|
HC SOM CAH PROGESTERONE
|
Facility
|
IP
|
$54.83
|
|
|
Service Code
|
CPT 84144
|
| Hospital Charge Code |
900912777
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.92 |
| Max. Negotiated Rate |
$41.12 |
| Rate for Payer: Adventist Health Commercial |
$10.97
|
| Rate for Payer: Cash Price |
$54.83
|
| Rate for Payer: Heritage Provider Network Commercial |
$37.12
|
| Rate for Payer: Heritage Provider Network Senior |
$37.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.71
|
| Rate for Payer: Multiplan Commercial |
$41.12
|
|
|
HC SOM CAH PROGESTERONE
|
Facility
|
OP
|
$54.83
|
|
|
Service Code
|
CPT 84144
|
| Hospital Charge Code |
900912777
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.92 |
| Max. Negotiated Rate |
$190.47 |
| Rate for Payer: Adventist Health Commercial |
$10.97
|
| Rate for Payer: Aetna of CA Gatekeeper |
$29.31
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$37.67
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$31.29
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$22.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$20.86
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$190.47
|
| Rate for Payer: Blue Shield of California Commercial |
$167.90
|
| Rate for Payer: Blue Shield of California EPN |
$134.67
|
| Rate for Payer: Cash Price |
$54.83
|
| Rate for Payer: Cash Price |
$54.83
|
| Rate for Payer: Cigna of CA HMO/PPO |
$35.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$31.29
|
| Rate for Payer: Dignity Health Medi-Cal |
$22.95
|
| Rate for Payer: Dignity Health Senior |
$20.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$35.64
|
| Rate for Payer: EPIC Health Plan Medicare |
$20.86
|
| Rate for Payer: Heritage Provider Network Commercial |
$33.94
|
| Rate for Payer: Heritage Provider Network Senior |
$33.94
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$29.65
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$20.86
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$26.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.92
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$23.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.71
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$26.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$26.28
|
| Rate for Payer: Multiplan Commercial |
$41.12
|
| Rate for Payer: TriValley Medical Group Commercial |
$20.86
|
| Rate for Payer: TriValley Medical Group Senior |
$20.86
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$22.52
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$22.52
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$31.29
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$22.95
|
| Rate for Payer: Vantage Medical Group Senior |
$20.86
|
|
|
HC SOM CAH TESTOSTERONE
|
Facility
|
IP
|
$67.83
|
|
|
Service Code
|
CPT 84403
|
| Hospital Charge Code |
900912779
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.28 |
| Max. Negotiated Rate |
$50.87 |
| Rate for Payer: Adventist Health Commercial |
$13.57
|
| Rate for Payer: Cash Price |
$67.83
|
| Rate for Payer: Heritage Provider Network Commercial |
$45.92
|
| Rate for Payer: Heritage Provider Network Senior |
$45.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.96
|
| Rate for Payer: Multiplan Commercial |
$50.87
|
|
|
HC SOM CAH TESTOSTERONE
|
Facility
|
OP
|
$67.83
|
|
|
Service Code
|
CPT 84403
|
| Hospital Charge Code |
900912779
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.28 |
| Max. Negotiated Rate |
$235.65 |
| Rate for Payer: Adventist Health Commercial |
$13.57
|
| Rate for Payer: Aetna of CA Gatekeeper |
$36.26
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$46.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$38.72
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$28.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$25.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$235.65
|
| Rate for Payer: Blue Shield of California Commercial |
$207.82
|
| Rate for Payer: Blue Shield of California EPN |
$166.69
|
| Rate for Payer: Cash Price |
$67.83
|
| Rate for Payer: Cash Price |
$67.83
|
| Rate for Payer: Cigna of CA HMO/PPO |
$44.09
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$38.72
|
| Rate for Payer: Dignity Health Medi-Cal |
$28.39
|
| Rate for Payer: Dignity Health Senior |
$25.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$44.09
|
| Rate for Payer: EPIC Health Plan Medicare |
$25.81
|
| Rate for Payer: Heritage Provider Network Commercial |
$41.99
|
| Rate for Payer: Heritage Provider Network Senior |
$41.99
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$36.94
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$25.81
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$32.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.96
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$32.52
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$32.52
|
| Rate for Payer: Multiplan Commercial |
$50.87
|
| Rate for Payer: TriValley Medical Group Commercial |
$25.81
|
| Rate for Payer: TriValley Medical Group Senior |
$25.81
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$27.88
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$27.88
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$38.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$28.39
|
| Rate for Payer: Vantage Medical Group Senior |
$25.81
|
|
|
HC SOM CALCITONIN
|
Facility
|
OP
|
$20.00
|
|
|
Service Code
|
CPT 82308
|
| Hospital Charge Code |
900911003
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.62 |
| Max. Negotiated Rate |
$244.50 |
| Rate for Payer: Adventist Health Commercial |
$4.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$10.69
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$13.74
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$40.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$29.47
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$26.79
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$244.50
|
| Rate for Payer: Blue Shield of California Commercial |
$215.48
|
| Rate for Payer: Blue Shield of California EPN |
$172.83
|
| Rate for Payer: Cash Price |
$20.00
|
| Rate for Payer: Cash Price |
$20.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$13.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$40.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$29.47
|
| Rate for Payer: Dignity Health Senior |
$26.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$26.79
|
| Rate for Payer: Heritage Provider Network Commercial |
$12.38
|
| Rate for Payer: Heritage Provider Network Senior |
$12.38
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$38.57
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$26.79
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$9.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$30.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$33.76
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$33.76
|
| Rate for Payer: Multiplan Commercial |
$15.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$26.79
|
| Rate for Payer: TriValley Medical Group Senior |
$26.79
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$28.93
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$28.93
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$40.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$29.47
|
| Rate for Payer: Vantage Medical Group Senior |
$26.79
|
|
|
HC SOM CALCITONIN
|
Facility
|
IP
|
$20.00
|
|
|
Service Code
|
CPT 82308
|
| Hospital Charge Code |
900911003
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.62 |
| Max. Negotiated Rate |
$15.00 |
| Rate for Payer: Adventist Health Commercial |
$4.00
|
| Rate for Payer: Cash Price |
$20.00
|
| 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 SOM CALPROTECTIN
|
Facility
|
IP
|
$90.00
|
|
|
Service Code
|
CPT 83993
|
| Hospital Charge Code |
900912938
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$16.29 |
| Max. Negotiated Rate |
$67.50 |
| Rate for Payer: Adventist Health Commercial |
$18.00
|
| Rate for Payer: Cash Price |
$90.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$60.93
|
| Rate for Payer: Heritage Provider Network Senior |
$60.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$16.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.50
|
| Rate for Payer: Multiplan Commercial |
$67.50
|
|
|
HC SOM CALPROTECTIN
|
Facility
|
OP
|
$90.00
|
|
|
Service Code
|
CPT 83993
|
| Hospital Charge Code |
900912938
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$16.29 |
| Max. Negotiated Rate |
$179.16 |
| Rate for Payer: Adventist Health Commercial |
$18.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$48.10
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$61.83
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$29.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$21.59
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$19.63
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$179.16
|
| Rate for Payer: Blue Shield of California Commercial |
$157.94
|
| Rate for Payer: Blue Shield of California EPN |
$126.68
|
| Rate for Payer: Cash Price |
$90.00
|
| Rate for Payer: Cash Price |
$90.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$58.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$29.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$21.59
|
| Rate for Payer: Dignity Health Senior |
$19.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$58.50
|
| Rate for Payer: EPIC Health Plan Medicare |
$19.63
|
| Rate for Payer: Heritage Provider Network Commercial |
$55.71
|
| Rate for Payer: Heritage Provider Network Senior |
$55.71
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$28.27
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$19.63
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$42.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$16.29
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$24.73
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$24.73
|
| Rate for Payer: Multiplan Commercial |
$67.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$19.63
|
| Rate for Payer: TriValley Medical Group Senior |
$19.63
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$21.20
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$21.20
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$29.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$21.59
|
| Rate for Payer: Vantage Medical Group Senior |
$19.63
|
|
|
HC SOM CANDIDA AURIS SURV PCR
|
Facility
|
OP
|
$494.90
|
|
|
Service Code
|
CPT 87481
|
| Hospital Charge Code |
900915483
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$35.09 |
| Max. Negotiated Rate |
$371.18 |
| Rate for Payer: Adventist Health Commercial |
$98.98
|
| Rate for Payer: Aetna of CA Gatekeeper |
$264.52
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$340.00
|
| 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 |
$310.02
|
| 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 |
$494.90
|
| Rate for Payer: Cash Price |
$494.90
|
| Rate for Payer: Cigna of CA HMO/PPO |
$321.69
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$52.63
|
| Rate for Payer: Dignity Health Medi-Cal |
$38.60
|
| Rate for Payer: Dignity Health Senior |
$35.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$321.69
|
| Rate for Payer: EPIC Health Plan Medicare |
$35.09
|
| Rate for Payer: Heritage Provider Network Commercial |
$306.34
|
| Rate for Payer: Heritage Provider Network Senior |
$306.34
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$50.53
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$35.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$236.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$89.58
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$40.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$123.72
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$44.21
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$44.21
|
| Rate for Payer: Multiplan Commercial |
$371.18
|
| 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 SOM CANDIDA AURIS SURV PCR
|
Facility
|
IP
|
$494.90
|
|
|
Service Code
|
CPT 87481
|
| Hospital Charge Code |
900915483
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$89.58 |
| Max. Negotiated Rate |
$371.18 |
| Rate for Payer: Adventist Health Commercial |
$98.98
|
| Rate for Payer: Cash Price |
$494.90
|
| Rate for Payer: Heritage Provider Network Commercial |
$335.05
|
| Rate for Payer: Heritage Provider Network Senior |
$335.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$89.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$123.72
|
| Rate for Payer: Multiplan Commercial |
$371.18
|
|
|
HC SOM CARBAPEN MOD HODGE TEST
|
Facility
|
IP
|
$164.70
|
|
|
Service Code
|
CPT 87185
|
| Hospital Charge Code |
900914208
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$29.81 |
| Max. Negotiated Rate |
$123.53 |
| Rate for Payer: Adventist Health Commercial |
$32.94
|
| Rate for Payer: Cash Price |
$164.70
|
| Rate for Payer: Heritage Provider Network Commercial |
$111.50
|
| Rate for Payer: Heritage Provider Network Senior |
$111.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$29.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$41.17
|
| Rate for Payer: Multiplan Commercial |
$123.53
|
|
|
HC SOM CARBAPEN MOD HODGE TEST
|
Facility
|
OP
|
$164.70
|
|
|
Service Code
|
CPT 87185
|
| Hospital Charge Code |
900914208
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$1.96 |
| Max. Negotiated Rate |
$123.53 |
| Rate for Payer: Adventist Health Commercial |
$32.94
|
| Rate for Payer: Aetna of CA Gatekeeper |
$88.03
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$113.15
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.12
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.22
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$26.31
|
| Rate for Payer: Blue Shield of California Commercial |
$23.16
|
| Rate for Payer: Blue Shield of California EPN |
$18.57
|
| Rate for Payer: Cash Price |
$164.70
|
| Rate for Payer: Cash Price |
$164.70
|
| Rate for Payer: Cigna of CA HMO/PPO |
$107.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.22
|
| Rate for Payer: Dignity Health Senior |
$4.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$107.06
|
| Rate for Payer: EPIC Health Plan Medicare |
$4.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$101.95
|
| Rate for Payer: Heritage Provider Network Senior |
$101.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1.96
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$78.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$29.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$41.17
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5.99
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5.99
|
| Rate for Payer: Multiplan Commercial |
$123.53
|
| Rate for Payer: TriValley Medical Group Commercial |
$4.75
|
| Rate for Payer: TriValley Medical Group Senior |
$4.75
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$5.14
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$5.14
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.22
|
| Rate for Payer: Vantage Medical Group Senior |
$4.75
|
|
|
HC SOM CARB DEF TRANS CONGENITAL
|
Facility
|
OP
|
$200.00
|
|
|
Service Code
|
CPT 82373
|
| Hospital Charge Code |
900912514
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.10 |
| Max. Negotiated Rate |
$150.00 |
| Rate for Payer: Adventist Health Commercial |
$40.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$106.90
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$137.40
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$27.09
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19.87
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$18.06
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$65.70
|
| Rate for Payer: Blue Shield of California Commercial |
$145.32
|
| Rate for Payer: Blue Shield of California EPN |
$116.56
|
| Rate for Payer: Cash Price |
$200.00
|
| Rate for Payer: Cash Price |
$200.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$130.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$27.09
|
| Rate for Payer: Dignity Health Medi-Cal |
$19.87
|
| Rate for Payer: Dignity Health Senior |
$18.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$130.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$18.06
|
| Rate for Payer: Heritage Provider Network Commercial |
$123.80
|
| Rate for Payer: Heritage Provider Network Senior |
$123.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$15.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$18.06
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$95.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$36.20
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$20.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$50.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$22.76
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$22.76
|
| Rate for Payer: Multiplan Commercial |
$150.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$18.06
|
| Rate for Payer: TriValley Medical Group Senior |
$18.06
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$19.50
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$19.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$27.09
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.87
|
| Rate for Payer: Vantage Medical Group Senior |
$18.06
|
|
|
HC SOM CARB DEF TRANS CONGENITAL
|
Facility
|
IP
|
$200.00
|
|
|
Service Code
|
CPT 82373
|
| Hospital Charge Code |
900912514
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$36.20 |
| Max. Negotiated Rate |
$150.00 |
| Rate for Payer: Adventist Health Commercial |
$40.00
|
| Rate for Payer: Cash Price |
$200.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$135.40
|
| Rate for Payer: Heritage Provider Network Senior |
$135.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$36.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$50.00
|
| Rate for Payer: Multiplan Commercial |
$150.00
|
|
|
HC SOM CARB DEF TRANSFERRIN ADULT
|
Facility
|
IP
|
$354.50
|
|
|
Service Code
|
CPT 82373
|
| Hospital Charge Code |
900912717
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$64.16 |
| Max. Negotiated Rate |
$265.88 |
| Rate for Payer: Adventist Health Commercial |
$70.90
|
| Rate for Payer: Cash Price |
$354.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$240.00
|
| Rate for Payer: Heritage Provider Network Senior |
$240.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$64.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$88.62
|
| Rate for Payer: Multiplan Commercial |
$265.88
|
|
|
HC SOM CARB DEF TRANSFERRIN ADULT
|
Facility
|
OP
|
$354.50
|
|
|
Service Code
|
CPT 82373
|
| Hospital Charge Code |
900912717
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.10 |
| Max. Negotiated Rate |
$265.88 |
| Rate for Payer: Adventist Health Commercial |
$70.90
|
| Rate for Payer: Aetna of CA Gatekeeper |
$189.48
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$243.54
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$27.09
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19.87
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$18.06
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$65.70
|
| Rate for Payer: Blue Shield of California Commercial |
$145.32
|
| Rate for Payer: Blue Shield of California EPN |
$116.56
|
| Rate for Payer: Cash Price |
$354.50
|
| Rate for Payer: Cash Price |
$354.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$230.43
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$27.09
|
| Rate for Payer: Dignity Health Medi-Cal |
$19.87
|
| Rate for Payer: Dignity Health Senior |
$18.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$230.43
|
| Rate for Payer: EPIC Health Plan Medicare |
$18.06
|
| Rate for Payer: Heritage Provider Network Commercial |
$219.44
|
| Rate for Payer: Heritage Provider Network Senior |
$219.44
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$15.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$18.06
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$169.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$64.16
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$20.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$88.62
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$22.76
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$22.76
|
| Rate for Payer: Multiplan Commercial |
$265.88
|
| Rate for Payer: TriValley Medical Group Commercial |
$18.06
|
| Rate for Payer: TriValley Medical Group Senior |
$18.06
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$19.50
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$19.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$27.09
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.87
|
| Rate for Payer: Vantage Medical Group Senior |
$18.06
|
|
|
HC SOM CARBOXYHEMOGLOBIN
|
Facility
|
IP
|
$35.00
|
|
|
Service Code
|
CPT 82375
|
| Hospital Charge Code |
900911041
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.33 |
| Max. Negotiated Rate |
$26.25 |
| Rate for Payer: Adventist Health Commercial |
$7.00
|
| Rate for Payer: Cash Price |
$35.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$23.70
|
| Rate for Payer: Heritage Provider Network Senior |
$23.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.75
|
| Rate for Payer: Multiplan Commercial |
$26.25
|
|
|
HC SOM CARBOXYHEMOGLOBIN
|
Facility
|
OP
|
$35.00
|
|
|
Service Code
|
CPT 82375
|
| Hospital Charge Code |
900911041
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.33 |
| Max. Negotiated Rate |
$112.54 |
| Rate for Payer: Adventist Health Commercial |
$7.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$18.71
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$24.05
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$18.48
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12.32
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$112.54
|
| Rate for Payer: Blue Shield of California Commercial |
$99.19
|
| Rate for Payer: Blue Shield of California EPN |
$79.56
|
| Rate for Payer: Cash Price |
$35.00
|
| Rate for Payer: Cash Price |
$35.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$22.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$18.48
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.55
|
| Rate for Payer: Dignity Health Senior |
$12.32
|
| Rate for Payer: EPIC Health Plan Commercial |
$22.75
|
| Rate for Payer: EPIC Health Plan Medicare |
$12.32
|
| Rate for Payer: Heritage Provider Network Commercial |
$21.66
|
| Rate for Payer: Heritage Provider Network Senior |
$21.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$17.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$12.32
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$16.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6.33
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$15.52
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$15.52
|
| Rate for Payer: Multiplan Commercial |
$26.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$12.32
|
| Rate for Payer: TriValley Medical Group Senior |
$12.32
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$13.31
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$13.31
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$18.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.55
|
| Rate for Payer: Vantage Medical Group Senior |
$12.32
|
|
|
HC SOM CARNITINE PLASMA
|
Facility
|
IP
|
$25.00
|
|
|
Service Code
|
CPT 82379
|
| Hospital Charge Code |
900911103
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.53 |
| Max. Negotiated Rate |
$18.75 |
| Rate for Payer: Adventist Health Commercial |
$5.00
|
| Rate for Payer: Cash Price |
$25.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$16.93
|
| Rate for Payer: Heritage Provider Network Senior |
$16.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.25
|
| Rate for Payer: Multiplan Commercial |
$18.75
|
|
|
HC SOM CARNITINE PLASMA
|
Facility
|
OP
|
$25.00
|
|
|
Service Code
|
CPT 82379
|
| Hospital Charge Code |
900911103
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.53 |
| Max. Negotiated Rate |
$153.29 |
| Rate for Payer: Adventist Health Commercial |
$5.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$13.36
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$17.18
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$25.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$18.56
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$16.87
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$153.29
|
| Rate for Payer: Blue Shield of California Commercial |
$135.76
|
| Rate for Payer: Blue Shield of California EPN |
$108.89
|
| Rate for Payer: Cash Price |
$25.00
|
| Rate for Payer: Cash Price |
$25.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$16.25
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$25.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$18.56
|
| Rate for Payer: Dignity Health Senior |
$16.87
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.25
|
| Rate for Payer: EPIC Health Plan Medicare |
$16.87
|
| Rate for Payer: Heritage Provider Network Commercial |
$15.47
|
| Rate for Payer: Heritage Provider Network Senior |
$15.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$24.28
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$16.87
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$11.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$19.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$21.26
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$21.26
|
| Rate for Payer: Multiplan Commercial |
$18.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$16.87
|
| Rate for Payer: TriValley Medical Group Senior |
$16.87
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$18.22
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$18.22
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$25.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$18.56
|
| Rate for Payer: Vantage Medical Group Senior |
$16.87
|
|
|
HC SOM CARNITINE URINE
|
Facility
|
IP
|
$60.00
|
|
|
Service Code
|
CPT 82379
|
| Hospital Charge Code |
900910730
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.86 |
| Max. Negotiated Rate |
$45.00 |
| Rate for Payer: Adventist Health Commercial |
$12.00
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$40.62
|
| Rate for Payer: Heritage Provider Network Senior |
$40.62
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.00
|
| Rate for Payer: Multiplan Commercial |
$45.00
|
|
|
HC SOM CARNITINE URINE
|
Facility
|
OP
|
$60.00
|
|
|
Service Code
|
CPT 82379
|
| Hospital Charge Code |
900910730
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.86 |
| Max. Negotiated Rate |
$153.29 |
| Rate for Payer: Adventist Health Commercial |
$12.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$32.07
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$41.22
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$25.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$18.56
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$16.87
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$153.29
|
| Rate for Payer: Blue Shield of California Commercial |
$135.76
|
| Rate for Payer: Blue Shield of California EPN |
$108.89
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$39.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$25.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$18.56
|
| Rate for Payer: Dignity Health Senior |
$16.87
|
| Rate for Payer: EPIC Health Plan Commercial |
$39.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$16.87
|
| Rate for Payer: Heritage Provider Network Commercial |
$37.14
|
| Rate for Payer: Heritage Provider Network Senior |
$37.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$24.28
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$16.87
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$28.62
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10.86
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$19.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$21.26
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$21.26
|
| Rate for Payer: Multiplan Commercial |
$45.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$16.87
|
| Rate for Payer: TriValley Medical Group Senior |
$16.87
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$18.22
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$18.22
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$25.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$18.56
|
| Rate for Payer: Vantage Medical Group Senior |
$16.87
|
|
|
HC SOM CAROTENE
|
Facility
|
OP
|
$122.75
|
|
|
Service Code
|
CPT 82380
|
| Hospital Charge Code |
900911303
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.22 |
| Max. Negotiated Rate |
$92.06 |
| Rate for Payer: Adventist Health Commercial |
$24.55
|
| Rate for Payer: Aetna of CA Gatekeeper |
$65.61
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$84.33
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13.83
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10.14
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$84.27
|
| Rate for Payer: Blue Shield of California Commercial |
$74.25
|
| Rate for Payer: Blue Shield of California EPN |
$59.55
|
| Rate for Payer: Cash Price |
$122.75
|
| Rate for Payer: Cash Price |
$122.75
|
| Rate for Payer: Cigna of CA HMO/PPO |
$79.79
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13.83
|
| Rate for Payer: Dignity Health Medi-Cal |
$10.14
|
| Rate for Payer: Dignity Health Senior |
$9.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$79.79
|
| Rate for Payer: EPIC Health Plan Medicare |
$9.22
|
| Rate for Payer: Heritage Provider Network Commercial |
$75.98
|
| Rate for Payer: Heritage Provider Network Senior |
$75.98
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$13.28
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$9.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$58.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$22.22
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$30.69
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11.62
|
| Rate for Payer: Multiplan Commercial |
$92.06
|
| Rate for Payer: TriValley Medical Group Commercial |
$9.22
|
| Rate for Payer: TriValley Medical Group Senior |
$9.22
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$9.96
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$9.96
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.14
|
| Rate for Payer: Vantage Medical Group Senior |
$9.22
|
|
|
HC SOM CAROTENE
|
Facility
|
IP
|
$122.75
|
|
|
Service Code
|
CPT 82380
|
| Hospital Charge Code |
900911303
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$22.22 |
| Max. Negotiated Rate |
$92.06 |
| Rate for Payer: Adventist Health Commercial |
$24.55
|
| Rate for Payer: Cash Price |
$122.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$83.10
|
| Rate for Payer: Heritage Provider Network Senior |
$83.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$22.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$30.69
|
| Rate for Payer: Multiplan Commercial |
$92.06
|
|
|
HC SOM CATECHOLAMINE FRACT FREE UR
|
Facility
|
OP
|
$30.00
|
|
|
Service Code
|
CPT 82384
|
| Hospital Charge Code |
900914081
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.43 |
| Max. Negotiated Rate |
$230.55 |
| 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 |
$37.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$27.77
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$25.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$230.55
|
| Rate for Payer: Blue Shield of California Commercial |
$203.21
|
| Rate for Payer: Blue Shield of California EPN |
$162.99
|
| 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 |
$37.88
|
| Rate for Payer: Dignity Health Medi-Cal |
$27.77
|
| Rate for Payer: Dignity Health Senior |
$25.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.50
|
| Rate for Payer: EPIC Health Plan Medicare |
$25.25
|
| 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 |
$36.37
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$25.25
|
| 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 |
$29.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$31.82
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$31.82
|
| Rate for Payer: Multiplan Commercial |
$22.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$25.25
|
| Rate for Payer: TriValley Medical Group Senior |
$25.25
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$27.28
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$27.28
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$37.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$27.77
|
| Rate for Payer: Vantage Medical Group Senior |
$25.25
|
|
