|
HC SOM FACTOR VIII INH. SCREEN
|
Facility
|
OP
|
$125.00
|
|
|
Service Code
|
CPT 85335
|
| Hospital Charge Code |
900912803
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$12.87 |
| Max. Negotiated Rate |
$117.52 |
| Rate for Payer: Adventist Health Commercial |
$25.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$66.81
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$85.88
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12.87
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$117.52
|
| Rate for Payer: Blue Shield of California Commercial |
$103.62
|
| Rate for Payer: Blue Shield of California EPN |
$83.11
|
| Rate for Payer: Cash Price |
$125.00
|
| Rate for Payer: Cash Price |
$125.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$81.25
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.16
|
| Rate for Payer: Dignity Health Senior |
$12.87
|
| Rate for Payer: EPIC Health Plan Commercial |
$81.25
|
| Rate for Payer: EPIC Health Plan Medicare |
$12.87
|
| Rate for Payer: Heritage Provider Network Commercial |
$77.38
|
| Rate for Payer: Heritage Provider Network Senior |
$77.38
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$18.53
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$12.87
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$59.62
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$22.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$31.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16.22
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16.22
|
| Rate for Payer: Multiplan Commercial |
$93.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$12.87
|
| Rate for Payer: TriValley Medical Group Senior |
$12.87
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$13.90
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$13.90
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.16
|
| Rate for Payer: Vantage Medical Group Senior |
$12.87
|
|
|
HC SOM FACTOR VIII INH. SCREEN
|
Facility
|
IP
|
$125.00
|
|
|
Service Code
|
CPT 85335
|
| Hospital Charge Code |
900912803
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$22.62 |
| Max. Negotiated Rate |
$93.75 |
| Rate for Payer: Adventist Health Commercial |
$25.00
|
| Rate for Payer: Cash Price |
$125.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$84.62
|
| Rate for Payer: Heritage Provider Network Senior |
$84.62
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$22.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$31.25
|
| Rate for Payer: Multiplan Commercial |
$93.75
|
|
|
HC SOM FANBF 86038
|
Facility
|
IP
|
$75.00
|
|
|
Service Code
|
CPT 86038
|
| Hospital Charge Code |
900914925
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.57 |
| Max. Negotiated Rate |
$56.25 |
| Rate for Payer: Adventist Health Commercial |
$15.00
|
| Rate for Payer: Cash Price |
$75.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$50.77
|
| Rate for Payer: Heritage Provider Network Senior |
$50.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18.75
|
| Rate for Payer: Multiplan Commercial |
$56.25
|
|
|
HC SOM FANBF 86038
|
Facility
|
OP
|
$75.00
|
|
|
Service Code
|
CPT 86038
|
| Hospital Charge Code |
900914925
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.09 |
| Max. Negotiated Rate |
$110.33 |
| Rate for Payer: Adventist Health Commercial |
$15.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$40.09
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$51.52
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$18.14
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13.30
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$110.33
|
| Rate for Payer: Blue Shield of California Commercial |
$97.29
|
| Rate for Payer: Blue Shield of California EPN |
$78.03
|
| Rate for Payer: Cash Price |
$75.00
|
| Rate for Payer: Cash Price |
$75.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$48.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$18.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.30
|
| Rate for Payer: Dignity Health Senior |
$12.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$48.75
|
| Rate for Payer: EPIC Health Plan Medicare |
$12.09
|
| Rate for Payer: Heritage Provider Network Commercial |
$46.42
|
| Rate for Payer: Heritage Provider Network Senior |
$46.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$17.22
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$12.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$35.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$15.23
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$15.23
|
| Rate for Payer: Multiplan Commercial |
$56.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$12.09
|
| Rate for Payer: TriValley Medical Group Senior |
$12.09
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$13.06
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$13.06
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$18.14
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.30
|
| Rate for Payer: Vantage Medical Group Senior |
$12.09
|
|
|
HC SOM FAP KNOWN MUT EXTRACT
|
Facility
|
IP
|
$318.21
|
|
|
Service Code
|
CPT 81202
|
| Hospital Charge Code |
900914620
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$57.60 |
| Max. Negotiated Rate |
$238.66 |
| Rate for Payer: Adventist Health Commercial |
$63.64
|
| Rate for Payer: Cash Price |
$318.21
|
| Rate for Payer: Heritage Provider Network Commercial |
$215.43
|
| Rate for Payer: Heritage Provider Network Senior |
$215.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$57.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$79.55
|
| Rate for Payer: Multiplan Commercial |
$238.66
|
|
|
HC SOM FAP KNOWN MUT EXTRACT
|
Facility
|
OP
|
$318.21
|
|
|
Service Code
|
CPT 81202
|
| Hospital Charge Code |
900914620
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$57.60 |
| Max. Negotiated Rate |
$420.00 |
| Rate for Payer: Adventist Health Commercial |
$63.64
|
| Rate for Payer: Aetna of CA Gatekeeper |
$170.08
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$218.61
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$420.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$308.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$280.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$119.61
|
| Rate for Payer: Blue Shield of California Commercial |
$194.11
|
| Rate for Payer: Blue Shield of California EPN |
$155.29
|
| Rate for Payer: Cash Price |
$318.21
|
| Rate for Payer: Cash Price |
$318.21
|
| Rate for Payer: Cigna of CA HMO/PPO |
$206.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$420.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$308.00
|
| Rate for Payer: Dignity Health Senior |
$280.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$206.84
|
| Rate for Payer: EPIC Health Plan Medicare |
$280.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$196.97
|
| Rate for Payer: Heritage Provider Network Senior |
$196.97
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$121.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$280.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$151.79
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$57.60
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$322.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$79.55
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$352.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$352.80
|
| Rate for Payer: Multiplan Commercial |
$238.66
|
| Rate for Payer: TriValley Medical Group Commercial |
$280.00
|
| Rate for Payer: TriValley Medical Group Senior |
$280.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$302.40
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$302.40
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$420.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$308.00
|
| Rate for Payer: Vantage Medical Group Senior |
$280.00
|
|
|
HC SOM FASP 86606
|
Facility
|
OP
|
$77.80
|
|
|
Service Code
|
CPT 86606
|
| Hospital Charge Code |
900914727
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$14.08 |
| Max. Negotiated Rate |
$137.43 |
| Rate for Payer: Adventist Health Commercial |
$15.56
|
| Rate for Payer: Aetna of CA Gatekeeper |
$41.58
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$53.45
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$22.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$16.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$15.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$137.43
|
| Rate for Payer: Blue Shield of California Commercial |
$121.13
|
| Rate for Payer: Blue Shield of California EPN |
$97.16
|
| Rate for Payer: Cash Price |
$77.80
|
| Rate for Payer: Cash Price |
$77.80
|
| Rate for Payer: Cigna of CA HMO/PPO |
$50.57
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$22.57
|
| Rate for Payer: Dignity Health Medi-Cal |
$16.55
|
| Rate for Payer: Dignity Health Senior |
$15.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$50.57
|
| Rate for Payer: EPIC Health Plan Medicare |
$15.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$48.16
|
| Rate for Payer: Heritage Provider Network Senior |
$48.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$21.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$15.05
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$37.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14.08
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$17.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.45
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18.96
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18.96
|
| Rate for Payer: Multiplan Commercial |
$58.35
|
| Rate for Payer: TriValley Medical Group Commercial |
$15.05
|
| Rate for Payer: TriValley Medical Group Senior |
$15.05
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$16.26
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$16.26
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$22.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$16.55
|
| Rate for Payer: Vantage Medical Group Senior |
$15.05
|
|
|
HC SOM FASP 86606
|
Facility
|
IP
|
$77.80
|
|
|
Service Code
|
CPT 86606
|
| Hospital Charge Code |
900914727
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$14.08 |
| Max. Negotiated Rate |
$58.35 |
| Rate for Payer: Adventist Health Commercial |
$15.56
|
| Rate for Payer: Cash Price |
$77.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$52.67
|
| Rate for Payer: Heritage Provider Network Senior |
$52.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.45
|
| Rate for Payer: Multiplan Commercial |
$58.35
|
|
|
HC SOM FAT FECAL QUANT
|
Facility
|
OP
|
$28.02
|
|
|
Service Code
|
CPT 82710
|
| Hospital Charge Code |
900911139
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.07 |
| Max. Negotiated Rate |
$153.41 |
| Rate for Payer: Adventist Health Commercial |
$5.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$14.98
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$19.25
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$25.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$18.48
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$16.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$153.41
|
| Rate for Payer: Blue Shield of California Commercial |
$135.19
|
| Rate for Payer: Blue Shield of California EPN |
$108.43
|
| Rate for Payer: Cash Price |
$28.02
|
| Rate for Payer: Cash Price |
$28.02
|
| Rate for Payer: Cigna of CA HMO/PPO |
$18.21
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$25.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$18.48
|
| Rate for Payer: Dignity Health Senior |
$16.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$18.21
|
| Rate for Payer: EPIC Health Plan Medicare |
$16.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$17.34
|
| Rate for Payer: Heritage Provider Network Senior |
$17.34
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$24.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$16.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$13.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.07
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$19.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$21.17
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$21.17
|
| Rate for Payer: Multiplan Commercial |
$21.02
|
| Rate for Payer: TriValley Medical Group Commercial |
$16.80
|
| Rate for Payer: TriValley Medical Group Senior |
$16.80
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$18.14
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$18.14
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$25.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$18.48
|
| Rate for Payer: Vantage Medical Group Senior |
$16.80
|
|
|
HC SOM FAT FECAL QUANT
|
Facility
|
IP
|
$28.02
|
|
|
Service Code
|
CPT 82710
|
| Hospital Charge Code |
900911139
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.07 |
| Max. Negotiated Rate |
$21.02 |
| Rate for Payer: Adventist Health Commercial |
$5.60
|
| Rate for Payer: Cash Price |
$28.02
|
| Rate for Payer: Heritage Provider Network Commercial |
$18.97
|
| Rate for Payer: Heritage Provider Network Senior |
$18.97
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.00
|
| Rate for Payer: Multiplan Commercial |
$21.02
|
|
|
HC SOM FATTY ACIDS FREE
|
Facility
|
OP
|
$200.00
|
|
|
Service Code
|
CPT 82725
|
| Hospital Charge Code |
900910286
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$18.77 |
| 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 |
$28.16
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$20.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$18.77
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$121.57
|
| Rate for Payer: Blue Shield of California Commercial |
$107.14
|
| Rate for Payer: Blue Shield of California EPN |
$85.93
|
| 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 |
$28.16
|
| Rate for Payer: Dignity Health Medi-Cal |
$20.65
|
| Rate for Payer: Dignity Health Senior |
$18.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$130.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$18.77
|
| 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 |
$23.49
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$18.77
|
| 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 |
$21.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$50.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$23.65
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$23.65
|
| Rate for Payer: Multiplan Commercial |
$150.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$18.77
|
| Rate for Payer: TriValley Medical Group Senior |
$18.77
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$20.27
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$20.27
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$28.16
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$20.65
|
| Rate for Payer: Vantage Medical Group Senior |
$18.77
|
|
|
HC SOM FATTY ACIDS FREE
|
Facility
|
IP
|
$200.00
|
|
|
Service Code
|
CPT 82725
|
| Hospital Charge Code |
900910286
|
|
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 FATTY ACIDS PEROXISOMAL
|
Facility
|
OP
|
$150.00
|
|
|
Service Code
|
CPT 82726
|
| Hospital Charge Code |
900911471
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$19.75 |
| Max. Negotiated Rate |
$164.17 |
| Rate for Payer: Adventist Health Commercial |
$30.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$80.17
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$103.05
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$29.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$21.73
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$19.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$164.17
|
| 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 |
$150.00
|
| Rate for Payer: Cash Price |
$150.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$97.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$29.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$21.73
|
| Rate for Payer: Dignity Health Senior |
$19.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$97.50
|
| Rate for Payer: EPIC Health Plan Medicare |
$19.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$92.85
|
| Rate for Payer: Heritage Provider Network Senior |
$92.85
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$26.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$19.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$71.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$27.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$37.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$24.89
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$24.89
|
| Rate for Payer: Multiplan Commercial |
$112.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$19.75
|
| Rate for Payer: TriValley Medical Group Senior |
$19.75
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$21.34
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$21.34
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$29.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$21.73
|
| Rate for Payer: Vantage Medical Group Senior |
$19.75
|
|
|
HC SOM FATTY ACIDS PEROXISOMAL
|
Facility
|
IP
|
$150.00
|
|
|
Service Code
|
CPT 82726
|
| Hospital Charge Code |
900911471
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$27.15 |
| Max. Negotiated Rate |
$112.50 |
| Rate for Payer: Adventist Health Commercial |
$30.00
|
| Rate for Payer: Cash Price |
$150.00
|
| 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 SOM FBIOT 84591
|
Facility
|
OP
|
$100.00
|
|
|
Service Code
|
CPT 84591
|
| Hospital Charge Code |
900914760
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$17.06 |
| Max. Negotiated Rate |
$105.78 |
| Rate for Payer: Adventist Health Commercial |
$20.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$53.45
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$68.70
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$25.59
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$18.77
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$17.06
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$105.78
|
| Rate for Payer: Blue Shield of California Commercial |
$93.31
|
| Rate for Payer: Blue Shield of California EPN |
$74.84
|
| Rate for Payer: Cash Price |
$100.00
|
| Rate for Payer: Cash Price |
$100.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$65.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$25.59
|
| Rate for Payer: Dignity Health Medi-Cal |
$18.77
|
| Rate for Payer: Dignity Health Senior |
$17.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$65.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$17.06
|
| Rate for Payer: Heritage Provider Network Commercial |
$61.90
|
| Rate for Payer: Heritage Provider Network Senior |
$61.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$20.46
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$17.06
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$47.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$18.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$19.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$21.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$21.50
|
| Rate for Payer: Multiplan Commercial |
$75.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$17.06
|
| Rate for Payer: TriValley Medical Group Senior |
$17.06
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$18.42
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$18.42
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$25.59
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$18.77
|
| Rate for Payer: Vantage Medical Group Senior |
$17.06
|
|
|
HC SOM FBIOT 84591
|
Facility
|
IP
|
$100.00
|
|
|
Service Code
|
CPT 84591
|
| Hospital Charge Code |
900914760
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$18.10 |
| Max. Negotiated Rate |
$75.00 |
| Rate for Payer: Adventist Health Commercial |
$20.00
|
| Rate for Payer: Cash Price |
$100.00
|
| 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 SOM FBP1 88273
|
Facility
|
OP
|
$84.86
|
|
|
Service Code
|
CPT 88273
|
| Hospital Charge Code |
900914874
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$15.36 |
| Max. Negotiated Rate |
$1,734.73 |
| Rate for Payer: Adventist Health Commercial |
$16.97
|
| Rate for Payer: Aetna of CA Gatekeeper |
$45.36
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$58.30
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$52.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$38.29
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$34.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,734.73
|
| Rate for Payer: Blue Shield of California Commercial |
$258.57
|
| Rate for Payer: Blue Shield of California EPN |
$207.39
|
| Rate for Payer: Cash Price |
$84.86
|
| Rate for Payer: Cash Price |
$84.86
|
| Rate for Payer: Cigna of CA HMO/PPO |
$55.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$52.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$38.29
|
| Rate for Payer: Dignity Health Senior |
$34.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$55.16
|
| Rate for Payer: EPIC Health Plan Medicare |
$34.81
|
| Rate for Payer: Heritage Provider Network Commercial |
$52.53
|
| Rate for Payer: Heritage Provider Network Senior |
$52.53
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$46.27
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$34.81
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$40.48
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$15.36
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$40.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$21.21
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$43.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$43.86
|
| Rate for Payer: Multiplan Commercial |
$63.65
|
| Rate for Payer: TriValley Medical Group Commercial |
$34.81
|
| Rate for Payer: TriValley Medical Group Senior |
$34.81
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$37.60
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$37.60
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$52.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$38.29
|
| Rate for Payer: Vantage Medical Group Senior |
$34.81
|
|
|
HC SOM FBP1 88273
|
Facility
|
IP
|
$84.86
|
|
|
Service Code
|
CPT 88273
|
| Hospital Charge Code |
900914874
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$15.36 |
| Max. Negotiated Rate |
$63.65 |
| Rate for Payer: Adventist Health Commercial |
$16.97
|
| Rate for Payer: Cash Price |
$84.86
|
| Rate for Payer: Heritage Provider Network Commercial |
$57.45
|
| Rate for Payer: Heritage Provider Network Senior |
$57.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$15.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$21.21
|
| Rate for Payer: Multiplan Commercial |
$63.65
|
|
|
HC SOM FBP1 88291
|
Facility
|
OP
|
$71.15
|
|
|
Service Code
|
CPT 88291
|
| Hospital Charge Code |
900914873
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$12.88 |
| Max. Negotiated Rate |
$170.56 |
| Rate for Payer: Adventist Health Commercial |
$14.23
|
| Rate for Payer: Aetna of CA Gatekeeper |
$38.03
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$48.88
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$60.48
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$39.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$53.36
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$170.56
|
| Rate for Payer: Blue Shield of California Commercial |
$37.25
|
| Rate for Payer: Blue Shield of California EPN |
$29.95
|
| Rate for Payer: Cash Price |
$71.15
|
| Rate for Payer: Cash Price |
$71.15
|
| Rate for Payer: Cigna of CA HMO/PPO |
$46.25
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$60.48
|
| Rate for Payer: Dignity Health Medi-Cal |
$60.48
|
| Rate for Payer: Dignity Health Senior |
$60.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$46.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$44.04
|
| Rate for Payer: Heritage Provider Network Senior |
$44.04
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$22.06
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$33.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$17.79
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$49.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$49.80
|
| Rate for Payer: Multiplan Commercial |
$53.36
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$36.25
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$36.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$60.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$60.48
|
| Rate for Payer: Vantage Medical Group Senior |
$60.48
|
|
|
HC SOM FBP1 88291
|
Facility
|
IP
|
$71.15
|
|
|
Service Code
|
CPT 88291
|
| Hospital Charge Code |
900914873
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$12.88 |
| Max. Negotiated Rate |
$53.36 |
| Rate for Payer: Adventist Health Commercial |
$14.23
|
| Rate for Payer: Cash Price |
$71.15
|
| Rate for Payer: Heritage Provider Network Commercial |
$48.17
|
| Rate for Payer: Heritage Provider Network Senior |
$48.17
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$17.79
|
| Rate for Payer: Multiplan Commercial |
$53.36
|
|
|
HC SOM FCFQN 86171
|
Facility
|
IP
|
$67.00
|
|
|
Service Code
|
CPT 86171
|
| Hospital Charge Code |
900914248
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.13 |
| Max. Negotiated Rate |
$50.25 |
| Rate for Payer: Adventist Health Commercial |
$13.40
|
| Rate for Payer: Cash Price |
$67.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$45.36
|
| Rate for Payer: Heritage Provider Network Senior |
$45.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.75
|
| Rate for Payer: Multiplan Commercial |
$50.25
|
|
|
HC SOM FCFQN 86171
|
Facility
|
OP
|
$67.00
|
|
|
Service Code
|
CPT 86171
|
| Hospital Charge Code |
900914248
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.01 |
| Max. Negotiated Rate |
$91.46 |
| Rate for Payer: Adventist Health Commercial |
$13.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$35.81
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$46.03
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15.02
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10.01
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$91.46
|
| Rate for Payer: Blue Shield of California Commercial |
$80.64
|
| Rate for Payer: Blue Shield of California EPN |
$64.68
|
| Rate for Payer: Cash Price |
$67.00
|
| Rate for Payer: Cash Price |
$67.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$43.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15.02
|
| Rate for Payer: Dignity Health Medi-Cal |
$11.01
|
| Rate for Payer: Dignity Health Senior |
$10.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$43.55
|
| Rate for Payer: EPIC Health Plan Medicare |
$10.01
|
| Rate for Payer: Heritage Provider Network Commercial |
$41.47
|
| Rate for Payer: Heritage Provider Network Senior |
$41.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$14.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$31.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12.13
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$11.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$12.61
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$12.61
|
| Rate for Payer: Multiplan Commercial |
$50.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$10.01
|
| Rate for Payer: TriValley Medical Group Senior |
$10.01
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$10.81
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$10.81
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15.02
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11.01
|
| Rate for Payer: Vantage Medical Group Senior |
$10.01
|
|
|
HC SOM FCTRC 87110
|
Facility
|
IP
|
$69.57
|
|
|
Service Code
|
CPT 87110
|
| Hospital Charge Code |
900914725
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$12.59 |
| Max. Negotiated Rate |
$52.18 |
| Rate for Payer: Adventist Health Commercial |
$13.91
|
| Rate for Payer: Cash Price |
$69.57
|
| Rate for Payer: Heritage Provider Network Commercial |
$47.10
|
| Rate for Payer: Heritage Provider Network Senior |
$47.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$17.39
|
| Rate for Payer: Multiplan Commercial |
$52.18
|
|
|
HC SOM FCTRC 87110
|
Facility
|
OP
|
$69.57
|
|
|
Service Code
|
CPT 87110
|
| Hospital Charge Code |
900914725
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$12.59 |
| Max. Negotiated Rate |
$178.92 |
| Rate for Payer: Adventist Health Commercial |
$13.91
|
| Rate for Payer: Aetna of CA Gatekeeper |
$37.19
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$47.79
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$29.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$21.56
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$19.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$178.92
|
| Rate for Payer: Blue Shield of California Commercial |
$157.65
|
| Rate for Payer: Blue Shield of California EPN |
$126.45
|
| Rate for Payer: Cash Price |
$69.57
|
| Rate for Payer: Cash Price |
$69.57
|
| Rate for Payer: Cigna of CA HMO/PPO |
$45.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$29.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$21.56
|
| Rate for Payer: Dignity Health Senior |
$19.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$45.22
|
| Rate for Payer: EPIC Health Plan Medicare |
$19.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$43.06
|
| Rate for Payer: Heritage Provider Network Senior |
$43.06
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$28.01
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$19.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$33.18
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$17.39
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$24.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$24.70
|
| Rate for Payer: Multiplan Commercial |
$52.18
|
| Rate for Payer: TriValley Medical Group Commercial |
$19.60
|
| Rate for Payer: TriValley Medical Group Senior |
$19.60
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$21.17
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$21.17
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$29.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$21.56
|
| Rate for Payer: Vantage Medical Group Senior |
$19.60
|
|
|
HC SOM FCTRC 87140
|
Facility
|
OP
|
$19.81
|
|
|
Service Code
|
CPT 87140
|
| Hospital Charge Code |
900914726
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$3.59 |
| Max. Negotiated Rate |
$50.95 |
| Rate for Payer: Adventist Health Commercial |
$3.96
|
| Rate for Payer: Aetna of CA Gatekeeper |
$10.59
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$13.61
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$8.36
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.57
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$50.95
|
| Rate for Payer: Blue Shield of California Commercial |
$44.87
|
| Rate for Payer: Blue Shield of California EPN |
$35.99
|
| Rate for Payer: Cash Price |
$19.81
|
| Rate for Payer: Cash Price |
$19.81
|
| Rate for Payer: Cigna of CA HMO/PPO |
$12.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8.36
|
| Rate for Payer: Dignity Health Medi-Cal |
$6.13
|
| Rate for Payer: Dignity Health Senior |
$5.57
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.88
|
| Rate for Payer: EPIC Health Plan Medicare |
$5.57
|
| Rate for Payer: Heritage Provider Network Commercial |
$12.26
|
| Rate for Payer: Heritage Provider Network Senior |
$12.26
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$8.02
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.57
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$9.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.95
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$7.02
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$7.02
|
| Rate for Payer: Multiplan Commercial |
$14.86
|
| Rate for Payer: TriValley Medical Group Commercial |
$5.57
|
| Rate for Payer: TriValley Medical Group Senior |
$5.57
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$6.01
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$6.01
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$8.36
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6.13
|
| Rate for Payer: Vantage Medical Group Senior |
$5.57
|
|
