|
HC LAB REF ANTI-EPITHELIAL AB
|
Facility
IP
|
$17.26
|
|
|
Service Code
|
CPT 86256
|
| Hospital Charge Code |
900911410
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.12 |
| Max. Negotiated Rate |
$12.94 |
| Rate for Payer: Adventist Health Commercial |
$3.45
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$11.86
|
| Rate for Payer: Cash Price |
$7.77
|
| Rate for Payer: Heritage Provider Network Commercial |
$11.69
|
| Rate for Payer: Heritage Provider Network Senior |
$11.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.32
|
| Rate for Payer: Multiplan Commercial |
$12.94
|
|
|
HC LAB REF ANTI-EPITHELIAL AB
|
Facility
OP
|
$17.26
|
|
|
Service Code
|
CPT 86256
|
| Hospital Charge Code |
900911410
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.12 |
| Max. Negotiated Rate |
$100.92 |
| Rate for Payer: Adventist Health Commercial |
$3.45
|
| Rate for Payer: Aetna of CA Gatekeeper |
$35.07
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$11.86
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$18.08
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$13.26
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$12.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$100.92
|
| Rate for Payer: Blue Shield of California Commercial |
$94.14
|
| Rate for Payer: Blue Shield of California EPN |
$73.59
|
| Rate for Payer: Cash Price |
$7.77
|
| Rate for Payer: Cash Price |
$7.77
|
| Rate for Payer: Cigna of CA HMO/PPO |
$11.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$18.08
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.26
|
| Rate for Payer: Dignity Health Senior |
$12.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.22
|
| Rate for Payer: EPIC Health Plan Medicare |
$12.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$10.68
|
| Rate for Payer: Heritage Provider Network Senior |
$10.68
|
| Rate for Payer: Humana Medicare |
$12.05
|
| Rate for Payer: IEHP Medi-Cal |
$16.21
|
| Rate for Payer: IEHP Medicare Advantage |
$12.05
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$22.90
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$15.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$15.18
|
| Rate for Payer: Multiplan Commercial |
$12.94
|
| Rate for Payer: TriValley Medical Group Commercial |
$12.05
|
| Rate for Payer: TriValley Medical Group Senior |
$12.05
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$13.02
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$13.02
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$18.08
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.26
|
| Rate for Payer: Vantage Medical Group Senior |
$12.05
|
|
|
HC LAB REF ANTI-PM1 AB
|
Facility
OP
|
$90.00
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
900911424
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.29 |
| Max. Negotiated Rate |
$140.09 |
| Rate for Payer: Adventist Health Commercial |
$18.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$47.62
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$61.83
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$26.90
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$17.93
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$127.47
|
| Rate for Payer: Blue Shield of California Commercial |
$140.09
|
| Rate for Payer: Blue Shield of California EPN |
$109.51
|
| Rate for Payer: Cash Price |
$40.50
|
| Rate for Payer: Cash Price |
$40.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$58.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$26.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$19.72
|
| Rate for Payer: Dignity Health Senior |
$17.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$58.50
|
| Rate for Payer: EPIC Health Plan Medicare |
$17.93
|
| Rate for Payer: Heritage Provider Network Commercial |
$55.71
|
| Rate for Payer: Heritage Provider Network Senior |
$55.71
|
| Rate for Payer: Humana Medicare |
$17.93
|
| Rate for Payer: IEHP Medi-Cal |
$22.76
|
| Rate for Payer: IEHP Medicare Advantage |
$17.93
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$34.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$16.29
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$22.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$22.59
|
| Rate for Payer: Multiplan Commercial |
$67.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$17.93
|
| Rate for Payer: TriValley Medical Group Senior |
$17.93
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$19.37
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$19.37
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$26.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Vantage Medical Group Senior |
$17.93
|
|
|
HC LAB REF ANTI-PM1 AB
|
Facility
IP
|
$90.00
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
900911424
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.29 |
| Max. Negotiated Rate |
$67.50 |
| Rate for Payer: Adventist Health Commercial |
$18.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$61.83
|
| Rate for Payer: Cash Price |
$40.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$60.93
|
| Rate for Payer: Heritage Provider Network Senior |
$60.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$16.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.50
|
| Rate for Payer: Multiplan Commercial |
$67.50
|
|
|
HC LAB REF ASPERGILLUS AB
|
Facility
IP
|
$39.80
|
|
|
Service Code
|
CPT 86606
|
| Hospital Charge Code |
900911117
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.20 |
| Max. Negotiated Rate |
$29.85 |
| Rate for Payer: Adventist Health Commercial |
$7.96
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$27.34
|
| Rate for Payer: Cash Price |
$17.91
|
| Rate for Payer: Heritage Provider Network Commercial |
$26.94
|
| Rate for Payer: Heritage Provider Network Senior |
$26.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.95
|
| Rate for Payer: Multiplan Commercial |
$29.85
|
|
|
HC LAB REF ASPERGILLUS AB
|
Facility
OP
|
$39.80
|
|
|
Service Code
|
CPT 86606
|
| Hospital Charge Code |
900911117
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.20 |
| Max. Negotiated Rate |
$126.00 |
| Rate for Payer: Adventist Health Commercial |
$7.96
|
| Rate for Payer: Aetna of CA Gatekeeper |
$43.81
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$27.34
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$22.58
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$16.56
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$15.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$126.00
|
| Rate for Payer: Blue Shield of California Commercial |
$117.56
|
| Rate for Payer: Blue Shield of California EPN |
$91.90
|
| Rate for Payer: Cash Price |
$17.91
|
| Rate for Payer: Cash Price |
$17.91
|
| Rate for Payer: Cigna of CA HMO/PPO |
$25.87
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$22.58
|
| Rate for Payer: Dignity Health Medi-Cal |
$16.56
|
| Rate for Payer: Dignity Health Senior |
$15.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$25.87
|
| Rate for Payer: EPIC Health Plan Medicare |
$15.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$24.64
|
| Rate for Payer: Heritage Provider Network Senior |
$24.64
|
| Rate for Payer: Humana Medicare |
$15.05
|
| Rate for Payer: IEHP Medi-Cal |
$20.87
|
| Rate for Payer: IEHP Medicare Advantage |
$15.05
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$28.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7.20
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$17.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.95
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18.96
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18.96
|
| Rate for Payer: Multiplan Commercial |
$29.85
|
| Rate for Payer: TriValley Medical Group Commercial |
$15.05
|
| Rate for Payer: TriValley Medical Group Senior |
$15.05
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$16.26
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$16.26
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$22.58
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$16.56
|
| Rate for Payer: Vantage Medical Group Senior |
$15.05
|
|
|
HC LAB REF BIOTINADASE
|
Facility
IP
|
$24.16
|
|
|
Service Code
|
CPT 82261
|
| Hospital Charge Code |
900910727
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.37 |
| Max. Negotiated Rate |
$18.12 |
| Rate for Payer: Adventist Health Commercial |
$4.83
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$16.60
|
| Rate for Payer: Cash Price |
$10.87
|
| Rate for Payer: Heritage Provider Network Commercial |
$16.36
|
| Rate for Payer: Heritage Provider Network Senior |
$16.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.04
|
| Rate for Payer: Multiplan Commercial |
$18.12
|
|
|
HC LAB REF BIOTINADASE
|
Facility
OP
|
$24.16
|
|
|
Service Code
|
CPT 82261
|
| Hospital Charge Code |
900910727
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.37 |
| Max. Negotiated Rate |
$140.54 |
| Rate for Payer: Adventist Health Commercial |
$4.83
|
| Rate for Payer: Aetna of CA Gatekeeper |
$49.08
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$16.60
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$25.30
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$18.56
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$16.87
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$140.54
|
| Rate for Payer: Blue Shield of California Commercial |
$131.76
|
| Rate for Payer: Blue Shield of California EPN |
$103.00
|
| Rate for Payer: Cash Price |
$10.87
|
| Rate for Payer: Cash Price |
$10.87
|
| Rate for Payer: Cigna of CA HMO/PPO |
$15.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$25.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$18.56
|
| Rate for Payer: Dignity Health Senior |
$16.87
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.70
|
| Rate for Payer: EPIC Health Plan Medicare |
$16.87
|
| Rate for Payer: Heritage Provider Network Commercial |
$14.96
|
| Rate for Payer: Heritage Provider Network Senior |
$14.96
|
| Rate for Payer: Humana Medicare |
$16.87
|
| Rate for Payer: IEHP Medi-Cal |
$21.62
|
| Rate for Payer: IEHP Medicare Advantage |
$16.87
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$32.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.37
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$19.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.04
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$21.26
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$21.26
|
| Rate for Payer: Multiplan Commercial |
$18.12
|
| Rate for Payer: TriValley Medical Group Commercial |
$16.87
|
| Rate for Payer: TriValley Medical Group Senior |
$16.87
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$18.22
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$18.22
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$25.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$18.56
|
| Rate for Payer: Vantage Medical Group Senior |
$16.87
|
|
|
HC LAB REF BK VIRUS BY PCR
|
Facility
OP
|
$50.27
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
900912606
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$9.10 |
| Max. Negotiated Rate |
$284.23 |
| Rate for Payer: Adventist Health Commercial |
$10.05
|
| Rate for Payer: Aetna of CA Gatekeeper |
$102.11
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$34.54
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$52.64
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$38.60
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$35.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$284.23
|
| Rate for Payer: Blue Shield of California Commercial |
$274.13
|
| Rate for Payer: Blue Shield of California EPN |
$214.30
|
| Rate for Payer: Cash Price |
$22.62
|
| Rate for Payer: Cash Price |
$22.62
|
| Rate for Payer: Cigna of CA HMO/PPO |
$32.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$52.64
|
| Rate for Payer: Dignity Health Medi-Cal |
$38.60
|
| Rate for Payer: Dignity Health Senior |
$35.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$32.68
|
| Rate for Payer: EPIC Health Plan Medicare |
$35.09
|
| Rate for Payer: Heritage Provider Network Commercial |
$31.12
|
| Rate for Payer: Heritage Provider Network Senior |
$31.12
|
| Rate for Payer: Humana Medicare |
$35.09
|
| Rate for Payer: IEHP Medi-Cal |
$47.03
|
| Rate for Payer: IEHP Medicare Advantage |
$35.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$66.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$41.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.57
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$44.21
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$44.21
|
| Rate for Payer: Multiplan Commercial |
$37.70
|
| Rate for Payer: TriValley Medical Group Commercial |
$35.09
|
| Rate for Payer: TriValley Medical Group Senior |
$35.09
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$37.90
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$37.90
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$52.64
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$38.60
|
| Rate for Payer: Vantage Medical Group Senior |
$35.09
|
|
|
HC LAB REF BK VIRUS BY PCR
|
Facility
IP
|
$50.27
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
900912606
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$9.10 |
| Max. Negotiated Rate |
$37.70 |
| Rate for Payer: Adventist Health Commercial |
$10.05
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$34.54
|
| Rate for Payer: Cash Price |
$22.62
|
| Rate for Payer: Heritage Provider Network Commercial |
$34.03
|
| Rate for Payer: Heritage Provider Network Senior |
$34.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.57
|
| Rate for Payer: Multiplan Commercial |
$37.70
|
|
|
HC LAB REF BK VIRUS QUANT PCR, URINE
|
Facility
OP
|
$61.35
|
|
|
Service Code
|
CPT 87799
|
| Hospital Charge Code |
900912695
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.10 |
| Max. Negotiated Rate |
$334.56 |
| Rate for Payer: Adventist Health Commercial |
$12.27
|
| Rate for Payer: Aetna of CA Gatekeeper |
$124.63
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$42.15
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$64.26
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$47.12
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$42.84
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$216.56
|
| Rate for Payer: Blue Shield of California Commercial |
$334.56
|
| Rate for Payer: Blue Shield of California EPN |
$261.54
|
| Rate for Payer: Cash Price |
$27.61
|
| Rate for Payer: Cash Price |
$27.61
|
| Rate for Payer: Cigna of CA HMO/PPO |
$39.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$64.26
|
| Rate for Payer: Dignity Health Medi-Cal |
$47.12
|
| Rate for Payer: Dignity Health Senior |
$42.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$39.88
|
| Rate for Payer: EPIC Health Plan Medicare |
$42.84
|
| Rate for Payer: Heritage Provider Network Commercial |
$37.98
|
| Rate for Payer: Heritage Provider Network Senior |
$37.98
|
| Rate for Payer: Humana Medicare |
$42.84
|
| Rate for Payer: IEHP Medi-Cal |
$59.40
|
| Rate for Payer: IEHP Medicare Advantage |
$42.84
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$81.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$50.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.34
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$53.98
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$53.98
|
| Rate for Payer: Multiplan Commercial |
$46.01
|
| Rate for Payer: TriValley Medical Group Commercial |
$42.84
|
| Rate for Payer: TriValley Medical Group Senior |
$42.84
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$46.27
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$46.27
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$64.26
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$47.12
|
| Rate for Payer: Vantage Medical Group Senior |
$42.84
|
|
|
HC LAB REF BK VIRUS QUANT PCR, URINE
|
Facility
IP
|
$61.35
|
|
|
Service Code
|
CPT 87799
|
| Hospital Charge Code |
900912695
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.10 |
| Max. Negotiated Rate |
$46.01 |
| Rate for Payer: Adventist Health Commercial |
$12.27
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$42.15
|
| Rate for Payer: Cash Price |
$27.61
|
| Rate for Payer: Heritage Provider Network Commercial |
$41.53
|
| Rate for Payer: Heritage Provider Network Senior |
$41.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.34
|
| Rate for Payer: Multiplan Commercial |
$46.01
|
|
|
HC LAB REF CALCIUM RANDOM URINE
|
Facility
IP
|
$8.64
|
|
|
Service Code
|
CPT 82340
|
| Hospital Charge Code |
900912784
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$1.56 |
| Max. Negotiated Rate |
$6.48 |
| Rate for Payer: Adventist Health Commercial |
$1.73
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$5.94
|
| Rate for Payer: Cash Price |
$3.89
|
| Rate for Payer: Heritage Provider Network Commercial |
$5.85
|
| Rate for Payer: Heritage Provider Network Senior |
$5.85
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.16
|
| Rate for Payer: Multiplan Commercial |
$6.48
|
|
|
HC LAB REF CALCIUM RANDOM URINE
|
Facility
OP
|
$8.64
|
|
|
Service Code
|
CPT 82340
|
| Hospital Charge Code |
900912784
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$1.56 |
| Max. Negotiated Rate |
$50.49 |
| Rate for Payer: Adventist Health Commercial |
$1.73
|
| Rate for Payer: Aetna of CA Gatekeeper |
$17.56
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$5.94
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$9.04
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$6.63
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$6.03
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$50.49
|
| Rate for Payer: Blue Shield of California Commercial |
$47.12
|
| Rate for Payer: Blue Shield of California EPN |
$36.84
|
| Rate for Payer: Cash Price |
$3.89
|
| Rate for Payer: Cash Price |
$3.89
|
| Rate for Payer: Cigna of CA HMO/PPO |
$5.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9.04
|
| Rate for Payer: Dignity Health Medi-Cal |
$6.63
|
| Rate for Payer: Dignity Health Senior |
$6.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.62
|
| Rate for Payer: EPIC Health Plan Medicare |
$6.03
|
| Rate for Payer: Heritage Provider Network Commercial |
$5.35
|
| Rate for Payer: Heritage Provider Network Senior |
$5.35
|
| Rate for Payer: Humana Medicare |
$6.03
|
| Rate for Payer: IEHP Medi-Cal |
$8.36
|
| Rate for Payer: IEHP Medicare Advantage |
$6.03
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$11.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.56
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$7.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$7.60
|
| Rate for Payer: Multiplan Commercial |
$6.48
|
| Rate for Payer: TriValley Medical Group Commercial |
$6.03
|
| Rate for Payer: TriValley Medical Group Senior |
$6.03
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$6.52
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$6.52
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$9.04
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6.63
|
| Rate for Payer: Vantage Medical Group Senior |
$6.03
|
|
|
HC LAB REF CALCIUM URINE
|
Facility
IP
|
$8.64
|
|
|
Service Code
|
CPT 82340
|
| Hospital Charge Code |
900910213
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$1.56 |
| Max. Negotiated Rate |
$6.48 |
| Rate for Payer: Adventist Health Commercial |
$1.73
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$5.94
|
| Rate for Payer: Cash Price |
$3.89
|
| Rate for Payer: Heritage Provider Network Commercial |
$5.85
|
| Rate for Payer: Heritage Provider Network Senior |
$5.85
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.16
|
| Rate for Payer: Multiplan Commercial |
$6.48
|
|
|
HC LAB REF CALCIUM URINE
|
Facility
OP
|
$8.64
|
|
|
Service Code
|
CPT 82340
|
| Hospital Charge Code |
900910213
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$1.56 |
| Max. Negotiated Rate |
$50.49 |
| Rate for Payer: Adventist Health Commercial |
$1.73
|
| Rate for Payer: Aetna of CA Gatekeeper |
$17.56
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$5.94
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$9.04
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$6.63
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$6.03
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$50.49
|
| Rate for Payer: Blue Shield of California Commercial |
$47.12
|
| Rate for Payer: Blue Shield of California EPN |
$36.84
|
| Rate for Payer: Cash Price |
$3.89
|
| Rate for Payer: Cash Price |
$3.89
|
| Rate for Payer: Cigna of CA HMO/PPO |
$5.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9.04
|
| Rate for Payer: Dignity Health Medi-Cal |
$6.63
|
| Rate for Payer: Dignity Health Senior |
$6.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.62
|
| Rate for Payer: EPIC Health Plan Medicare |
$6.03
|
| Rate for Payer: Heritage Provider Network Commercial |
$5.35
|
| Rate for Payer: Heritage Provider Network Senior |
$5.35
|
| Rate for Payer: Humana Medicare |
$6.03
|
| Rate for Payer: IEHP Medi-Cal |
$8.36
|
| Rate for Payer: IEHP Medicare Advantage |
$6.03
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$11.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.56
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$7.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$7.60
|
| Rate for Payer: Multiplan Commercial |
$6.48
|
| Rate for Payer: TriValley Medical Group Commercial |
$6.03
|
| Rate for Payer: TriValley Medical Group Senior |
$6.03
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$6.52
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$6.52
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$9.04
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6.63
|
| Rate for Payer: Vantage Medical Group Senior |
$6.03
|
|
|
HC LAB REF CALIFORNIA ENCEPH AB IGG
|
Facility
IP
|
$18.75
|
|
|
Service Code
|
CPT 86651
|
| Hospital Charge Code |
900911466
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.39 |
| Max. Negotiated Rate |
$14.06 |
| Rate for Payer: Adventist Health Commercial |
$3.75
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$12.88
|
| Rate for Payer: Cash Price |
$8.44
|
| Rate for Payer: Heritage Provider Network Commercial |
$12.69
|
| Rate for Payer: Heritage Provider Network Senior |
$12.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.69
|
| Rate for Payer: Multiplan Commercial |
$14.06
|
|
|
HC LAB REF CALIFORNIA ENCEPH AB IGG
|
Facility
OP
|
$18.75
|
|
|
Service Code
|
CPT 86651
|
| Hospital Charge Code |
900911466
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.39 |
| Max. Negotiated Rate |
$110.39 |
| Rate for Payer: Adventist Health Commercial |
$3.75
|
| Rate for Payer: Aetna of CA Gatekeeper |
$38.38
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$12.88
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$19.78
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$14.51
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$13.19
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$110.39
|
| Rate for Payer: Blue Shield of California Commercial |
$103.02
|
| Rate for Payer: Blue Shield of California EPN |
$80.54
|
| Rate for Payer: Cash Price |
$8.44
|
| Rate for Payer: Cash Price |
$8.44
|
| Rate for Payer: Cigna of CA HMO/PPO |
$12.19
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.78
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.51
|
| Rate for Payer: Dignity Health Senior |
$13.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.19
|
| Rate for Payer: EPIC Health Plan Medicare |
$13.19
|
| Rate for Payer: Heritage Provider Network Commercial |
$11.61
|
| Rate for Payer: Heritage Provider Network Senior |
$11.61
|
| Rate for Payer: Humana Medicare |
$13.19
|
| Rate for Payer: IEHP Medi-Cal |
$18.28
|
| Rate for Payer: IEHP Medicare Advantage |
$13.19
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$25.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.39
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.69
|
| 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 |
$14.06
|
| 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 |
$19.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.51
|
| Rate for Payer: Vantage Medical Group Senior |
$13.19
|
|
|
HC LAB REF CALIFORNIA ENCEPH AB IGM
|
Facility
OP
|
$18.75
|
|
|
Service Code
|
CPT 86651
|
| Hospital Charge Code |
900912654
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.39 |
| Max. Negotiated Rate |
$110.39 |
| Rate for Payer: Adventist Health Commercial |
$3.75
|
| Rate for Payer: Aetna of CA Gatekeeper |
$38.38
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$12.88
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$19.78
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$14.51
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$13.19
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$110.39
|
| Rate for Payer: Blue Shield of California Commercial |
$103.02
|
| Rate for Payer: Blue Shield of California EPN |
$80.54
|
| Rate for Payer: Cash Price |
$8.44
|
| Rate for Payer: Cash Price |
$8.44
|
| Rate for Payer: Cigna of CA HMO/PPO |
$12.19
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.78
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.51
|
| Rate for Payer: Dignity Health Senior |
$13.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.19
|
| Rate for Payer: EPIC Health Plan Medicare |
$13.19
|
| Rate for Payer: Heritage Provider Network Commercial |
$11.61
|
| Rate for Payer: Heritage Provider Network Senior |
$11.61
|
| Rate for Payer: Humana Medicare |
$13.19
|
| Rate for Payer: IEHP Medi-Cal |
$18.28
|
| Rate for Payer: IEHP Medicare Advantage |
$13.19
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$25.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.39
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.69
|
| 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 |
$14.06
|
| 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 |
$19.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.51
|
| Rate for Payer: Vantage Medical Group Senior |
$13.19
|
|
|
HC LAB REF CALIFORNIA ENCEPH AB IGM
|
Facility
IP
|
$18.75
|
|
|
Service Code
|
CPT 86651
|
| Hospital Charge Code |
900912654
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.39 |
| Max. Negotiated Rate |
$14.06 |
| Rate for Payer: Adventist Health Commercial |
$3.75
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$12.88
|
| Rate for Payer: Cash Price |
$8.44
|
| Rate for Payer: Heritage Provider Network Commercial |
$12.69
|
| Rate for Payer: Heritage Provider Network Senior |
$12.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.69
|
| Rate for Payer: Multiplan Commercial |
$14.06
|
|
|
HC LAB REF CHLAMYDIA PNEUMONIA
|
Facility
OP
|
$74.20
|
|
|
Service Code
|
CPT 87486
|
| Hospital Charge Code |
900912516
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$13.43 |
| Max. Negotiated Rate |
$284.23 |
| Rate for Payer: Adventist Health Commercial |
$14.84
|
| Rate for Payer: Aetna of CA Gatekeeper |
$102.11
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$50.98
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$52.64
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$38.60
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$35.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$284.23
|
| Rate for Payer: Blue Shield of California Commercial |
$274.13
|
| Rate for Payer: Blue Shield of California EPN |
$214.30
|
| Rate for Payer: Cash Price |
$33.39
|
| Rate for Payer: Cash Price |
$33.39
|
| Rate for Payer: Cigna of CA HMO/PPO |
$48.23
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$52.64
|
| Rate for Payer: Dignity Health Medi-Cal |
$38.60
|
| Rate for Payer: Dignity Health Senior |
$35.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$48.23
|
| Rate for Payer: EPIC Health Plan Medicare |
$35.09
|
| Rate for Payer: Heritage Provider Network Commercial |
$45.93
|
| Rate for Payer: Heritage Provider Network Senior |
$45.93
|
| Rate for Payer: Humana Medicare |
$35.09
|
| Rate for Payer: IEHP Medi-Cal |
$48.66
|
| Rate for Payer: IEHP Medicare Advantage |
$35.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$66.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13.43
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$41.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18.55
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$44.21
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$44.21
|
| Rate for Payer: Multiplan Commercial |
$55.65
|
| Rate for Payer: TriValley Medical Group Commercial |
$35.09
|
| Rate for Payer: TriValley Medical Group Senior |
$35.09
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$37.90
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$37.90
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$52.64
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$38.60
|
| Rate for Payer: Vantage Medical Group Senior |
$35.09
|
|
|
HC LAB REF CHLAMYDIA PNEUMONIA
|
Facility
IP
|
$74.20
|
|
|
Service Code
|
CPT 87486
|
| Hospital Charge Code |
900912516
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$13.43 |
| Max. Negotiated Rate |
$55.65 |
| Rate for Payer: Adventist Health Commercial |
$14.84
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$50.98
|
| Rate for Payer: Cash Price |
$33.39
|
| Rate for Payer: Heritage Provider Network Commercial |
$50.23
|
| Rate for Payer: Heritage Provider Network Senior |
$50.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18.55
|
| Rate for Payer: Multiplan Commercial |
$55.65
|
|
|
HC LAB REF CHOLINESTERASE
|
Facility
OP
|
$23.00
|
|
|
Service Code
|
CPT 82480
|
| Hospital Charge Code |
900911118
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.16 |
| Max. Negotiated Rate |
$65.93 |
| Rate for Payer: Adventist Health Commercial |
$4.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$22.94
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$15.80
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$11.80
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$8.66
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$7.87
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$65.93
|
| Rate for Payer: Blue Shield of California Commercial |
$61.55
|
| Rate for Payer: Blue Shield of California EPN |
$48.11
|
| Rate for Payer: Cash Price |
$10.35
|
| Rate for Payer: Cash Price |
$10.35
|
| Rate for Payer: Cigna of CA HMO/PPO |
$14.95
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$8.66
|
| Rate for Payer: Dignity Health Senior |
$7.87
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.95
|
| Rate for Payer: EPIC Health Plan Medicare |
$7.87
|
| Rate for Payer: Heritage Provider Network Commercial |
$14.24
|
| Rate for Payer: Heritage Provider Network Senior |
$14.24
|
| Rate for Payer: Humana Medicare |
$7.87
|
| Rate for Payer: IEHP Medi-Cal |
$10.92
|
| Rate for Payer: IEHP Medicare Advantage |
$7.87
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$14.95
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.16
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9.92
|
| Rate for Payer: Multiplan Commercial |
$17.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$7.87
|
| Rate for Payer: TriValley Medical Group Senior |
$7.87
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$8.50
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$8.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.66
|
| Rate for Payer: Vantage Medical Group Senior |
$7.87
|
|
|
HC LAB REF CHOLINESTERASE
|
Facility
IP
|
$23.00
|
|
|
Service Code
|
CPT 82480
|
| Hospital Charge Code |
900911118
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.16 |
| Max. Negotiated Rate |
$17.25 |
| Rate for Payer: Adventist Health Commercial |
$4.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$15.80
|
| Rate for Payer: Cash Price |
$10.35
|
| Rate for Payer: Heritage Provider Network Commercial |
$15.57
|
| Rate for Payer: Heritage Provider Network Senior |
$15.57
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.75
|
| Rate for Payer: Multiplan Commercial |
$17.25
|
|
|
HC LAB REF CHORIONIC VILLUS
|
Facility
OP
|
$257.48
|
|
|
Service Code
|
CPT 88267
|
| Hospital Charge Code |
900912555
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$46.60 |
| Max. Negotiated Rate |
$1,504.68 |
| Rate for Payer: Adventist Health Commercial |
$51.50
|
| Rate for Payer: Aetna of CA Gatekeeper |
$523.02
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$176.89
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$282.86
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$207.43
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$188.57
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,504.68
|
| Rate for Payer: Blue Shield of California Commercial |
$1,404.04
|
| Rate for Payer: Blue Shield of California EPN |
$1,097.61
|
| Rate for Payer: Cash Price |
$115.87
|
| Rate for Payer: Cash Price |
$115.87
|
| Rate for Payer: Cigna of CA HMO/PPO |
$167.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$282.86
|
| Rate for Payer: Dignity Health Medi-Cal |
$207.43
|
| Rate for Payer: Dignity Health Senior |
$188.57
|
| Rate for Payer: EPIC Health Plan Commercial |
$167.36
|
| Rate for Payer: EPIC Health Plan Medicare |
$188.57
|
| Rate for Payer: Heritage Provider Network Commercial |
$159.38
|
| Rate for Payer: Heritage Provider Network Senior |
$159.38
|
| Rate for Payer: Humana Medicare |
$188.57
|
| Rate for Payer: IEHP Medi-Cal |
$249.29
|
| Rate for Payer: IEHP Medicare Advantage |
$188.57
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$358.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$46.60
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$222.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$64.37
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$237.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$237.60
|
| Rate for Payer: Multiplan Commercial |
$193.11
|
| Rate for Payer: TriValley Medical Group Commercial |
$188.57
|
| Rate for Payer: TriValley Medical Group Senior |
$188.57
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$203.65
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$203.65
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$282.86
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$207.43
|
| Rate for Payer: Vantage Medical Group Senior |
$188.57
|
|
