|
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: Aetna of CA Non-Gatekeeper |
$48.30
|
| Rate for Payer: Cash Price |
$33.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$50.77
|
| Rate for Payer: Heritage Provider Network Senior |
$50.77
|
| Rate for Payer: Kaiser Foundation Hospitals 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 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 |
$939.08 |
| Rate for Payer: Multiplan Commercial |
$75.75
|
| Rate for Payer: Adventist Health Commercial |
$20.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$62.42
|
| 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 |
$939.08
|
| 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 |
$45.45
|
| Rate for Payer: Cash Price |
$45.45
|
| 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 Medicare Advantage |
$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) Medicare Advantage |
$116.49
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$48.18
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$18.28
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$133.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$156.10
|
| 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 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: Aetna of CA Non-Gatekeeper |
$65.04
|
| Rate for Payer: Cash Price |
$45.45
|
| Rate for Payer: Heritage Provider Network Commercial |
$68.38
|
| Rate for Payer: Heritage Provider Network Senior |
$68.38
|
| Rate for Payer: Kaiser Foundation Hospitals 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 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: Aetna of CA Non-Gatekeeper |
$130.73
|
| Rate for Payer: Cash Price |
$91.35
|
| Rate for Payer: Heritage Provider Network Commercial |
$137.43
|
| Rate for Payer: Heritage Provider Network Senior |
$137.43
|
| Rate for Payer: Kaiser Foundation Hospitals 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 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 |
$1,018.09 |
| Rate for Payer: Adventist Health Commercial |
$40.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$125.45
|
| 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 |
$1,018.09
|
| 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 |
$91.35
|
| Rate for Payer: Cash Price |
$91.35
|
| 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 Medicare Advantage |
$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) Medicare Advantage |
$143.75
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$96.83
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$36.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$165.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$50.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$192.62
|
| 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 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: Aetna of CA Non-Gatekeeper |
$152.63
|
| Rate for Payer: Cash Price |
$106.65
|
| Rate for Payer: Heritage Provider Network Commercial |
$160.45
|
| Rate for Payer: Heritage Provider Network Senior |
$160.45
|
| Rate for Payer: Kaiser Foundation Hospitals 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 |
$1,355.40 |
| Rate for Payer: Adventist Health Commercial |
$47.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$146.47
|
| 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 |
$1,355.40
|
| 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 |
$106.65
|
| Rate for Payer: Cash Price |
$106.65
|
| 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 Medicare Advantage |
$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) Medicare Advantage |
$147.52
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$113.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$42.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$169.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$59.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$197.68
|
| 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
|
OP
|
$151.00
|
|
|
Service Code
|
CPT 88233
|
| Hospital Charge Code |
900912790
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$27.33 |
| Max. Negotiated Rate |
$1,134.30 |
| Rate for Payer: Adventist Health Commercial |
$30.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$93.32
|
| 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 |
$1,134.30
|
| 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 |
$67.95
|
| Rate for Payer: Cash Price |
$67.95
|
| 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 Medicare Advantage |
$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) Medicare Advantage |
$140.73
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$72.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$27.33
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$161.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$37.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$188.58
|
| 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 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: Aetna of CA Non-Gatekeeper |
$97.24
|
| Rate for Payer: Cash Price |
$67.95
|
| Rate for Payer: Heritage Provider Network Commercial |
$102.23
|
| Rate for Payer: Heritage Provider Network Senior |
$102.23
|
| Rate for Payer: Kaiser Foundation Hospitals 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 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: Aetna of CA Non-Gatekeeper |
$34.78
|
| Rate for Payer: Cash Price |
$24.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$36.56
|
| Rate for Payer: Heritage Provider Network Senior |
$36.56
|
| Rate for Payer: Kaiser Foundation Hospitals 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 Non-Gatekeeper |
$33.37
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$328.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$241.03
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$219.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$91.86
|
| 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 |
$24.30
|
| Rate for Payer: Cash Price |
$24.30
|
| Rate for Payer: Cigna of CA HMO/PPO |
$35.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$328.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$241.03
|
| Rate for Payer: Dignity Health Medicare Advantage |
$219.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$35.10
|
| Rate for Payer: EPIC Health Plan Medicare |
$219.12
|
| 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) Medicare Advantage |
$219.12
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$25.76
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$9.77
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$251.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$293.62
|
| Rate for Payer: Multiplan Commercial |
$40.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$219.12
|
| Rate for Payer: TriValley Medical Group Senior |
$219.12
|
| 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 |
$328.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$241.03
|
| Rate for Payer: Vantage Medical Group Senior |
$219.12
|
|
|
HC LAB REF TRYPSINOGEN
|
Facility
|
IP
|
$70.00
|
|
|
Service Code
|
CPT 83519
|
| Hospital Charge Code |
900910733
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.67 |
| Max. Negotiated Rate |
$52.50 |
| Rate for Payer: Adventist Health Commercial |
$14.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$45.08
|
| Rate for Payer: Cash Price |
$31.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$47.39
|
| Rate for Payer: Heritage Provider Network Senior |
$47.39
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$12.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$17.50
|
| Rate for Payer: Multiplan Commercial |
$52.50
|
|
|
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 |
$128.29 |
| Rate for Payer: Adventist Health Commercial |
$14.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$43.26
|
| 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 |
$128.29
|
| 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 |
$31.50
|
| Rate for Payer: Cash Price |
$31.50
|
| 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 Medicare Advantage |
$18.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$41.30
|
| 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) Medicare Advantage |
$18.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$33.39
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$12.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$21.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$17.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$24.66
|
| 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
|
|
|
HC LAB REF VARICELLA-ZOSTER AB ACIF CSF
|
Facility
|
OP
|
$43.00
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
900911362
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.78 |
| Max. Negotiated Rate |
$322.42 |
| Rate for Payer: Adventist Health Commercial |
$8.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$26.57
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$52.63
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$38.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$35.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$322.42
|
| Rate for Payer: Blue Shield of California Commercial |
$282.47
|
| Rate for Payer: Blue Shield of California EPN |
$226.56
|
| Rate for Payer: Cash Price |
$19.35
|
| Rate for Payer: Cash Price |
$19.35
|
| Rate for Payer: Cigna of CA HMO/PPO |
$27.95
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$52.63
|
| Rate for Payer: Dignity Health Medi-Cal |
$38.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$35.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$25.37
|
| Rate for Payer: EPIC Health Plan Medicare |
$35.09
|
| Rate for Payer: Heritage Provider Network Commercial |
$26.62
|
| Rate for Payer: Heritage Provider Network Senior |
$26.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$35.09
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$20.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$7.78
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$40.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$47.02
|
| Rate for Payer: Multiplan Commercial |
$32.25
|
| 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 |
$52.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$38.60
|
| Rate for Payer: Vantage Medical Group Senior |
$35.09
|
|
|
HC LAB REF VARICELLA-ZOSTER AB ACIF CSF
|
Facility
|
IP
|
$43.00
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
900911362
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.78 |
| Max. Negotiated Rate |
$32.25 |
| Rate for Payer: Adventist Health Commercial |
$8.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$27.69
|
| Rate for Payer: Cash Price |
$19.35
|
| Rate for Payer: Heritage Provider Network Commercial |
$29.11
|
| Rate for Payer: Heritage Provider Network Senior |
$29.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$7.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.75
|
| Rate for Payer: Multiplan Commercial |
$32.25
|
|
|
HC LAB REF VITAMIN D 1 25-DIHYDROXY
|
Facility
|
OP
|
$24.00
|
|
|
Service Code
|
CPT 82652
|
| Hospital Charge Code |
900911098
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.34 |
| Max. Negotiated Rate |
$284.33 |
| Rate for Payer: Adventist Health Commercial |
$4.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$14.83
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$57.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$42.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$38.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$284.33
|
| Rate for Payer: Blue Shield of California Commercial |
$260.58
|
| Rate for Payer: Blue Shield of California EPN |
$209.01
|
| Rate for Payer: Cash Price |
$10.80
|
| Rate for Payer: Cash Price |
$10.80
|
| Rate for Payer: Cigna of CA HMO/PPO |
$15.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$57.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$42.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$38.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.16
|
| Rate for Payer: EPIC Health Plan Medicare |
$38.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$14.86
|
| Rate for Payer: Heritage Provider Network Senior |
$14.86
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$38.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$11.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$4.34
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$44.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$51.59
|
| Rate for Payer: Multiplan Commercial |
$18.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$38.50
|
| Rate for Payer: TriValley Medical Group Senior |
$38.50
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$41.58
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$41.58
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$57.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$42.35
|
| Rate for Payer: Vantage Medical Group Senior |
$38.50
|
|
|
HC LAB REF VITAMIN D 1 25-DIHYDROXY
|
Facility
|
IP
|
$24.00
|
|
|
Service Code
|
CPT 82652
|
| Hospital Charge Code |
900911098
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.34 |
| Max. Negotiated Rate |
$18.00 |
| Rate for Payer: Adventist Health Commercial |
$4.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$15.46
|
| Rate for Payer: Cash Price |
$10.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$16.25
|
| Rate for Payer: Heritage Provider Network Senior |
$16.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$4.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.00
|
| Rate for Payer: Multiplan Commercial |
$18.00
|
|
|
HC LAB REF VZV AB IMMUNITY SCREEN
|
Facility
|
OP
|
$87.00
|
|
|
Service Code
|
CPT 86787
|
| Hospital Charge Code |
900912872
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.88 |
| Max. Negotiated Rate |
$122.35 |
| Rate for Payer: Adventist Health Commercial |
$17.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$53.77
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19.32
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.17
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$122.35
|
| Rate for Payer: Blue Shield of California Commercial |
$103.68
|
| Rate for Payer: Blue Shield of California EPN |
$83.16
|
| Rate for Payer: Cash Price |
$39.15
|
| Rate for Payer: Cash Price |
$39.15
|
| Rate for Payer: Cigna of CA HMO/PPO |
$56.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.32
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.17
|
| Rate for Payer: Dignity Health Medicare Advantage |
$12.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$51.33
|
| Rate for Payer: EPIC Health Plan Medicare |
$12.88
|
| Rate for Payer: Heritage Provider Network Commercial |
$53.85
|
| Rate for Payer: Heritage Provider Network Senior |
$53.85
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$12.88
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$41.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$15.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$14.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$21.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$17.26
|
| Rate for Payer: Multiplan Commercial |
$65.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$12.88
|
| Rate for Payer: TriValley Medical Group Senior |
$12.88
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$13.91
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$13.91
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.17
|
| Rate for Payer: Vantage Medical Group Senior |
$12.88
|
|
|
HC LAB REF VZV AB IMMUNITY SCREEN
|
Facility
|
IP
|
$87.00
|
|
|
Service Code
|
CPT 86787
|
| Hospital Charge Code |
900912872
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.75 |
| Max. Negotiated Rate |
$65.25 |
| Rate for Payer: Adventist Health Commercial |
$17.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$56.03
|
| Rate for Payer: Cash Price |
$39.15
|
| Rate for Payer: Heritage Provider Network Commercial |
$58.90
|
| Rate for Payer: Heritage Provider Network Senior |
$58.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$15.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$21.75
|
| Rate for Payer: Multiplan Commercial |
$65.25
|
|
|
HC LAB REF WHITE BEAN IGE
|
Facility
|
OP
|
$13.00
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
900912545
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.35 |
| Max. Negotiated Rate |
$150.09 |
| Rate for Payer: Adventist Health Commercial |
$2.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$8.03
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.83
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.74
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$150.09
|
| Rate for Payer: Blue Shield of California Commercial |
$42.05
|
| Rate for Payer: Blue Shield of California EPN |
$33.73
|
| Rate for Payer: Cash Price |
$5.85
|
| Rate for Payer: Cash Price |
$5.85
|
| Rate for Payer: Cigna of CA HMO/PPO |
$8.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.83
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.74
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.67
|
| Rate for Payer: EPIC Health Plan Medicare |
$5.22
|
| Rate for Payer: Heritage Provider Network Commercial |
$8.05
|
| Rate for Payer: Heritage Provider Network Senior |
$8.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.22
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$6.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$6.99
|
| Rate for Payer: Multiplan Commercial |
$9.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$5.22
|
| Rate for Payer: TriValley Medical Group Senior |
$5.22
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$5.64
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$5.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.74
|
| Rate for Payer: Vantage Medical Group Senior |
$5.22
|
|
|
HC LAB REF WHITE BEAN IGE
|
Facility
|
IP
|
$13.00
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
900912545
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.35 |
| Max. Negotiated Rate |
$9.75 |
| Rate for Payer: Adventist Health Commercial |
$2.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$8.37
|
| Rate for Payer: Cash Price |
$5.85
|
| Rate for Payer: Heritage Provider Network Commercial |
$8.80
|
| Rate for Payer: Heritage Provider Network Senior |
$8.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.25
|
| Rate for Payer: Multiplan Commercial |
$9.75
|
|
|
HC LACTATE CH
|
Facility
|
OP
|
$54.00
|
|
|
Service Code
|
CPT 83605
|
| Hospital Charge Code |
900912184
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.77 |
| Max. Negotiated Rate |
$101.38 |
| Rate for Payer: Adventist Health Commercial |
$10.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$33.37
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$17.36
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$12.73
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11.57
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$101.38
|
| Rate for Payer: Blue Shield of California Commercial |
$85.94
|
| Rate for Payer: Blue Shield of California EPN |
$68.93
|
| Rate for Payer: Cash Price |
$24.30
|
| Rate for Payer: Cash Price |
$24.30
|
| Rate for Payer: Cigna of CA HMO/PPO |
$35.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$17.36
|
| Rate for Payer: Dignity Health Medi-Cal |
$12.73
|
| Rate for Payer: Dignity Health Medicare Advantage |
$11.57
|
| Rate for Payer: EPIC Health Plan Commercial |
$31.86
|
| Rate for Payer: EPIC Health Plan Medicare |
$11.57
|
| 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) Medicare Advantage |
$11.57
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$25.76
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$9.77
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$13.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$15.50
|
| Rate for Payer: Multiplan Commercial |
$40.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$11.57
|
| Rate for Payer: TriValley Medical Group Senior |
$11.57
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$12.49
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$12.49
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$17.36
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$12.73
|
| Rate for Payer: Vantage Medical Group Senior |
$11.57
|
|
|
HC LACTATE CH
|
Facility
|
IP
|
$54.00
|
|
|
Service Code
|
CPT 83605
|
| Hospital Charge Code |
900912184
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.77 |
| Max. Negotiated Rate |
$40.50 |
| Rate for Payer: Adventist Health Commercial |
$10.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$34.78
|
| Rate for Payer: Cash Price |
$24.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$36.56
|
| Rate for Payer: Heritage Provider Network Senior |
$36.56
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$9.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.50
|
| Rate for Payer: Multiplan Commercial |
$40.50
|
|
|
HC LACTATE (CSF/POC)
|
Facility
|
IP
|
$308.00
|
|
|
Service Code
|
CPT 83605
|
| Hospital Charge Code |
900910245
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$55.75 |
| Max. Negotiated Rate |
$231.00 |
| Rate for Payer: Adventist Health Commercial |
$61.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$198.35
|
| Rate for Payer: Cash Price |
$138.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$208.52
|
| Rate for Payer: Heritage Provider Network Senior |
$208.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$55.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$77.00
|
| Rate for Payer: Multiplan Commercial |
$231.00
|
|
|
HC LACTATE (CSF/POC)
|
Facility
|
OP
|
$82.00
|
|
|
Service Code
|
CPT 83605
|
| Hospital Charge Code |
900910245
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.57 |
| Max. Negotiated Rate |
$101.38 |
| Rate for Payer: Adventist Health Commercial |
$16.40
|
| Rate for Payer: Adventist Health Commercial |
$61.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$190.34
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$50.68
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$17.36
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$17.36
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$12.73
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$12.73
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11.57
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11.57
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$101.38
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$101.38
|
| Rate for Payer: Blue Shield of California Commercial |
$85.94
|
| Rate for Payer: Blue Shield of California Commercial |
$85.94
|
| Rate for Payer: Blue Shield of California EPN |
$68.93
|
| Rate for Payer: Blue Shield of California EPN |
$68.93
|
| Rate for Payer: Cash Price |
$36.90
|
| Rate for Payer: Cash Price |
$36.90
|
| Rate for Payer: Cash Price |
$138.60
|
| Rate for Payer: Cash Price |
$138.60
|
| Rate for Payer: Cigna of CA HMO/PPO |
$200.20
|
| Rate for Payer: Cigna of CA HMO/PPO |
$53.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$17.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$17.36
|
| Rate for Payer: Dignity Health Medi-Cal |
$12.73
|
| Rate for Payer: Dignity Health Medi-Cal |
$12.73
|
| Rate for Payer: Dignity Health Medicare Advantage |
$11.57
|
| Rate for Payer: Dignity Health Medicare Advantage |
$11.57
|
| Rate for Payer: EPIC Health Plan Commercial |
$48.38
|
| Rate for Payer: EPIC Health Plan Commercial |
$181.72
|
| Rate for Payer: EPIC Health Plan Medicare |
$11.57
|
| Rate for Payer: EPIC Health Plan Medicare |
$11.57
|
| Rate for Payer: Heritage Provider Network Commercial |
$190.65
|
| Rate for Payer: Heritage Provider Network Commercial |
$50.76
|
| Rate for Payer: Heritage Provider Network Senior |
$190.65
|
| Rate for Payer: Heritage Provider Network Senior |
$50.76
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$11.57
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$11.57
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$146.92
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$39.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$55.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$14.84
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$13.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$13.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$77.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$15.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$15.50
|
| Rate for Payer: Multiplan Commercial |
$231.00
|
| Rate for Payer: Multiplan Commercial |
$61.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$11.57
|
| Rate for Payer: TriValley Medical Group Commercial |
$11.57
|
| Rate for Payer: TriValley Medical Group Senior |
$11.57
|
| Rate for Payer: TriValley Medical Group Senior |
$11.57
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$12.49
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$12.49
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$12.49
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$12.49
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$17.36
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$17.36
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$12.73
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$12.73
|
| Rate for Payer: Vantage Medical Group Senior |
$11.57
|
| Rate for Payer: Vantage Medical Group Senior |
$11.57
|
|
