|
HC SBBB RBC LEUKOREDUCED
|
Facility
|
IP
|
$238.00
|
|
|
Service Code
|
CPT P9016
|
| Hospital Charge Code |
900904408
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$43.08 |
| Max. Negotiated Rate |
$178.50 |
| Rate for Payer: Adventist Health Commercial |
$47.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$163.51
|
| Rate for Payer: Cash Price |
$107.10
|
| Rate for Payer: Heritage Provider Network Commercial |
$161.13
|
| Rate for Payer: Heritage Provider Network Senior |
$161.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$43.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$59.50
|
| Rate for Payer: Multiplan Commercial |
$178.50
|
|
|
HC SBBB RBC LEUKOREDUCED
|
Facility
|
OP
|
$238.00
|
|
|
Service Code
|
CPT P9016
|
| Hospital Charge Code |
900904408
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$43.08 |
| Max. Negotiated Rate |
$596.00 |
| Rate for Payer: Adventist Health Commercial |
$47.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$516.50
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$163.51
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$355.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$260.83
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$237.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$136.49
|
| Rate for Payer: Blue Shield of California Commercial |
$147.80
|
| Rate for Payer: Blue Shield of California EPN |
$139.71
|
| Rate for Payer: Cash Price |
$107.10
|
| Rate for Payer: Cash Price |
$107.10
|
| Rate for Payer: Cash Price |
$107.10
|
| Rate for Payer: Cigna of CA HMO/PPO |
$154.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$355.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$260.83
|
| Rate for Payer: Dignity Health Senior |
$237.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$154.70
|
| Rate for Payer: EPIC Health Plan Medicare |
$237.12
|
| Rate for Payer: Heritage Provider Network Commercial |
$147.32
|
| Rate for Payer: Heritage Provider Network Senior |
$147.32
|
| Rate for Payer: Humana Medicare |
$237.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$288.83
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$237.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$450.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$43.08
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$279.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$59.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$298.77
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$298.77
|
| Rate for Payer: Multiplan Commercial |
$178.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$260.83
|
| Rate for Payer: TriValley Medical Group Senior |
$237.12
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$596.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$501.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$355.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$260.83
|
| Rate for Payer: Vantage Medical Group Senior |
$237.12
|
|
|
HC SBBB RBC LEUKOREDU CPDA-1 SPLIT UNIT
|
Facility
|
IP
|
$570.00
|
|
|
Service Code
|
CPT P9011
|
| Hospital Charge Code |
900909509
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$103.17 |
| Max. Negotiated Rate |
$427.50 |
| Rate for Payer: Adventist Health Commercial |
$114.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$391.59
|
| Rate for Payer: Cash Price |
$256.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$385.89
|
| Rate for Payer: Heritage Provider Network Senior |
$385.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$103.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$142.50
|
| Rate for Payer: Multiplan Commercial |
$427.50
|
|
|
HC SBBB RBC LEUKOREDU CPDA-1 SPLIT UNIT
|
Facility
|
OP
|
$570.00
|
|
|
Service Code
|
CPT P9011
|
| Hospital Charge Code |
900909509
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$103.17 |
| Max. Negotiated Rate |
$596.00 |
| Rate for Payer: Adventist Health Commercial |
$114.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$134.02
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$391.59
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$293.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$215.03
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$195.48
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$326.90
|
| Rate for Payer: Blue Shield of California Commercial |
$353.97
|
| Rate for Payer: Blue Shield of California EPN |
$334.59
|
| Rate for Payer: Cash Price |
$256.50
|
| Rate for Payer: Cash Price |
$256.50
|
| Rate for Payer: Cash Price |
$256.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$370.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$293.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$215.03
|
| Rate for Payer: Dignity Health Senior |
$195.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$370.50
|
| Rate for Payer: EPIC Health Plan Medicare |
$195.48
|
| Rate for Payer: Heritage Provider Network Commercial |
$352.83
|
| Rate for Payer: Heritage Provider Network Senior |
$352.83
|
| Rate for Payer: Humana Medicare |
$195.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$232.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$195.48
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$371.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$103.17
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$230.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$142.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$246.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$246.30
|
| Rate for Payer: Multiplan Commercial |
$427.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$215.03
|
| Rate for Payer: TriValley Medical Group Senior |
$195.48
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$596.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$501.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$293.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$215.03
|
| Rate for Payer: Vantage Medical Group Senior |
$195.48
|
|
|
HC SBBB RBC LEUKOREDU CPDA-1 WHOLE UNIT
|
Facility
|
OP
|
$445.00
|
|
|
Service Code
|
CPT P9016
|
| Hospital Charge Code |
900909508
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$80.54 |
| Max. Negotiated Rate |
$596.00 |
| Rate for Payer: Adventist Health Commercial |
$89.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$516.50
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$305.72
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$355.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$260.83
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$237.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$255.21
|
| Rate for Payer: Blue Shield of California Commercial |
$276.34
|
| Rate for Payer: Blue Shield of California EPN |
$261.22
|
| Rate for Payer: Cash Price |
$200.25
|
| Rate for Payer: Cash Price |
$200.25
|
| Rate for Payer: Cash Price |
$200.25
|
| Rate for Payer: Cigna of CA HMO/PPO |
$289.25
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$355.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$260.83
|
| Rate for Payer: Dignity Health Senior |
$237.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$289.25
|
| Rate for Payer: EPIC Health Plan Medicare |
$237.12
|
| Rate for Payer: Heritage Provider Network Commercial |
$275.46
|
| Rate for Payer: Heritage Provider Network Senior |
$275.46
|
| Rate for Payer: Humana Medicare |
$237.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$288.83
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$237.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$450.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$80.54
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$279.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$111.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$298.77
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$298.77
|
| Rate for Payer: Multiplan Commercial |
$333.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$260.83
|
| Rate for Payer: TriValley Medical Group Senior |
$237.12
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$596.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$501.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$355.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$260.83
|
| Rate for Payer: Vantage Medical Group Senior |
$237.12
|
|
|
HC SBBB RBC LEUKOREDU CPDA-1 WHOLE UNIT
|
Facility
|
IP
|
$445.00
|
|
|
Service Code
|
CPT P9016
|
| Hospital Charge Code |
900909508
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$80.54 |
| Max. Negotiated Rate |
$333.75 |
| Rate for Payer: Adventist Health Commercial |
$89.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$305.72
|
| Rate for Payer: Cash Price |
$200.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$301.26
|
| Rate for Payer: Heritage Provider Network Senior |
$301.26
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$80.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$111.25
|
| Rate for Payer: Multiplan Commercial |
$333.75
|
|
|
HC SBBB RBC OCTOPED CMV LEUKOREDU
|
Facility
|
OP
|
$451.00
|
|
|
Service Code
|
CPT P9016
|
| Hospital Charge Code |
900904705
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$81.63 |
| Max. Negotiated Rate |
$596.00 |
| Rate for Payer: Adventist Health Commercial |
$90.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$516.50
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$309.84
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$355.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$260.83
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$237.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$258.65
|
| Rate for Payer: Blue Shield of California Commercial |
$280.07
|
| Rate for Payer: Blue Shield of California EPN |
$264.74
|
| Rate for Payer: Cash Price |
$202.95
|
| Rate for Payer: Cash Price |
$202.95
|
| Rate for Payer: Cash Price |
$202.95
|
| Rate for Payer: Cigna of CA HMO/PPO |
$293.15
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$355.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$260.83
|
| Rate for Payer: Dignity Health Senior |
$237.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$293.15
|
| Rate for Payer: EPIC Health Plan Medicare |
$237.12
|
| Rate for Payer: Heritage Provider Network Commercial |
$279.17
|
| Rate for Payer: Heritage Provider Network Senior |
$279.17
|
| Rate for Payer: Humana Medicare |
$237.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$288.83
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$237.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$450.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$81.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$279.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$112.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$298.77
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$298.77
|
| Rate for Payer: Multiplan Commercial |
$338.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$260.83
|
| Rate for Payer: TriValley Medical Group Senior |
$237.12
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$596.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$501.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$355.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$260.83
|
| Rate for Payer: Vantage Medical Group Senior |
$237.12
|
|
|
HC SBBB RBC OCTOPED CMV LEUKOREDU
|
Facility
|
IP
|
$451.00
|
|
|
Service Code
|
CPT P9016
|
| Hospital Charge Code |
900904705
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$81.63 |
| Max. Negotiated Rate |
$338.25 |
| Rate for Payer: Adventist Health Commercial |
$90.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$309.84
|
| Rate for Payer: Cash Price |
$202.95
|
| Rate for Payer: Heritage Provider Network Commercial |
$305.33
|
| Rate for Payer: Heritage Provider Network Senior |
$305.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$81.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$112.75
|
| Rate for Payer: Multiplan Commercial |
$338.25
|
|
|
HC SBBB RETIC SEPARATION
|
Facility
|
IP
|
$75.00
|
|
|
Service Code
|
CPT 86972
|
| Hospital Charge Code |
900904737
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$13.58 |
| Max. Negotiated Rate |
$56.25 |
| Rate for Payer: Adventist Health Commercial |
$15.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$51.52
|
| Rate for Payer: Cash Price |
$33.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$50.78
|
| Rate for Payer: Heritage Provider Network Senior |
$50.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18.75
|
| Rate for Payer: Multiplan Commercial |
$56.25
|
|
|
HC SBBB RETIC SEPARATION
|
Facility
|
OP
|
$75.00
|
|
|
Service Code
|
CPT 86972
|
| Hospital Charge Code |
900904737
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$13.58 |
| Max. Negotiated Rate |
$405.48 |
| Rate for Payer: Adventist Health Commercial |
$15.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$61.34
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$51.52
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$320.12
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$234.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$213.41
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$150.63
|
| Rate for Payer: Blue Shield of California Commercial |
$46.58
|
| Rate for Payer: Blue Shield of California EPN |
$44.02
|
| Rate for Payer: Cash Price |
$33.75
|
| Rate for Payer: Cash Price |
$33.75
|
| Rate for Payer: Cigna of CA HMO/PPO |
$48.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$320.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$234.75
|
| Rate for Payer: Dignity Health Senior |
$213.41
|
| Rate for Payer: EPIC Health Plan Commercial |
$48.75
|
| Rate for Payer: EPIC Health Plan Medicare |
$213.41
|
| Rate for Payer: Heritage Provider Network Commercial |
$46.42
|
| Rate for Payer: Heritage Provider Network Senior |
$46.42
|
| Rate for Payer: Humana Medicare |
$213.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$25.97
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$213.41
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$405.48
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13.58
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$251.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$268.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$268.90
|
| Rate for Payer: Multiplan Commercial |
$56.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$213.41
|
| Rate for Payer: TriValley Medical Group Senior |
$213.41
|
| 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 |
$320.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$234.75
|
| Rate for Payer: Vantage Medical Group Senior |
$213.41
|
|
|
HC SBBB RH D TYPING
|
Facility
|
OP
|
$20.00
|
|
|
Service Code
|
CPT 86901
|
| Hospital Charge Code |
900904732
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$3.23 |
| Max. Negotiated Rate |
$95.21 |
| Rate for Payer: Adventist Health Commercial |
$4.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$8.68
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$13.74
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$75.16
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$55.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$50.11
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$52.74
|
| Rate for Payer: Blue Shield of California Commercial |
$23.31
|
| Rate for Payer: Blue Shield of California EPN |
$18.22
|
| Rate for Payer: Cash Price |
$9.00
|
| Rate for Payer: Cash Price |
$9.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$13.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$75.16
|
| Rate for Payer: Dignity Health Medi-Cal |
$55.12
|
| Rate for Payer: Dignity Health Senior |
$50.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$50.11
|
| Rate for Payer: Heritage Provider Network Commercial |
$12.38
|
| Rate for Payer: Heritage Provider Network Senior |
$12.38
|
| Rate for Payer: Humana Medicare |
$50.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$3.84
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$50.11
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$95.21
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$59.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$63.14
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$63.14
|
| Rate for Payer: Multiplan Commercial |
$15.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$50.11
|
| Rate for Payer: TriValley Medical Group Senior |
$50.11
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3.23
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$3.23
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$75.16
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$55.12
|
| Rate for Payer: Vantage Medical Group Senior |
$50.11
|
|
|
HC SBBB RH D TYPING
|
Facility
|
IP
|
$20.00
|
|
|
Service Code
|
CPT 86901
|
| Hospital Charge Code |
900904732
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$3.62 |
| Max. Negotiated Rate |
$15.00 |
| Rate for Payer: Adventist Health Commercial |
$4.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$13.74
|
| Rate for Payer: Cash Price |
$9.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$13.54
|
| Rate for Payer: Heritage Provider Network Senior |
$13.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.00
|
| Rate for Payer: Multiplan Commercial |
$15.00
|
|
|
HC SBBB RH PHENOTYPING
|
Facility
|
OP
|
$75.00
|
|
|
Service Code
|
CPT 86906
|
| Hospital Charge Code |
900904623
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$8.13 |
| Max. Negotiated Rate |
$95.21 |
| Rate for Payer: Adventist Health Commercial |
$15.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$22.55
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$51.52
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$75.16
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$55.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$50.11
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$64.86
|
| Rate for Payer: Blue Shield of California Commercial |
$60.54
|
| Rate for Payer: Blue Shield of California EPN |
$47.33
|
| Rate for Payer: Cash Price |
$33.75
|
| Rate for Payer: Cash Price |
$33.75
|
| Rate for Payer: Cigna of CA HMO/PPO |
$48.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$75.16
|
| Rate for Payer: Dignity Health Medi-Cal |
$55.12
|
| Rate for Payer: Dignity Health Senior |
$50.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$48.75
|
| Rate for Payer: EPIC Health Plan Medicare |
$50.11
|
| Rate for Payer: Heritage Provider Network Commercial |
$46.42
|
| Rate for Payer: Heritage Provider Network Senior |
$46.42
|
| Rate for Payer: Humana Medicare |
$50.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$8.13
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$50.11
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$95.21
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13.58
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$59.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$63.14
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$63.14
|
| Rate for Payer: Multiplan Commercial |
$56.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$50.11
|
| Rate for Payer: TriValley Medical Group Senior |
$50.11
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$8.38
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$8.38
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$75.16
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$55.12
|
| Rate for Payer: Vantage Medical Group Senior |
$50.11
|
|
|
HC SBBB RH PHENOTYPING
|
Facility
|
IP
|
$75.00
|
|
|
Service Code
|
CPT 86906
|
| Hospital Charge Code |
900904623
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$13.58 |
| Max. Negotiated Rate |
$56.25 |
| Rate for Payer: Adventist Health Commercial |
$15.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$51.52
|
| Rate for Payer: Cash Price |
$33.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$50.78
|
| Rate for Payer: Heritage Provider Network Senior |
$50.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18.75
|
| Rate for Payer: Multiplan Commercial |
$56.25
|
|
|
HC SBBB SEND OUT COORDINATION FEE
|
Facility
|
OP
|
$50.00
|
|
|
Service Code
|
CPT 86999
|
| Hospital Charge Code |
900905001
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$9.05 |
| Max. Negotiated Rate |
$596.00 |
| Rate for Payer: Adventist Health Commercial |
$10.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$26.72
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$34.35
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$55.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$40.92
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$37.20
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$28.68
|
| 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: Cash Price |
$22.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$32.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$55.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$40.92
|
| Rate for Payer: Dignity Health Senior |
$37.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$32.50
|
| Rate for Payer: EPIC Health Plan Medicare |
$37.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$30.95
|
| Rate for Payer: Heritage Provider Network Senior |
$30.95
|
| Rate for Payer: Humana Medicare |
$37.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$37.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$70.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.05
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$43.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$46.87
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$46.87
|
| Rate for Payer: Multiplan Commercial |
$37.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$40.92
|
| Rate for Payer: TriValley Medical Group Senior |
$37.20
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$596.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$501.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$55.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$40.92
|
| Rate for Payer: Vantage Medical Group Senior |
$37.20
|
|
|
HC SBBB SEND OUT COORDINATION FEE
|
Facility
|
IP
|
$50.00
|
|
|
Service Code
|
CPT 86999
|
| Hospital Charge Code |
900905001
|
|
Hospital Revenue Code
|
390
|
| 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 SBBB SHIPPING OF BLOOD 1-6 UNI
|
Facility
|
IP
|
$100.00
|
|
|
Service Code
|
CPT 99001
|
| Hospital Charge Code |
900904609
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$18.10 |
| Max. Negotiated Rate |
$75.00 |
| Rate for Payer: Adventist Health Commercial |
$20.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$68.70
|
| Rate for Payer: Cash Price |
$45.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$67.70
|
| Rate for Payer: Heritage Provider Network Senior |
$67.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$18.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.00
|
| Rate for Payer: Multiplan Commercial |
$75.00
|
|
|
HC SBBB SHIPPING OF BLOOD 1-6 UNI
|
Facility
|
OP
|
$100.00
|
|
|
Service Code
|
CPT 99001
|
| Hospital Charge Code |
900904609
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$13.00 |
| Max. Negotiated Rate |
$596.00 |
| Rate for Payer: Adventist Health Commercial |
$20.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$13.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$13.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$85.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$55.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$75.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$57.35
|
| Rate for Payer: Blue Shield of California Commercial |
$62.10
|
| Rate for Payer: Blue Shield of California EPN |
$58.70
|
| Rate for Payer: Cash Price |
$45.00
|
| Rate for Payer: Cash Price |
$45.00
|
| Rate for Payer: Cash Price |
$45.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$65.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$85.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$85.00
|
| Rate for Payer: Dignity Health Senior |
$85.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$65.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$61.90
|
| Rate for Payer: Heritage Provider Network Senior |
$61.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$48.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$18.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.00
|
| Rate for Payer: Multiplan Commercial |
$75.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$596.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$501.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$85.00
|
| Rate for Payer: Vantage Medical Group Senior |
$85.00
|
|
|
HC SBBB STAT LABORATORY PROCEDURE
|
Facility
|
IP
|
$95.00
|
|
|
Service Code
|
CPT 86999
|
| Hospital Charge Code |
900904619
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$17.20 |
| Max. Negotiated Rate |
$71.25 |
| Rate for Payer: Adventist Health Commercial |
$19.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$65.26
|
| Rate for Payer: Cash Price |
$42.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$64.32
|
| Rate for Payer: Heritage Provider Network Senior |
$64.32
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$17.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23.75
|
| Rate for Payer: Multiplan Commercial |
$71.25
|
|
|
HC SBBB STAT LABORATORY PROCEDURE
|
Facility
|
OP
|
$95.00
|
|
|
Service Code
|
CPT 86999
|
| Hospital Charge Code |
900904619
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$17.20 |
| Max. Negotiated Rate |
$71.25 |
| Rate for Payer: Adventist Health Commercial |
$19.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$50.78
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$65.26
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$55.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$40.92
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$37.20
|
| Rate for Payer: Blue Shield of California Commercial |
$59.00
|
| Rate for Payer: Blue Shield of California EPN |
$55.76
|
| Rate for Payer: Cash Price |
$42.75
|
| Rate for Payer: Cash Price |
$42.75
|
| Rate for Payer: Cigna of CA HMO/PPO |
$61.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$55.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$40.92
|
| Rate for Payer: Dignity Health Senior |
$37.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$61.75
|
| Rate for Payer: EPIC Health Plan Medicare |
$37.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$58.80
|
| Rate for Payer: Heritage Provider Network Senior |
$58.80
|
| Rate for Payer: Humana Medicare |
$37.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$37.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$70.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$17.20
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$43.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$46.87
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$46.87
|
| Rate for Payer: Multiplan Commercial |
$71.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$37.20
|
| Rate for Payer: TriValley Medical Group Senior |
$37.20
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$27.25
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$27.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$55.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$40.92
|
| Rate for Payer: Vantage Medical Group Senior |
$37.20
|
|
|
HC SBBB STAT SPECIMEN PICK UP/DEL
|
Facility
|
OP
|
$75.00
|
|
|
Service Code
|
CPT 99001
|
| Hospital Charge Code |
900904617
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$7.10 |
| Max. Negotiated Rate |
$82.10 |
| Rate for Payer: Adventist Health Commercial |
$15.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$13.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$13.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$63.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$41.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$56.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$82.10
|
| Rate for Payer: Blue Shield of California Commercial |
$46.58
|
| Rate for Payer: Blue Shield of California EPN |
$44.02
|
| Rate for Payer: Cash Price |
$33.75
|
| Rate for Payer: Cash Price |
$33.75
|
| Rate for Payer: Cigna of CA HMO/PPO |
$48.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$63.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$63.75
|
| Rate for Payer: Dignity Health Senior |
$63.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$48.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$46.42
|
| Rate for Payer: Heritage Provider Network Senior |
$46.42
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$36.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18.75
|
| Rate for Payer: Multiplan Commercial |
$56.25
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$7.10
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$7.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$63.75
|
| Rate for Payer: Vantage Medical Group Senior |
$63.75
|
|
|
HC SBBB STAT SPECIMEN PICK UP/DEL
|
Facility
|
IP
|
$75.00
|
|
|
Service Code
|
CPT 99001
|
| Hospital Charge Code |
900904617
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$13.58 |
| Max. Negotiated Rate |
$56.25 |
| Rate for Payer: Adventist Health Commercial |
$15.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$51.52
|
| Rate for Payer: Cash Price |
$33.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$50.78
|
| Rate for Payer: Heritage Provider Network Senior |
$50.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18.75
|
| Rate for Payer: Multiplan Commercial |
$56.25
|
|
|
HC SBBB TITRATION
|
Facility
|
OP
|
$150.00
|
|
|
Service Code
|
CPT 86886
|
| Hospital Charge Code |
900904740
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$6.58 |
| Max. Negotiated Rate |
$596.00 |
| Rate for Payer: Adventist Health Commercial |
$30.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$15.06
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$103.05
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$320.12
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$234.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$213.41
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$86.02
|
| Rate for Payer: Blue Shield of California Commercial |
$93.15
|
| Rate for Payer: Blue Shield of California EPN |
$88.05
|
| Rate for Payer: Cash Price |
$67.50
|
| Rate for Payer: Cash Price |
$67.50
|
| Rate for Payer: Cash Price |
$67.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$97.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$320.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$234.75
|
| Rate for Payer: Dignity Health Senior |
$213.41
|
| Rate for Payer: EPIC Health Plan Commercial |
$97.50
|
| Rate for Payer: EPIC Health Plan Medicare |
$213.41
|
| Rate for Payer: Heritage Provider Network Commercial |
$92.85
|
| Rate for Payer: Heritage Provider Network Senior |
$92.85
|
| Rate for Payer: Humana Medicare |
$213.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$6.58
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$213.41
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$405.48
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$27.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$251.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$37.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$268.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$268.90
|
| Rate for Payer: Multiplan Commercial |
$112.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$234.75
|
| Rate for Payer: TriValley Medical Group Senior |
$213.41
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$596.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$501.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$320.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$234.75
|
| Rate for Payer: Vantage Medical Group Senior |
$213.41
|
|
|
HC SBBB TITRATION
|
Facility
|
IP
|
$150.00
|
|
|
Service Code
|
CPT 86886
|
| Hospital Charge Code |
900904740
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$27.15 |
| Max. Negotiated Rate |
$112.50 |
| Rate for Payer: Adventist Health Commercial |
$30.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$103.05
|
| Rate for Payer: Cash Price |
$67.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$101.55
|
| Rate for Payer: Heritage Provider Network Senior |
$101.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$27.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$37.50
|
| Rate for Payer: Multiplan Commercial |
$112.50
|
|
|
HC SBBB UNIT SEARCH CHARGE
|
Facility
|
OP
|
$110.00
|
|
|
Service Code
|
CPT 86999
|
| Hospital Charge Code |
900904428
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$19.91 |
| Max. Negotiated Rate |
$82.50 |
| Rate for Payer: Adventist Health Commercial |
$22.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$58.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$75.57
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$55.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$40.92
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$37.20
|
| Rate for Payer: Blue Shield of California Commercial |
$68.31
|
| Rate for Payer: Blue Shield of California EPN |
$64.57
|
| Rate for Payer: Cash Price |
$49.50
|
| Rate for Payer: Cash Price |
$49.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$71.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$55.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$40.92
|
| Rate for Payer: Dignity Health Senior |
$37.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$71.50
|
| Rate for Payer: EPIC Health Plan Medicare |
$37.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$68.09
|
| Rate for Payer: Heritage Provider Network Senior |
$68.09
|
| Rate for Payer: Humana Medicare |
$37.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$37.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$70.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$19.91
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$43.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$46.87
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$46.87
|
| Rate for Payer: Multiplan Commercial |
$82.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$37.20
|
| Rate for Payer: TriValley Medical Group Senior |
$37.20
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$27.25
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$27.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$55.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$40.92
|
| Rate for Payer: Vantage Medical Group Senior |
$37.20
|
|
