|
HC SOM BRUCELLA AB IGG
|
Facility
|
OP
|
$20.74
|
|
|
Service Code
|
CPT 86622
|
| Hospital Charge Code |
900911628
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.75 |
| Max. Negotiated Rate |
$73.63 |
| Rate for Payer: Adventist Health Commercial |
$4.15
|
| Rate for Payer: Aetna of CA Gatekeeper |
$11.09
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$14.25
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13.39
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9.82
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.93
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$73.63
|
| Rate for Payer: Blue Shield of California Commercial |
$70.16
|
| Rate for Payer: Blue Shield of California EPN |
$56.27
|
| Rate for Payer: Cash Price |
$20.74
|
| Rate for Payer: Cash Price |
$20.74
|
| Rate for Payer: Cigna of CA HMO/PPO |
$13.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13.39
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.82
|
| Rate for Payer: Dignity Health Senior |
$8.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.48
|
| Rate for Payer: EPIC Health Plan Medicare |
$8.93
|
| Rate for Payer: Heritage Provider Network Commercial |
$12.84
|
| Rate for Payer: Heritage Provider Network Senior |
$12.84
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$12.86
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.93
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$9.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.18
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11.25
|
| Rate for Payer: Multiplan Commercial |
$15.55
|
| Rate for Payer: TriValley Medical Group Commercial |
$8.93
|
| Rate for Payer: TriValley Medical Group Senior |
$8.93
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$9.65
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$9.65
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13.39
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.82
|
| Rate for Payer: Vantage Medical Group Senior |
$8.93
|
|
|
HC SOM BRUCELLA AB IGM
|
Facility
|
OP
|
$20.74
|
|
|
Service Code
|
CPT 86622
|
| Hospital Charge Code |
900912667
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.75 |
| Max. Negotiated Rate |
$73.63 |
| Rate for Payer: Adventist Health Commercial |
$4.15
|
| Rate for Payer: Aetna of CA Gatekeeper |
$11.09
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$14.25
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13.39
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9.82
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.93
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$73.63
|
| Rate for Payer: Blue Shield of California Commercial |
$70.16
|
| Rate for Payer: Blue Shield of California EPN |
$56.27
|
| Rate for Payer: Cash Price |
$20.74
|
| Rate for Payer: Cash Price |
$20.74
|
| Rate for Payer: Cigna of CA HMO/PPO |
$13.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13.39
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.82
|
| Rate for Payer: Dignity Health Senior |
$8.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.48
|
| Rate for Payer: EPIC Health Plan Medicare |
$8.93
|
| Rate for Payer: Heritage Provider Network Commercial |
$12.84
|
| Rate for Payer: Heritage Provider Network Senior |
$12.84
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$12.86
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.93
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$9.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.18
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11.25
|
| Rate for Payer: Multiplan Commercial |
$15.55
|
| Rate for Payer: TriValley Medical Group Commercial |
$8.93
|
| Rate for Payer: TriValley Medical Group Senior |
$8.93
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$9.65
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$9.65
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13.39
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.82
|
| Rate for Payer: Vantage Medical Group Senior |
$8.93
|
|
|
HC SOM BRUCELLA AB IGM
|
Facility
|
IP
|
$20.74
|
|
|
Service Code
|
CPT 86622
|
| Hospital Charge Code |
900912667
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.75 |
| Max. Negotiated Rate |
$15.55 |
| Rate for Payer: Adventist Health Commercial |
$4.15
|
| Rate for Payer: Cash Price |
$20.74
|
| Rate for Payer: Heritage Provider Network Commercial |
$14.04
|
| Rate for Payer: Heritage Provider Network Senior |
$14.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.18
|
| Rate for Payer: Multiplan Commercial |
$15.55
|
|
|
HC SOM C-1 ESTERASE INHIBITOR ACTIVIT
|
Facility
|
IP
|
$18.00
|
|
|
Service Code
|
CPT 83883
|
| Hospital Charge Code |
900911175
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.26 |
| Max. Negotiated Rate |
$13.50 |
| Rate for Payer: Adventist Health Commercial |
$3.60
|
| Rate for Payer: Cash Price |
$18.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$12.19
|
| Rate for Payer: Heritage Provider Network Senior |
$12.19
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.50
|
| Rate for Payer: Multiplan Commercial |
$13.50
|
|
|
HC SOM C-1 ESTERASE INHIBITOR ACTIVIT
|
Facility
|
OP
|
$18.00
|
|
|
Service Code
|
CPT 83883
|
| Hospital Charge Code |
900911175
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.26 |
| Max. Negotiated Rate |
$124.28 |
| Rate for Payer: Adventist Health Commercial |
$3.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$9.62
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$12.37
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.96
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$124.28
|
| Rate for Payer: Blue Shield of California Commercial |
$109.44
|
| Rate for Payer: Blue Shield of California EPN |
$87.78
|
| Rate for Payer: Cash Price |
$18.00
|
| Rate for Payer: Cash Price |
$18.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$11.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.96
|
| Rate for Payer: Dignity Health Senior |
$13.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.70
|
| Rate for Payer: EPIC Health Plan Medicare |
$13.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$11.14
|
| Rate for Payer: Heritage Provider Network Senior |
$11.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$19.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$8.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.26
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17.14
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17.14
|
| Rate for Payer: Multiplan Commercial |
$13.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$13.60
|
| Rate for Payer: TriValley Medical Group Senior |
$13.60
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$14.69
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$14.69
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.96
|
| Rate for Payer: Vantage Medical Group Senior |
$13.60
|
|
|
HC SOM C1 EXTERASE INHIBITOR FUNCTION
|
Facility
|
OP
|
$30.00
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
900912844
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.43 |
| Max. Negotiated Rate |
$118.19 |
| Rate for Payer: Adventist Health Commercial |
$6.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$16.04
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$20.61
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$25.91
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$17.27
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$118.19
|
| Rate for Payer: Blue Shield of California Commercial |
$104.20
|
| Rate for Payer: Blue Shield of California EPN |
$83.58
|
| Rate for Payer: Cash Price |
$30.00
|
| Rate for Payer: Cash Price |
$30.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$19.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$25.91
|
| Rate for Payer: Dignity Health Medi-Cal |
$19.00
|
| Rate for Payer: Dignity Health Senior |
$17.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.50
|
| Rate for Payer: EPIC Health Plan Medicare |
$17.27
|
| Rate for Payer: Heritage Provider Network Commercial |
$18.57
|
| Rate for Payer: Heritage Provider Network Senior |
$18.57
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$16.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$17.27
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$14.31
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.43
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$19.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$21.76
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$21.76
|
| Rate for Payer: Multiplan Commercial |
$22.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$17.27
|
| Rate for Payer: TriValley Medical Group Senior |
$17.27
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$18.65
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$18.65
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$25.91
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.00
|
| Rate for Payer: Vantage Medical Group Senior |
$17.27
|
|
|
HC SOM C1 EXTERASE INHIBITOR FUNCTION
|
Facility
|
IP
|
$30.00
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
900912844
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.43 |
| Max. Negotiated Rate |
$22.50 |
| Rate for Payer: Adventist Health Commercial |
$6.00
|
| Rate for Payer: Cash Price |
$30.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$20.31
|
| Rate for Payer: Heritage Provider Network Senior |
$20.31
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.50
|
| Rate for Payer: Multiplan Commercial |
$22.50
|
|
|
HC SOM CA 27.29
|
Facility
|
IP
|
$14.75
|
|
|
Service Code
|
CPT 86300
|
| Hospital Charge Code |
900911430
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.67 |
| Max. Negotiated Rate |
$11.06 |
| Rate for Payer: Adventist Health Commercial |
$2.95
|
| Rate for Payer: Cash Price |
$14.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$9.99
|
| Rate for Payer: Heritage Provider Network Senior |
$9.99
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.69
|
| Rate for Payer: Multiplan Commercial |
$11.06
|
|
|
HC SOM CA 27.29
|
Facility
|
OP
|
$14.75
|
|
|
Service Code
|
CPT 86300
|
| Hospital Charge Code |
900911430
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.67 |
| Max. Negotiated Rate |
$189.86 |
| Rate for Payer: Adventist Health Commercial |
$2.95
|
| Rate for Payer: Aetna of CA Gatekeeper |
$7.88
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$10.13
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$31.21
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$22.89
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$20.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$189.86
|
| Rate for Payer: Blue Shield of California Commercial |
$167.44
|
| Rate for Payer: Blue Shield of California EPN |
$134.30
|
| Rate for Payer: Cash Price |
$14.75
|
| Rate for Payer: Cash Price |
$14.75
|
| Rate for Payer: Cigna of CA HMO/PPO |
$9.59
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$31.21
|
| Rate for Payer: Dignity Health Medi-Cal |
$22.89
|
| Rate for Payer: Dignity Health Senior |
$20.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.59
|
| Rate for Payer: EPIC Health Plan Medicare |
$20.81
|
| Rate for Payer: Heritage Provider Network Commercial |
$9.13
|
| Rate for Payer: Heritage Provider Network Senior |
$9.13
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$29.97
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$20.81
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$7.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$23.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.69
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$26.22
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$26.22
|
| Rate for Payer: Multiplan Commercial |
$11.06
|
| Rate for Payer: TriValley Medical Group Commercial |
$20.81
|
| Rate for Payer: TriValley Medical Group Senior |
$20.81
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$22.48
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$22.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$31.21
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$22.89
|
| Rate for Payer: Vantage Medical Group Senior |
$20.81
|
|
|
HC SOM CADMIUM WHOLE BLOOD
|
Facility
|
IP
|
$30.00
|
|
|
Service Code
|
CPT 82300
|
| Hospital Charge Code |
900911051
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.43 |
| Max. Negotiated Rate |
$22.50 |
| Rate for Payer: Adventist Health Commercial |
$6.00
|
| Rate for Payer: Cash Price |
$30.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$20.31
|
| Rate for Payer: Heritage Provider Network Senior |
$20.31
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.50
|
| Rate for Payer: Multiplan Commercial |
$22.50
|
|
|
HC SOM CADMIUM WHOLE BLOOD
|
Facility
|
OP
|
$30.00
|
|
|
Service Code
|
CPT 82300
|
| Hospital Charge Code |
900911051
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.43 |
| Max. Negotiated Rate |
$211.19 |
| Rate for Payer: Adventist Health Commercial |
$6.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$16.04
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$20.61
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$35.46
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$26.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$23.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$211.19
|
| Rate for Payer: Blue Shield of California Commercial |
$186.22
|
| Rate for Payer: Blue Shield of California EPN |
$149.36
|
| Rate for Payer: Cash Price |
$30.00
|
| Rate for Payer: Cash Price |
$30.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$19.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$35.46
|
| Rate for Payer: Dignity Health Medi-Cal |
$26.00
|
| Rate for Payer: Dignity Health Senior |
$23.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.50
|
| Rate for Payer: EPIC Health Plan Medicare |
$23.64
|
| Rate for Payer: Heritage Provider Network Commercial |
$18.57
|
| Rate for Payer: Heritage Provider Network Senior |
$18.57
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$33.32
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$23.64
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$14.31
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.43
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$27.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$29.79
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$29.79
|
| Rate for Payer: Multiplan Commercial |
$22.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$23.64
|
| Rate for Payer: TriValley Medical Group Senior |
$23.64
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$25.54
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$25.54
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$35.46
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$26.00
|
| Rate for Payer: Vantage Medical Group Senior |
$23.64
|
|
|
HC SOM CAH 11-DESOXYCORTISOL
|
Facility
|
OP
|
$76.96
|
|
|
Service Code
|
CPT 82634
|
| Hospital Charge Code |
900912775
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.93 |
| Max. Negotiated Rate |
$267.18 |
| Rate for Payer: Adventist Health Commercial |
$15.39
|
| Rate for Payer: Aetna of CA Gatekeeper |
$41.14
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$52.87
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$43.92
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$32.21
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$29.28
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$267.18
|
| Rate for Payer: Blue Shield of California Commercial |
$235.58
|
| Rate for Payer: Blue Shield of California EPN |
$188.96
|
| Rate for Payer: Cash Price |
$76.96
|
| Rate for Payer: Cash Price |
$76.96
|
| Rate for Payer: Cigna of CA HMO/PPO |
$50.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$43.92
|
| Rate for Payer: Dignity Health Medi-Cal |
$32.21
|
| Rate for Payer: Dignity Health Senior |
$29.28
|
| Rate for Payer: EPIC Health Plan Commercial |
$50.02
|
| Rate for Payer: EPIC Health Plan Medicare |
$29.28
|
| Rate for Payer: Heritage Provider Network Commercial |
$47.64
|
| Rate for Payer: Heritage Provider Network Senior |
$47.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$42.15
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$29.28
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$36.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$33.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$36.89
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$36.89
|
| Rate for Payer: Multiplan Commercial |
$57.72
|
| Rate for Payer: TriValley Medical Group Commercial |
$29.28
|
| Rate for Payer: TriValley Medical Group Senior |
$29.28
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$31.62
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$31.62
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$43.92
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$32.21
|
| Rate for Payer: Vantage Medical Group Senior |
$29.28
|
|
|
HC SOM CAH 11-DESOXYCORTISOL
|
Facility
|
IP
|
$76.96
|
|
|
Service Code
|
CPT 82634
|
| Hospital Charge Code |
900912775
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.93 |
| Max. Negotiated Rate |
$57.72 |
| Rate for Payer: Adventist Health Commercial |
$15.39
|
| Rate for Payer: Cash Price |
$76.96
|
| Rate for Payer: Heritage Provider Network Commercial |
$52.10
|
| Rate for Payer: Heritage Provider Network Senior |
$52.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.24
|
| Rate for Payer: Multiplan Commercial |
$57.72
|
|
|
HC SOM CAH 17-ALPHA-OH PROGESTERONE
|
Facility
|
OP
|
$71.41
|
|
|
Service Code
|
CPT 83498
|
| Hospital Charge Code |
900912778
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.93 |
| Max. Negotiated Rate |
$248.00 |
| Rate for Payer: Adventist Health Commercial |
$14.28
|
| Rate for Payer: Aetna of CA Gatekeeper |
$38.17
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$49.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$40.76
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$29.89
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$27.17
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$248.00
|
| Rate for Payer: Blue Shield of California Commercial |
$218.59
|
| Rate for Payer: Blue Shield of California EPN |
$175.33
|
| Rate for Payer: Cash Price |
$71.41
|
| Rate for Payer: Cash Price |
$71.41
|
| Rate for Payer: Cigna of CA HMO/PPO |
$46.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$40.76
|
| Rate for Payer: Dignity Health Medi-Cal |
$29.89
|
| Rate for Payer: Dignity Health Senior |
$27.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$46.42
|
| Rate for Payer: EPIC Health Plan Medicare |
$27.17
|
| Rate for Payer: Heritage Provider Network Commercial |
$44.20
|
| Rate for Payer: Heritage Provider Network Senior |
$44.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$38.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$27.17
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$34.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$31.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$17.85
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$34.23
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$34.23
|
| Rate for Payer: Multiplan Commercial |
$53.56
|
| Rate for Payer: TriValley Medical Group Commercial |
$27.17
|
| Rate for Payer: TriValley Medical Group Senior |
$27.17
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$29.34
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$29.34
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$40.76
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$29.89
|
| Rate for Payer: Vantage Medical Group Senior |
$27.17
|
|
|
HC SOM CAH 17-ALPHA-OH PROGESTERONE
|
Facility
|
IP
|
$71.41
|
|
|
Service Code
|
CPT 83498
|
| Hospital Charge Code |
900912778
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.93 |
| Max. Negotiated Rate |
$53.56 |
| Rate for Payer: Adventist Health Commercial |
$14.28
|
| Rate for Payer: Cash Price |
$71.41
|
| Rate for Payer: Heritage Provider Network Commercial |
$48.34
|
| Rate for Payer: Heritage Provider Network Senior |
$48.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$17.85
|
| Rate for Payer: Multiplan Commercial |
$53.56
|
|
|
HC SOM CAH 17-OH PREGNENOLONE
|
Facility
|
IP
|
$59.95
|
|
|
Service Code
|
CPT 84143
|
| Hospital Charge Code |
900912776
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.85 |
| Max. Negotiated Rate |
$44.96 |
| Rate for Payer: Adventist Health Commercial |
$11.99
|
| Rate for Payer: Cash Price |
$59.95
|
| Rate for Payer: Heritage Provider Network Commercial |
$40.59
|
| Rate for Payer: Heritage Provider Network Senior |
$40.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.99
|
| Rate for Payer: Multiplan Commercial |
$44.96
|
|
|
HC SOM CAH 17-OH PREGNENOLONE
|
Facility
|
OP
|
$59.95
|
|
|
Service Code
|
CPT 84143
|
| Hospital Charge Code |
900912776
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.85 |
| Max. Negotiated Rate |
$208.36 |
| Rate for Payer: Adventist Health Commercial |
$11.99
|
| Rate for Payer: Aetna of CA Gatekeeper |
$32.04
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$41.19
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$34.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$25.09
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$22.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$208.36
|
| Rate for Payer: Blue Shield of California Commercial |
$183.69
|
| Rate for Payer: Blue Shield of California EPN |
$147.33
|
| Rate for Payer: Cash Price |
$59.95
|
| Rate for Payer: Cash Price |
$59.95
|
| Rate for Payer: Cigna of CA HMO/PPO |
$38.97
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$34.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$25.09
|
| Rate for Payer: Dignity Health Senior |
$22.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$38.97
|
| Rate for Payer: EPIC Health Plan Medicare |
$22.81
|
| Rate for Payer: Heritage Provider Network Commercial |
$37.11
|
| Rate for Payer: Heritage Provider Network Senior |
$37.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$32.85
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$22.81
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$28.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10.85
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$26.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.99
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$28.74
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$28.74
|
| Rate for Payer: Multiplan Commercial |
$44.96
|
| Rate for Payer: TriValley Medical Group Commercial |
$22.81
|
| Rate for Payer: TriValley Medical Group Senior |
$22.81
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$24.64
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$24.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$34.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25.09
|
| Rate for Payer: Vantage Medical Group Senior |
$22.81
|
|
|
HC SOM CAH ANDROSTENEDIONE
|
Facility
|
OP
|
$76.95
|
|
|
Service Code
|
CPT 82157
|
| Hospital Charge Code |
900912771
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.93 |
| Max. Negotiated Rate |
$267.18 |
| Rate for Payer: Adventist Health Commercial |
$15.39
|
| Rate for Payer: Aetna of CA Gatekeeper |
$41.13
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$52.86
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$43.92
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$32.21
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$29.28
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$267.18
|
| Rate for Payer: Blue Shield of California Commercial |
$235.58
|
| Rate for Payer: Blue Shield of California EPN |
$188.96
|
| Rate for Payer: Cash Price |
$76.95
|
| Rate for Payer: Cash Price |
$76.95
|
| Rate for Payer: Cigna of CA HMO/PPO |
$50.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$43.92
|
| Rate for Payer: Dignity Health Medi-Cal |
$32.21
|
| Rate for Payer: Dignity Health Senior |
$29.28
|
| Rate for Payer: EPIC Health Plan Commercial |
$50.02
|
| Rate for Payer: EPIC Health Plan Medicare |
$29.28
|
| Rate for Payer: Heritage Provider Network Commercial |
$47.63
|
| Rate for Payer: Heritage Provider Network Senior |
$47.63
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$42.15
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$29.28
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$36.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$33.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$36.89
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$36.89
|
| Rate for Payer: Multiplan Commercial |
$57.71
|
| Rate for Payer: TriValley Medical Group Commercial |
$29.28
|
| Rate for Payer: TriValley Medical Group Senior |
$29.28
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$31.62
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$31.62
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$43.92
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$32.21
|
| Rate for Payer: Vantage Medical Group Senior |
$29.28
|
|
|
HC SOM CAH ANDROSTENEDIONE
|
Facility
|
IP
|
$76.95
|
|
|
Service Code
|
CPT 82157
|
| Hospital Charge Code |
900912771
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.93 |
| Max. Negotiated Rate |
$57.71 |
| Rate for Payer: Adventist Health Commercial |
$15.39
|
| Rate for Payer: Cash Price |
$76.95
|
| Rate for Payer: Heritage Provider Network Commercial |
$52.10
|
| Rate for Payer: Heritage Provider Network Senior |
$52.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.24
|
| Rate for Payer: Multiplan Commercial |
$57.71
|
|
|
HC SOM CAH CORTISOL
|
Facility
|
IP
|
$42.84
|
|
|
Service Code
|
CPT 82533
|
| Hospital Charge Code |
900912772
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.75 |
| Max. Negotiated Rate |
$32.13 |
| Rate for Payer: Adventist Health Commercial |
$8.57
|
| Rate for Payer: Cash Price |
$42.84
|
| Rate for Payer: Heritage Provider Network Commercial |
$29.00
|
| Rate for Payer: Heritage Provider Network Senior |
$29.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.71
|
| Rate for Payer: Multiplan Commercial |
$32.13
|
|
|
HC SOM CAH CORTISOL
|
Facility
|
OP
|
$42.84
|
|
|
Service Code
|
CPT 82533
|
| Hospital Charge Code |
900912772
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.75 |
| Max. Negotiated Rate |
$148.99 |
| Rate for Payer: Adventist Health Commercial |
$8.57
|
| Rate for Payer: Aetna of CA Gatekeeper |
$22.90
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$29.43
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$24.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$17.93
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$16.30
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$148.99
|
| Rate for Payer: Blue Shield of California Commercial |
$131.21
|
| Rate for Payer: Blue Shield of California EPN |
$105.24
|
| Rate for Payer: Cash Price |
$42.84
|
| Rate for Payer: Cash Price |
$42.84
|
| Rate for Payer: Cigna of CA HMO/PPO |
$27.85
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$24.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$17.93
|
| Rate for Payer: Dignity Health Senior |
$16.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$27.85
|
| Rate for Payer: EPIC Health Plan Medicare |
$16.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$26.52
|
| Rate for Payer: Heritage Provider Network Senior |
$26.52
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$23.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$16.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$20.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.71
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$20.54
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$20.54
|
| Rate for Payer: Multiplan Commercial |
$32.13
|
| Rate for Payer: TriValley Medical Group Commercial |
$16.30
|
| Rate for Payer: TriValley Medical Group Senior |
$16.30
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$17.60
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$17.60
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$24.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$17.93
|
| Rate for Payer: Vantage Medical Group Senior |
$16.30
|
|
|
HC SOM CAH DEHYDROEPIANDROSTERONE
|
Facility
|
IP
|
$66.41
|
|
|
Service Code
|
CPT 82626
|
| Hospital Charge Code |
900912774
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.02 |
| Max. Negotiated Rate |
$49.81 |
| Rate for Payer: Adventist Health Commercial |
$13.28
|
| Rate for Payer: Cash Price |
$66.41
|
| Rate for Payer: Heritage Provider Network Commercial |
$44.96
|
| Rate for Payer: Heritage Provider Network Senior |
$44.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.60
|
| Rate for Payer: Multiplan Commercial |
$49.81
|
|
|
HC SOM CAH DEHYDROEPIANDROSTERONE
|
Facility
|
OP
|
$66.41
|
|
|
Service Code
|
CPT 82626
|
| Hospital Charge Code |
900912774
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.02 |
| Max. Negotiated Rate |
$230.73 |
| Rate for Payer: Adventist Health Commercial |
$13.28
|
| Rate for Payer: Aetna of CA Gatekeeper |
$35.50
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$45.62
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$37.91
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$27.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$25.27
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$230.73
|
| Rate for Payer: Blue Shield of California Commercial |
$203.39
|
| Rate for Payer: Blue Shield of California EPN |
$163.13
|
| Rate for Payer: Cash Price |
$66.41
|
| Rate for Payer: Cash Price |
$66.41
|
| Rate for Payer: Cigna of CA HMO/PPO |
$43.17
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$37.91
|
| Rate for Payer: Dignity Health Medi-Cal |
$27.80
|
| Rate for Payer: Dignity Health Senior |
$25.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$43.17
|
| Rate for Payer: EPIC Health Plan Medicare |
$25.27
|
| Rate for Payer: Heritage Provider Network Commercial |
$41.11
|
| Rate for Payer: Heritage Provider Network Senior |
$41.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$36.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$25.27
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$31.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12.02
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$31.84
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$31.84
|
| Rate for Payer: Multiplan Commercial |
$49.81
|
| Rate for Payer: TriValley Medical Group Commercial |
$25.27
|
| Rate for Payer: TriValley Medical Group Senior |
$25.27
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$27.29
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$27.29
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$37.91
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$27.80
|
| Rate for Payer: Vantage Medical Group Senior |
$25.27
|
|
|
HC SOM CAH DEOXYCORTICOSTERONE
|
Facility
|
IP
|
$81.42
|
|
|
Service Code
|
CPT 82633
|
| Hospital Charge Code |
900912773
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.74 |
| Max. Negotiated Rate |
$61.06 |
| Rate for Payer: Adventist Health Commercial |
$16.28
|
| Rate for Payer: Cash Price |
$81.42
|
| Rate for Payer: Heritage Provider Network Commercial |
$55.12
|
| Rate for Payer: Heritage Provider Network Senior |
$55.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.36
|
| Rate for Payer: Multiplan Commercial |
$61.06
|
|
|
HC SOM CAH DEOXYCORTICOSTERONE
|
Facility
|
OP
|
$81.42
|
|
|
Service Code
|
CPT 82633
|
| Hospital Charge Code |
900912773
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.74 |
| Max. Negotiated Rate |
$273.63 |
| Rate for Payer: Adventist Health Commercial |
$16.28
|
| Rate for Payer: Aetna of CA Gatekeeper |
$43.52
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$55.94
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$46.47
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$34.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$30.98
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$273.63
|
| Rate for Payer: Blue Shield of California Commercial |
$249.29
|
| Rate for Payer: Blue Shield of California EPN |
$199.95
|
| Rate for Payer: Cash Price |
$81.42
|
| Rate for Payer: Cash Price |
$81.42
|
| Rate for Payer: Cigna of CA HMO/PPO |
$52.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$46.47
|
| Rate for Payer: Dignity Health Medi-Cal |
$34.08
|
| Rate for Payer: Dignity Health Senior |
$30.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$52.92
|
| Rate for Payer: EPIC Health Plan Medicare |
$30.98
|
| Rate for Payer: Heritage Provider Network Commercial |
$50.40
|
| Rate for Payer: Heritage Provider Network Senior |
$50.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$44.61
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$30.98
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$38.84
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$35.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$39.03
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$39.03
|
| Rate for Payer: Multiplan Commercial |
$61.06
|
| Rate for Payer: TriValley Medical Group Commercial |
$30.98
|
| Rate for Payer: TriValley Medical Group Senior |
$30.98
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$33.46
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$33.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$46.47
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$34.08
|
| Rate for Payer: Vantage Medical Group Senior |
$30.98
|
|
