
|
| Hospital Charge Code |
900910703
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$9.77 |
| Max. Negotiated Rate |
$366.48 |
| Rate for Payer: Adventist Health Commercial |
$10.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$28.86
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$37.10
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$326.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$239.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$217.73
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$88.32
|
| Rate for Payer: Blue Shield of California Commercial |
$366.48
|
| Rate for Payer: Blue Shield of California EPN |
$294.71
|
| Rate for Payer: Cash Price |
$29.70
|
| Rate for Payer: Cash Price |
$29.70
|
| Rate for Payer: Cigna of CA HMO/PPO |
$35.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$326.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$239.50
|
| Rate for Payer: Dignity Health Senior |
$217.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$35.10
|
| Rate for Payer: EPIC Health Plan Medicare |
$217.73
|
| Rate for Payer: Heritage Provider Network Commercial |
$33.43
|
| Rate for Payer: Heritage Provider Network Senior |
$33.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$141.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$217.73
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$25.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.77
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$250.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$274.34
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$274.34
|
| Rate for Payer: Multiplan Commercial |
$40.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$217.73
|
| Rate for Payer: TriValley Medical Group Senior |
$217.73
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$164.51
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$164.51
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$326.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$239.50
|
| Rate for Payer: Vantage Medical Group Senior |
$217.73
|
|
|
HC LAB REF TRYPSINOGEN
|
Facility
|
OP
|
$70.00
|
|
|
Service Code
|
CPT 83519
|
| Hospital Charge Code |
900910733
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.67 |
| Max. Negotiated Rate |
$123.36 |
| Rate for Payer: Adventist Health Commercial |
$14.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$37.41
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$48.09
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$27.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$20.24
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$18.40
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$123.36
|
| Rate for Payer: Blue Shield of California Commercial |
$108.75
|
| Rate for Payer: Blue Shield of California EPN |
$87.23
|
| Rate for Payer: Cash Price |
$38.50
|
| Rate for Payer: Cash Price |
$38.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$45.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$27.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$20.24
|
| Rate for Payer: Dignity Health Senior |
$18.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$45.50
|
| Rate for Payer: EPIC Health Plan Medicare |
$18.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$43.33
|
| Rate for Payer: Heritage Provider Network Senior |
$43.33
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$19.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$18.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$33.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$17.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$23.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$23.18
|
| Rate for Payer: Multiplan Commercial |
$52.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$18.40
|
| Rate for Payer: TriValley Medical Group Senior |
$18.40
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$19.87
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$19.87
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$27.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$20.24
|
| Rate for Payer: Vantage Medical Group Senior |
$18.40
|
|
