|
HC LAB REF ENTEROVIRUS AB COXSACKIE A7
|
Facility
OP
|
$18.14
|
|
|
Service Code
|
CPT 86658
|
| Hospital Charge Code |
900912729
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.28 |
| Max. Negotiated Rate |
$110.39 |
| Rate for Payer: Adventist Health Commercial |
$3.63
|
| Rate for Payer: Aetna of CA Gatekeeper |
$37.92
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$12.46
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$19.54
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$14.33
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$13.03
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$110.39
|
| Rate for Payer: Blue Shield of California Commercial |
$101.74
|
| Rate for Payer: Blue Shield of California EPN |
$79.53
|
| Rate for Payer: Cash Price |
$8.16
|
| Rate for Payer: Cash Price |
$8.16
|
| Rate for Payer: Cigna of CA HMO/PPO |
$11.79
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.54
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.33
|
| Rate for Payer: Dignity Health Senior |
$13.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.79
|
| Rate for Payer: EPIC Health Plan Medicare |
$13.03
|
| Rate for Payer: Heritage Provider Network Commercial |
$11.23
|
| Rate for Payer: Heritage Provider Network Senior |
$11.23
|
| Rate for Payer: Humana Medicare |
$13.03
|
| Rate for Payer: IEHP Medi-Cal |
$18.06
|
| Rate for Payer: IEHP Medicare Advantage |
$13.03
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$24.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.54
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16.42
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16.42
|
| Rate for Payer: Multiplan Commercial |
$13.60
|
| Rate for Payer: TriValley Medical Group Commercial |
$13.03
|
| Rate for Payer: TriValley Medical Group Senior |
$13.03
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$14.08
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$14.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.54
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.33
|
| Rate for Payer: Vantage Medical Group Senior |
$13.03
|
|
|
HC LAB REF ENTEROVIRUS AB COXSACKIE A9
|
Facility
OP
|
$18.14
|
|
|
Service Code
|
CPT 86658
|
| Hospital Charge Code |
900912730
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.28 |
| Max. Negotiated Rate |
$110.39 |
| Rate for Payer: Adventist Health Commercial |
$3.63
|
| Rate for Payer: Aetna of CA Gatekeeper |
$37.92
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$12.46
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$19.54
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$14.33
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$13.03
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$110.39
|
| Rate for Payer: Blue Shield of California Commercial |
$101.74
|
| Rate for Payer: Blue Shield of California EPN |
$79.53
|
| Rate for Payer: Cash Price |
$8.16
|
| Rate for Payer: Cash Price |
$8.16
|
| Rate for Payer: Cigna of CA HMO/PPO |
$11.79
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.54
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.33
|
| Rate for Payer: Dignity Health Senior |
$13.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.79
|
| Rate for Payer: EPIC Health Plan Medicare |
$13.03
|
| Rate for Payer: Heritage Provider Network Commercial |
$11.23
|
| Rate for Payer: Heritage Provider Network Senior |
$11.23
|
| Rate for Payer: Humana Medicare |
$13.03
|
| Rate for Payer: IEHP Medi-Cal |
$18.06
|
| Rate for Payer: IEHP Medicare Advantage |
$13.03
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$24.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.54
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16.42
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16.42
|
| Rate for Payer: Multiplan Commercial |
$13.60
|
| Rate for Payer: TriValley Medical Group Commercial |
$13.03
|
| Rate for Payer: TriValley Medical Group Senior |
$13.03
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$14.08
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$14.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.54
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.33
|
| Rate for Payer: Vantage Medical Group Senior |
$13.03
|
|
|
HC LAB REF ENTEROVIRUS AB COXSACKIE A9
|
Facility
IP
|
$18.14
|
|
|
Service Code
|
CPT 86658
|
| Hospital Charge Code |
900912730
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.28 |
| Max. Negotiated Rate |
$13.60 |
| Rate for Payer: Adventist Health Commercial |
$3.63
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$12.46
|
| Rate for Payer: Cash Price |
$8.16
|
| Rate for Payer: Heritage Provider Network Commercial |
$12.28
|
| Rate for Payer: Heritage Provider Network Senior |
$12.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.54
|
| Rate for Payer: Multiplan Commercial |
$13.60
|
|
|
HC LAB REF ENTEROVIRUS AB COXSACKIE B1
|
Facility
OP
|
$18.14
|
|
|
Service Code
|
CPT 86658
|
| Hospital Charge Code |
900911762
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.28 |
| Max. Negotiated Rate |
$110.39 |
| Rate for Payer: Adventist Health Commercial |
$3.63
|
| Rate for Payer: Aetna of CA Gatekeeper |
$37.92
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$12.46
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$19.54
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$14.33
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$13.03
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$110.39
|
| Rate for Payer: Blue Shield of California Commercial |
$101.74
|
| Rate for Payer: Blue Shield of California EPN |
$79.53
|
| Rate for Payer: Cash Price |
$8.16
|
| Rate for Payer: Cash Price |
$8.16
|
| Rate for Payer: Cigna of CA HMO/PPO |
$11.79
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.54
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.33
|
| Rate for Payer: Dignity Health Senior |
$13.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.79
|
| Rate for Payer: EPIC Health Plan Medicare |
$13.03
|
| Rate for Payer: Heritage Provider Network Commercial |
$11.23
|
| Rate for Payer: Heritage Provider Network Senior |
$11.23
|
| Rate for Payer: Humana Medicare |
$13.03
|
| Rate for Payer: IEHP Medi-Cal |
$18.06
|
| Rate for Payer: IEHP Medicare Advantage |
$13.03
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$24.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.54
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16.42
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16.42
|
| Rate for Payer: Multiplan Commercial |
$13.60
|
| Rate for Payer: TriValley Medical Group Commercial |
$13.03
|
| Rate for Payer: TriValley Medical Group Senior |
$13.03
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$14.08
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$14.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.54
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.33
|
| Rate for Payer: Vantage Medical Group Senior |
$13.03
|
|
|
HC LAB REF ENTEROVIRUS AB COXSACKIE B1
|
Facility
IP
|
$18.14
|
|
|
Service Code
|
CPT 86658
|
| Hospital Charge Code |
900911762
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.28 |
| Max. Negotiated Rate |
$13.60 |
| Rate for Payer: Adventist Health Commercial |
$3.63
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$12.46
|
| Rate for Payer: Cash Price |
$8.16
|
| Rate for Payer: Heritage Provider Network Commercial |
$12.28
|
| Rate for Payer: Heritage Provider Network Senior |
$12.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.54
|
| Rate for Payer: Multiplan Commercial |
$13.60
|
|
|
HC LAB REF ENTEROVIRUS AB COXSACKIE B2
|
Facility
OP
|
$18.14
|
|
|
Service Code
|
CPT 86658
|
| Hospital Charge Code |
900912731
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.28 |
| Max. Negotiated Rate |
$110.39 |
| Rate for Payer: Adventist Health Commercial |
$3.63
|
| Rate for Payer: Aetna of CA Gatekeeper |
$37.92
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$12.46
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$19.54
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$14.33
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$13.03
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$110.39
|
| Rate for Payer: Blue Shield of California Commercial |
$101.74
|
| Rate for Payer: Blue Shield of California EPN |
$79.53
|
| Rate for Payer: Cash Price |
$8.16
|
| Rate for Payer: Cash Price |
$8.16
|
| Rate for Payer: Cigna of CA HMO/PPO |
$11.79
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.54
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.33
|
| Rate for Payer: Dignity Health Senior |
$13.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.79
|
| Rate for Payer: EPIC Health Plan Medicare |
$13.03
|
| Rate for Payer: Heritage Provider Network Commercial |
$11.23
|
| Rate for Payer: Heritage Provider Network Senior |
$11.23
|
| Rate for Payer: Humana Medicare |
$13.03
|
| Rate for Payer: IEHP Medi-Cal |
$18.06
|
| Rate for Payer: IEHP Medicare Advantage |
$13.03
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$24.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.54
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16.42
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16.42
|
| Rate for Payer: Multiplan Commercial |
$13.60
|
| Rate for Payer: TriValley Medical Group Commercial |
$13.03
|
| Rate for Payer: TriValley Medical Group Senior |
$13.03
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$14.08
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$14.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.54
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.33
|
| Rate for Payer: Vantage Medical Group Senior |
$13.03
|
|
|
HC LAB REF ENTEROVIRUS AB COXSACKIE B2
|
Facility
IP
|
$18.14
|
|
|
Service Code
|
CPT 86658
|
| Hospital Charge Code |
900912731
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.28 |
| Max. Negotiated Rate |
$13.60 |
| Rate for Payer: Adventist Health Commercial |
$3.63
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$12.46
|
| Rate for Payer: Cash Price |
$8.16
|
| Rate for Payer: Heritage Provider Network Commercial |
$12.28
|
| Rate for Payer: Heritage Provider Network Senior |
$12.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.54
|
| Rate for Payer: Multiplan Commercial |
$13.60
|
|
|
HC LAB REF ENTEROVIRUS AB COXSACKIE B3
|
Facility
OP
|
$15.70
|
|
|
Service Code
|
CPT 86658
|
| Hospital Charge Code |
900912733
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.84 |
| Max. Negotiated Rate |
$110.39 |
| Rate for Payer: Adventist Health Commercial |
$3.14
|
| Rate for Payer: Aetna of CA Gatekeeper |
$37.92
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$10.79
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$19.54
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$14.33
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$13.03
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$110.39
|
| Rate for Payer: Blue Shield of California Commercial |
$101.74
|
| Rate for Payer: Blue Shield of California EPN |
$79.53
|
| Rate for Payer: Cash Price |
$7.07
|
| Rate for Payer: Cash Price |
$7.07
|
| Rate for Payer: Cigna of CA HMO/PPO |
$10.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.54
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.33
|
| Rate for Payer: Dignity Health Senior |
$13.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.20
|
| Rate for Payer: EPIC Health Plan Medicare |
$13.03
|
| Rate for Payer: Heritage Provider Network Commercial |
$9.72
|
| Rate for Payer: Heritage Provider Network Senior |
$9.72
|
| Rate for Payer: Humana Medicare |
$13.03
|
| Rate for Payer: IEHP Medi-Cal |
$18.06
|
| Rate for Payer: IEHP Medicare Advantage |
$13.03
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$24.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.84
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.92
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16.42
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16.42
|
| Rate for Payer: Multiplan Commercial |
$11.78
|
| Rate for Payer: TriValley Medical Group Commercial |
$13.03
|
| Rate for Payer: TriValley Medical Group Senior |
$13.03
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$14.08
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$14.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.54
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.33
|
| Rate for Payer: Vantage Medical Group Senior |
$13.03
|
|
|
HC LAB REF ENTEROVIRUS AB COXSACKIE B3
|
Facility
IP
|
$15.70
|
|
|
Service Code
|
CPT 86658
|
| Hospital Charge Code |
900912733
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.84 |
| Max. Negotiated Rate |
$11.78 |
| Rate for Payer: Adventist Health Commercial |
$3.14
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$10.79
|
| Rate for Payer: Cash Price |
$7.07
|
| Rate for Payer: Heritage Provider Network Commercial |
$10.63
|
| Rate for Payer: Heritage Provider Network Senior |
$10.63
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.92
|
| Rate for Payer: Multiplan Commercial |
$11.78
|
|
|
HC LAB REF ENTEROVIRUS AB COXSACKIE B4
|
Facility
OP
|
$18.14
|
|
|
Service Code
|
CPT 86658
|
| Hospital Charge Code |
900912734
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.28 |
| Max. Negotiated Rate |
$110.39 |
| Rate for Payer: Adventist Health Commercial |
$3.63
|
| Rate for Payer: Aetna of CA Gatekeeper |
$37.92
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$12.46
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$19.54
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$14.33
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$13.03
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$110.39
|
| Rate for Payer: Blue Shield of California Commercial |
$101.74
|
| Rate for Payer: Blue Shield of California EPN |
$79.53
|
| Rate for Payer: Cash Price |
$8.16
|
| Rate for Payer: Cash Price |
$8.16
|
| Rate for Payer: Cigna of CA HMO/PPO |
$11.79
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.54
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.33
|
| Rate for Payer: Dignity Health Senior |
$13.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.79
|
| Rate for Payer: EPIC Health Plan Medicare |
$13.03
|
| Rate for Payer: Heritage Provider Network Commercial |
$11.23
|
| Rate for Payer: Heritage Provider Network Senior |
$11.23
|
| Rate for Payer: Humana Medicare |
$13.03
|
| Rate for Payer: IEHP Medi-Cal |
$18.06
|
| Rate for Payer: IEHP Medicare Advantage |
$13.03
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$24.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.54
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16.42
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16.42
|
| Rate for Payer: Multiplan Commercial |
$13.60
|
| Rate for Payer: TriValley Medical Group Commercial |
$13.03
|
| Rate for Payer: TriValley Medical Group Senior |
$13.03
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$14.08
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$14.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.54
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.33
|
| Rate for Payer: Vantage Medical Group Senior |
$13.03
|
|
|
HC LAB REF ENTEROVIRUS AB COXSACKIE B4
|
Facility
IP
|
$18.14
|
|
|
Service Code
|
CPT 86658
|
| Hospital Charge Code |
900912734
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.28 |
| Max. Negotiated Rate |
$13.60 |
| Rate for Payer: Adventist Health Commercial |
$3.63
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$12.46
|
| Rate for Payer: Cash Price |
$8.16
|
| Rate for Payer: Heritage Provider Network Commercial |
$12.28
|
| Rate for Payer: Heritage Provider Network Senior |
$12.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.54
|
| Rate for Payer: Multiplan Commercial |
$13.60
|
|
|
HC LAB REF ENTEROVIRUS AB COXSACKIE B5
|
Facility
IP
|
$18.14
|
|
|
Service Code
|
CPT 86658
|
| Hospital Charge Code |
900912735
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.28 |
| Max. Negotiated Rate |
$13.60 |
| Rate for Payer: Adventist Health Commercial |
$3.63
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$12.46
|
| Rate for Payer: Cash Price |
$8.16
|
| Rate for Payer: Heritage Provider Network Commercial |
$12.28
|
| Rate for Payer: Heritage Provider Network Senior |
$12.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.54
|
| Rate for Payer: Multiplan Commercial |
$13.60
|
|
|
HC LAB REF ENTEROVIRUS AB COXSACKIE B5
|
Facility
OP
|
$18.14
|
|
|
Service Code
|
CPT 86658
|
| Hospital Charge Code |
900912735
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.28 |
| Max. Negotiated Rate |
$110.39 |
| Rate for Payer: Adventist Health Commercial |
$3.63
|
| Rate for Payer: Aetna of CA Gatekeeper |
$37.92
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$12.46
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$19.54
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$14.33
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$13.03
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$110.39
|
| Rate for Payer: Blue Shield of California Commercial |
$101.74
|
| Rate for Payer: Blue Shield of California EPN |
$79.53
|
| Rate for Payer: Cash Price |
$8.16
|
| Rate for Payer: Cash Price |
$8.16
|
| Rate for Payer: Cigna of CA HMO/PPO |
$11.79
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.54
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.33
|
| Rate for Payer: Dignity Health Senior |
$13.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.79
|
| Rate for Payer: EPIC Health Plan Medicare |
$13.03
|
| Rate for Payer: Heritage Provider Network Commercial |
$11.23
|
| Rate for Payer: Heritage Provider Network Senior |
$11.23
|
| Rate for Payer: Humana Medicare |
$13.03
|
| Rate for Payer: IEHP Medi-Cal |
$18.06
|
| Rate for Payer: IEHP Medicare Advantage |
$13.03
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$24.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.54
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16.42
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16.42
|
| Rate for Payer: Multiplan Commercial |
$13.60
|
| Rate for Payer: TriValley Medical Group Commercial |
$13.03
|
| Rate for Payer: TriValley Medical Group Senior |
$13.03
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$14.08
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$14.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.54
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.33
|
| Rate for Payer: Vantage Medical Group Senior |
$13.03
|
|
|
HC LAB REF ENTEROVIRUS AB COXSACKIE B6
|
Facility
OP
|
$18.14
|
|
|
Service Code
|
CPT 86658
|
| Hospital Charge Code |
900912736
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.28 |
| Max. Negotiated Rate |
$110.39 |
| Rate for Payer: Adventist Health Commercial |
$3.63
|
| Rate for Payer: Aetna of CA Gatekeeper |
$37.92
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$12.46
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$19.54
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$14.33
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$13.03
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$110.39
|
| Rate for Payer: Blue Shield of California Commercial |
$101.74
|
| Rate for Payer: Blue Shield of California EPN |
$79.53
|
| Rate for Payer: Cash Price |
$8.16
|
| Rate for Payer: Cash Price |
$8.16
|
| Rate for Payer: Cigna of CA HMO/PPO |
$11.79
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.54
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.33
|
| Rate for Payer: Dignity Health Senior |
$13.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.79
|
| Rate for Payer: EPIC Health Plan Medicare |
$13.03
|
| Rate for Payer: Heritage Provider Network Commercial |
$11.23
|
| Rate for Payer: Heritage Provider Network Senior |
$11.23
|
| Rate for Payer: Humana Medicare |
$13.03
|
| Rate for Payer: IEHP Medi-Cal |
$18.06
|
| Rate for Payer: IEHP Medicare Advantage |
$13.03
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$24.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.54
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16.42
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16.42
|
| Rate for Payer: Multiplan Commercial |
$13.60
|
| Rate for Payer: TriValley Medical Group Commercial |
$13.03
|
| Rate for Payer: TriValley Medical Group Senior |
$13.03
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$14.08
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$14.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.54
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.33
|
| Rate for Payer: Vantage Medical Group Senior |
$13.03
|
|
|
HC LAB REF ENTEROVIRUS AB COXSACKIE B6
|
Facility
IP
|
$18.14
|
|
|
Service Code
|
CPT 86658
|
| Hospital Charge Code |
900912736
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.28 |
| Max. Negotiated Rate |
$13.60 |
| Rate for Payer: Adventist Health Commercial |
$3.63
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$12.46
|
| Rate for Payer: Cash Price |
$8.16
|
| Rate for Payer: Heritage Provider Network Commercial |
$12.28
|
| Rate for Payer: Heritage Provider Network Senior |
$12.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.54
|
| Rate for Payer: Multiplan Commercial |
$13.60
|
|
|
HC LAB REF ENTEROVIRUS AB POLIO 1
|
Facility
OP
|
$25.42
|
|
|
Service Code
|
CPT 86658
|
| Hospital Charge Code |
900911777
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.60 |
| Max. Negotiated Rate |
$110.39 |
| Rate for Payer: Adventist Health Commercial |
$5.08
|
| Rate for Payer: Aetna of CA Gatekeeper |
$37.92
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$17.46
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$19.54
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$14.33
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$13.03
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$110.39
|
| Rate for Payer: Blue Shield of California Commercial |
$101.74
|
| Rate for Payer: Blue Shield of California EPN |
$79.53
|
| Rate for Payer: Cash Price |
$11.44
|
| Rate for Payer: Cash Price |
$11.44
|
| Rate for Payer: Cigna of CA HMO/PPO |
$16.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.54
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.33
|
| Rate for Payer: Dignity Health Senior |
$13.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.52
|
| Rate for Payer: EPIC Health Plan Medicare |
$13.03
|
| Rate for Payer: Heritage Provider Network Commercial |
$15.73
|
| Rate for Payer: Heritage Provider Network Senior |
$15.73
|
| Rate for Payer: Humana Medicare |
$13.03
|
| Rate for Payer: IEHP Medi-Cal |
$18.06
|
| Rate for Payer: IEHP Medicare Advantage |
$13.03
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$24.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.60
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16.42
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16.42
|
| Rate for Payer: Multiplan Commercial |
$19.06
|
| Rate for Payer: TriValley Medical Group Commercial |
$13.03
|
| Rate for Payer: TriValley Medical Group Senior |
$13.03
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$14.08
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$14.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.54
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.33
|
| Rate for Payer: Vantage Medical Group Senior |
$13.03
|
|
|
HC LAB REF ENTEROVIRUS AB POLIO 1
|
Facility
IP
|
$25.42
|
|
|
Service Code
|
CPT 86658
|
| Hospital Charge Code |
900911777
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.60 |
| Max. Negotiated Rate |
$19.06 |
| Rate for Payer: Adventist Health Commercial |
$5.08
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$17.46
|
| Rate for Payer: Cash Price |
$11.44
|
| Rate for Payer: Heritage Provider Network Commercial |
$17.21
|
| Rate for Payer: Heritage Provider Network Senior |
$17.21
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.36
|
| Rate for Payer: Multiplan Commercial |
$19.06
|
|
|
HC LAB REF ENTEROVIRUS AB POLIO 2
|
Facility
IP
|
$25.42
|
|
|
Service Code
|
CPT 86658
|
| Hospital Charge Code |
900912741
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.60 |
| Max. Negotiated Rate |
$19.06 |
| Rate for Payer: Adventist Health Commercial |
$5.08
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$17.46
|
| Rate for Payer: Cash Price |
$11.44
|
| Rate for Payer: Heritage Provider Network Commercial |
$17.21
|
| Rate for Payer: Heritage Provider Network Senior |
$17.21
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.36
|
| Rate for Payer: Multiplan Commercial |
$19.06
|
|
|
HC LAB REF ENTEROVIRUS AB POLIO 2
|
Facility
OP
|
$25.42
|
|
|
Service Code
|
CPT 86658
|
| Hospital Charge Code |
900912741
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.60 |
| Max. Negotiated Rate |
$110.39 |
| Rate for Payer: Adventist Health Commercial |
$5.08
|
| Rate for Payer: Aetna of CA Gatekeeper |
$37.92
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$17.46
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$19.54
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$14.33
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$13.03
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$110.39
|
| Rate for Payer: Blue Shield of California Commercial |
$101.74
|
| Rate for Payer: Blue Shield of California EPN |
$79.53
|
| Rate for Payer: Cash Price |
$11.44
|
| Rate for Payer: Cash Price |
$11.44
|
| Rate for Payer: Cigna of CA HMO/PPO |
$16.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.54
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.33
|
| Rate for Payer: Dignity Health Senior |
$13.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.52
|
| Rate for Payer: EPIC Health Plan Medicare |
$13.03
|
| Rate for Payer: Heritage Provider Network Commercial |
$15.73
|
| Rate for Payer: Heritage Provider Network Senior |
$15.73
|
| Rate for Payer: Humana Medicare |
$13.03
|
| Rate for Payer: IEHP Medi-Cal |
$18.06
|
| Rate for Payer: IEHP Medicare Advantage |
$13.03
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$24.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.60
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16.42
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16.42
|
| Rate for Payer: Multiplan Commercial |
$19.06
|
| Rate for Payer: TriValley Medical Group Commercial |
$13.03
|
| Rate for Payer: TriValley Medical Group Senior |
$13.03
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$14.08
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$14.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.54
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.33
|
| Rate for Payer: Vantage Medical Group Senior |
$13.03
|
|
|
HC LAB REF ENTEROVIRUS AB POLIO 3
|
Facility
IP
|
$25.43
|
|
|
Service Code
|
CPT 86658
|
| Hospital Charge Code |
900912726
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.60 |
| Max. Negotiated Rate |
$19.07 |
| Rate for Payer: Adventist Health Commercial |
$5.09
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$17.47
|
| Rate for Payer: Cash Price |
$11.44
|
| Rate for Payer: Heritage Provider Network Commercial |
$17.22
|
| Rate for Payer: Heritage Provider Network Senior |
$17.22
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.36
|
| Rate for Payer: Multiplan Commercial |
$19.07
|
|
|
HC LAB REF ENTEROVIRUS AB POLIO 3
|
Facility
OP
|
$25.43
|
|
|
Service Code
|
CPT 86658
|
| Hospital Charge Code |
900912726
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.60 |
| Max. Negotiated Rate |
$110.39 |
| Rate for Payer: Adventist Health Commercial |
$5.09
|
| Rate for Payer: Aetna of CA Gatekeeper |
$37.92
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$17.47
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$19.54
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$14.33
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$13.03
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$110.39
|
| Rate for Payer: Blue Shield of California Commercial |
$101.74
|
| Rate for Payer: Blue Shield of California EPN |
$79.53
|
| Rate for Payer: Cash Price |
$11.44
|
| Rate for Payer: Cash Price |
$11.44
|
| Rate for Payer: Cigna of CA HMO/PPO |
$16.53
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.54
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.33
|
| Rate for Payer: Dignity Health Senior |
$13.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.53
|
| Rate for Payer: EPIC Health Plan Medicare |
$13.03
|
| Rate for Payer: Heritage Provider Network Commercial |
$15.74
|
| Rate for Payer: Heritage Provider Network Senior |
$15.74
|
| Rate for Payer: Humana Medicare |
$13.03
|
| Rate for Payer: IEHP Medi-Cal |
$18.06
|
| Rate for Payer: IEHP Medicare Advantage |
$13.03
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$24.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.60
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16.42
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16.42
|
| Rate for Payer: Multiplan Commercial |
$19.07
|
| Rate for Payer: TriValley Medical Group Commercial |
$13.03
|
| Rate for Payer: TriValley Medical Group Senior |
$13.03
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$14.08
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$14.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.54
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.33
|
| Rate for Payer: Vantage Medical Group Senior |
$13.03
|
|
|
HC LAB REF EPI CELL AB BMZ
|
Facility
IP
|
$17.26
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
900912804
|
|
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 EPI CELL AB BMZ
|
Facility
OP
|
$17.26
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
900912804
|
|
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 |
$13.46
|
| 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 FISH ANEUPLOIDY REFLEX, POC
|
Facility
IP
|
$50.00
|
|
|
Service Code
|
CPT 88291
|
| Hospital Charge Code |
900912706
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$9.05 |
| Max. Negotiated Rate |
$37.50 |
| Rate for Payer: Adventist Health Commercial |
$10.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$34.35
|
| Rate for Payer: Cash Price |
$22.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$33.85
|
| Rate for Payer: Heritage Provider Network Senior |
$33.85
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.50
|
| Rate for Payer: Multiplan Commercial |
$37.50
|
|
|
HC LAB REF FISH ANEUPLOIDY REFLEX, POC
|
Facility
OP
|
$50.00
|
|
|
Service Code
|
CPT 88291
|
| Hospital Charge Code |
900912706
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$9.05 |
| Max. Negotiated Rate |
$156.37 |
| Rate for Payer: Adventist Health Commercial |
$10.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$61.73
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$34.35
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$42.50
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$27.50
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$37.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$156.37
|
| Rate for Payer: Blue Shield of California Commercial |
$31.05
|
| Rate for Payer: Blue Shield of California EPN |
$29.35
|
| Rate for Payer: Cash Price |
$22.50
|
| Rate for Payer: Cash Price |
$22.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$32.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$42.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$42.50
|
| Rate for Payer: Dignity Health Senior |
$42.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$32.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$30.95
|
| Rate for Payer: Heritage Provider Network Senior |
$30.95
|
| Rate for Payer: IEHP Medi-Cal |
$21.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$24.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.50
|
| Rate for Payer: Multiplan Commercial |
$37.50
|
| 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 Medi-Cal |
$42.50
|
| Rate for Payer: Vantage Medical Group Senior |
$42.50
|
|
