|
HC SOM CEA PANCREATIC CYST
|
Facility
OP
|
$45.00
|
|
|
Service Code
|
CPT 82378
|
| Hospital Charge Code |
900912997
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.14 |
| Max. Negotiated Rate |
$158.52 |
| Rate for Payer: Adventist Health Commercial |
$9.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$55.21
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$30.92
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$28.44
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$20.86
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$18.96
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$158.52
|
| Rate for Payer: Blue Shield of California Commercial |
$148.19
|
| Rate for Payer: Blue Shield of California EPN |
$115.85
|
| Rate for Payer: Cash Price |
$20.25
|
| Rate for Payer: Cash Price |
$20.25
|
| Rate for Payer: Cigna of CA HMO/PPO |
$29.25
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$28.44
|
| Rate for Payer: Dignity Health Medi-Cal |
$20.86
|
| Rate for Payer: Dignity Health Senior |
$18.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$29.25
|
| Rate for Payer: EPIC Health Plan Medicare |
$18.96
|
| Rate for Payer: Heritage Provider Network Commercial |
$27.86
|
| Rate for Payer: Heritage Provider Network Senior |
$27.86
|
| Rate for Payer: Humana Medicare |
$18.96
|
| Rate for Payer: IEHP Medi-Cal |
$26.29
|
| Rate for Payer: IEHP Medicare Advantage |
$18.96
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$36.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$23.89
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$23.89
|
| Rate for Payer: Multiplan Commercial |
$33.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$18.96
|
| Rate for Payer: TriValley Medical Group Senior |
$18.96
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$20.47
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$20.47
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$28.44
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$20.86
|
| Rate for Payer: Vantage Medical Group Senior |
$18.96
|
|
|
HC SOM CEA PANCREATIC CYST
|
Facility
IP
|
$45.00
|
|
|
Service Code
|
CPT 82378
|
| Hospital Charge Code |
900912997
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.14 |
| Max. Negotiated Rate |
$33.75 |
| Rate for Payer: Adventist Health Commercial |
$9.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$30.92
|
| Rate for Payer: Cash Price |
$20.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$30.46
|
| Rate for Payer: Heritage Provider Network Senior |
$30.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.25
|
| Rate for Payer: Multiplan Commercial |
$33.75
|
|
|
HC SOM CEA PERITONEAL FLUID
|
Facility
IP
|
$45.00
|
|
|
Service Code
|
CPT 82378
|
| Hospital Charge Code |
900914706
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.14 |
| Max. Negotiated Rate |
$33.75 |
| Rate for Payer: Adventist Health Commercial |
$9.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$30.92
|
| Rate for Payer: Cash Price |
$20.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$30.46
|
| Rate for Payer: Heritage Provider Network Senior |
$30.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.25
|
| Rate for Payer: Multiplan Commercial |
$33.75
|
|
|
HC SOM CEA PERITONEAL FLUID
|
Facility
OP
|
$45.00
|
|
|
Service Code
|
CPT 82378
|
| Hospital Charge Code |
900914706
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.14 |
| Max. Negotiated Rate |
$158.52 |
| Rate for Payer: Adventist Health Commercial |
$9.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$55.21
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$30.92
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$28.44
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$20.86
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$18.96
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$158.52
|
| Rate for Payer: Blue Shield of California Commercial |
$148.19
|
| Rate for Payer: Blue Shield of California EPN |
$115.85
|
| Rate for Payer: Cash Price |
$20.25
|
| Rate for Payer: Cash Price |
$20.25
|
| Rate for Payer: Cigna of CA HMO/PPO |
$29.25
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$28.44
|
| Rate for Payer: Dignity Health Medi-Cal |
$20.86
|
| Rate for Payer: Dignity Health Senior |
$18.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$29.25
|
| Rate for Payer: EPIC Health Plan Medicare |
$18.96
|
| Rate for Payer: Heritage Provider Network Commercial |
$27.86
|
| Rate for Payer: Heritage Provider Network Senior |
$27.86
|
| Rate for Payer: Humana Medicare |
$18.96
|
| Rate for Payer: IEHP Medi-Cal |
$26.29
|
| Rate for Payer: IEHP Medicare Advantage |
$18.96
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$36.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$23.89
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$23.89
|
| Rate for Payer: Multiplan Commercial |
$33.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$18.96
|
| Rate for Payer: TriValley Medical Group Senior |
$18.96
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$20.47
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$20.47
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$28.44
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$20.86
|
| Rate for Payer: Vantage Medical Group Senior |
$18.96
|
|
|
HC SOM CELIAC COMP HLA TYPING 1
|
Facility
OP
|
$85.17
|
|
|
Service Code
|
CPT 81376
|
| Hospital Charge Code |
900915327
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$15.42 |
| Max. Negotiated Rate |
$632.99 |
| Rate for Payer: Adventist Health Commercial |
$17.03
|
| Rate for Payer: Aetna of CA Gatekeeper |
$138.25
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$58.51
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$183.33
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$134.44
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$122.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$632.99
|
| Rate for Payer: Blue Shield of California Commercial |
$52.89
|
| Rate for Payer: Blue Shield of California EPN |
$49.99
|
| Rate for Payer: Cash Price |
$38.33
|
| Rate for Payer: Cash Price |
$38.33
|
| Rate for Payer: Cigna of CA HMO/PPO |
$55.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$183.33
|
| Rate for Payer: Dignity Health Medi-Cal |
$134.44
|
| Rate for Payer: Dignity Health Senior |
$122.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$55.36
|
| Rate for Payer: EPIC Health Plan Medicare |
$122.22
|
| Rate for Payer: Heritage Provider Network Commercial |
$52.72
|
| Rate for Payer: Heritage Provider Network Senior |
$52.72
|
| Rate for Payer: Humana Medicare |
$122.22
|
| Rate for Payer: IEHP Medi-Cal |
$169.48
|
| Rate for Payer: IEHP Medicare Advantage |
$122.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$232.22
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$15.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$144.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$21.29
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$154.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$154.00
|
| Rate for Payer: Multiplan Commercial |
$63.88
|
| Rate for Payer: TriValley Medical Group Commercial |
$122.22
|
| Rate for Payer: TriValley Medical Group Senior |
$122.22
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$132.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$132.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$183.33
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$134.44
|
| Rate for Payer: Vantage Medical Group Senior |
$122.22
|
|
|
HC SOM CELIAC COMP HLA TYPING 1
|
Facility
IP
|
$85.17
|
|
|
Service Code
|
CPT 81376
|
| Hospital Charge Code |
900915327
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$15.42 |
| Max. Negotiated Rate |
$63.88 |
| Rate for Payer: Adventist Health Commercial |
$17.03
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$58.51
|
| Rate for Payer: Cash Price |
$38.33
|
| Rate for Payer: Heritage Provider Network Commercial |
$57.66
|
| Rate for Payer: Heritage Provider Network Senior |
$57.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$15.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$21.29
|
| Rate for Payer: Multiplan Commercial |
$63.88
|
|
|
HC SOM CELIAC COMP HLA TYPING 2
|
Facility
OP
|
$85.18
|
|
|
Service Code
|
CPT 81376
|
| Hospital Charge Code |
900915328
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$15.42 |
| Max. Negotiated Rate |
$632.99 |
| Rate for Payer: Adventist Health Commercial |
$17.04
|
| Rate for Payer: Aetna of CA Gatekeeper |
$138.25
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$58.52
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$183.33
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$134.44
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$122.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$632.99
|
| Rate for Payer: Blue Shield of California Commercial |
$52.90
|
| Rate for Payer: Blue Shield of California EPN |
$50.00
|
| Rate for Payer: Cash Price |
$38.33
|
| Rate for Payer: Cash Price |
$38.33
|
| Rate for Payer: Cigna of CA HMO/PPO |
$55.37
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$183.33
|
| Rate for Payer: Dignity Health Medi-Cal |
$134.44
|
| Rate for Payer: Dignity Health Senior |
$122.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$55.37
|
| Rate for Payer: EPIC Health Plan Medicare |
$122.22
|
| Rate for Payer: Heritage Provider Network Commercial |
$52.73
|
| Rate for Payer: Heritage Provider Network Senior |
$52.73
|
| Rate for Payer: Humana Medicare |
$122.22
|
| Rate for Payer: IEHP Medi-Cal |
$169.48
|
| Rate for Payer: IEHP Medicare Advantage |
$122.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$232.22
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$15.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$144.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$21.30
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$154.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$154.00
|
| Rate for Payer: Multiplan Commercial |
$63.88
|
| Rate for Payer: TriValley Medical Group Commercial |
$122.22
|
| Rate for Payer: TriValley Medical Group Senior |
$122.22
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$132.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$132.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$183.33
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$134.44
|
| Rate for Payer: Vantage Medical Group Senior |
$122.22
|
|
|
HC SOM CELIAC COMP HLA TYPING 2
|
Facility
IP
|
$85.18
|
|
|
Service Code
|
CPT 81376
|
| Hospital Charge Code |
900915328
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$15.42 |
| Max. Negotiated Rate |
$63.88 |
| Rate for Payer: Adventist Health Commercial |
$17.04
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$58.52
|
| Rate for Payer: Cash Price |
$38.33
|
| Rate for Payer: Heritage Provider Network Commercial |
$57.67
|
| Rate for Payer: Heritage Provider Network Senior |
$57.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$15.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$21.30
|
| Rate for Payer: Multiplan Commercial |
$63.88
|
|
|
HC SOM CELIAC COMP IGA
|
Facility
OP
|
$6.48
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
900914382
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$1.17 |
| Max. Negotiated Rate |
$72.61 |
| Rate for Payer: Adventist Health Commercial |
$1.30
|
| Rate for Payer: Aetna of CA Gatekeeper |
$19.07
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$4.45
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$13.95
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$10.23
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$9.30
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$64.86
|
| Rate for Payer: Blue Shield of California Commercial |
$72.61
|
| Rate for Payer: Blue Shield of California EPN |
$56.77
|
| Rate for Payer: Cash Price |
$2.92
|
| Rate for Payer: Cash Price |
$2.92
|
| Rate for Payer: Cigna of CA HMO/PPO |
$4.21
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$10.23
|
| Rate for Payer: Dignity Health Senior |
$9.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.21
|
| Rate for Payer: EPIC Health Plan Medicare |
$9.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$4.01
|
| Rate for Payer: Heritage Provider Network Senior |
$4.01
|
| Rate for Payer: Humana Medicare |
$9.30
|
| Rate for Payer: IEHP Medi-Cal |
$9.48
|
| Rate for Payer: IEHP Medicare Advantage |
$9.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$17.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.17
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.62
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11.72
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11.72
|
| Rate for Payer: Multiplan Commercial |
$4.86
|
| Rate for Payer: TriValley Medical Group Commercial |
$9.30
|
| Rate for Payer: TriValley Medical Group Senior |
$9.30
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$10.04
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$10.04
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.23
|
| Rate for Payer: Vantage Medical Group Senior |
$9.30
|
|
|
HC SOM CELIAC COMP IGA
|
Facility
IP
|
$6.48
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
900914382
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$1.17 |
| Max. Negotiated Rate |
$4.86 |
| Rate for Payer: Adventist Health Commercial |
$1.30
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$4.45
|
| Rate for Payer: Cash Price |
$2.92
|
| Rate for Payer: Heritage Provider Network Commercial |
$4.39
|
| Rate for Payer: Heritage Provider Network Senior |
$4.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.62
|
| Rate for Payer: Multiplan Commercial |
$4.86
|
|
|
HC SOM CERULOPLASMIN
|
Facility
OP
|
$12.00
|
|
|
Service Code
|
CPT 82390
|
| Hospital Charge Code |
900915329
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.17 |
| Max. Negotiated Rate |
$89.88 |
| Rate for Payer: Adventist Health Commercial |
$2.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$31.26
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$8.24
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$16.11
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$11.81
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$10.74
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$89.88
|
| Rate for Payer: Blue Shield of California Commercial |
$83.91
|
| Rate for Payer: Blue Shield of California EPN |
$65.59
|
| Rate for Payer: Cash Price |
$5.40
|
| Rate for Payer: Cash Price |
$5.40
|
| Rate for Payer: Cigna of CA HMO/PPO |
$7.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$16.11
|
| Rate for Payer: Dignity Health Medi-Cal |
$11.81
|
| Rate for Payer: Dignity Health Senior |
$10.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.80
|
| Rate for Payer: EPIC Health Plan Medicare |
$10.74
|
| Rate for Payer: Heritage Provider Network Commercial |
$7.43
|
| Rate for Payer: Heritage Provider Network Senior |
$7.43
|
| Rate for Payer: Humana Medicare |
$10.74
|
| Rate for Payer: IEHP Medi-Cal |
$14.90
|
| Rate for Payer: IEHP Medicare Advantage |
$10.74
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$20.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.17
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$13.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$13.53
|
| Rate for Payer: Multiplan Commercial |
$9.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$10.74
|
| Rate for Payer: TriValley Medical Group Senior |
$10.74
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$11.60
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$11.60
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$16.11
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11.81
|
| Rate for Payer: Vantage Medical Group Senior |
$10.74
|
|
|
HC SOM CERULOPLASMIN
|
Facility
IP
|
$12.00
|
|
|
Service Code
|
CPT 82390
|
| Hospital Charge Code |
900915329
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.17 |
| Max. Negotiated Rate |
$9.00 |
| Rate for Payer: Adventist Health Commercial |
$2.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$8.24
|
| Rate for Payer: Cash Price |
$5.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$8.12
|
| Rate for Payer: Heritage Provider Network Senior |
$8.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.00
|
| Rate for Payer: Multiplan Commercial |
$9.00
|
|
|
HC SOM CHESTNUT IGE
|
Facility
OP
|
$7.47
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
900914685
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$1.35 |
| Max. Negotiated Rate |
$132.31 |
| Rate for Payer: Adventist Health Commercial |
$1.49
|
| Rate for Payer: Aetna of CA Gatekeeper |
$15.18
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$5.13
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$7.83
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$5.74
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$5.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$132.31
|
| Rate for Payer: Blue Shield of California Commercial |
$40.81
|
| Rate for Payer: Blue Shield of California EPN |
$31.90
|
| Rate for Payer: Cash Price |
$3.36
|
| Rate for Payer: Cash Price |
$3.36
|
| Rate for Payer: Cigna of CA HMO/PPO |
$4.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.83
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.74
|
| Rate for Payer: Dignity Health Senior |
$5.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.86
|
| Rate for Payer: EPIC Health Plan Medicare |
$5.22
|
| Rate for Payer: Heritage Provider Network Commercial |
$4.62
|
| Rate for Payer: Heritage Provider Network Senior |
$4.62
|
| Rate for Payer: Humana Medicare |
$5.22
|
| Rate for Payer: IEHP Medi-Cal |
$7.24
|
| Rate for Payer: IEHP Medicare Advantage |
$5.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$9.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.87
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.58
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.58
|
| Rate for Payer: Multiplan Commercial |
$5.60
|
| Rate for Payer: TriValley Medical Group Commercial |
$5.22
|
| Rate for Payer: TriValley Medical Group Senior |
$5.22
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$5.64
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$5.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.74
|
| Rate for Payer: Vantage Medical Group Senior |
$5.22
|
|
|
HC SOM CHESTNUT IGE
|
Facility
IP
|
$7.47
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
900914685
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$1.35 |
| Max. Negotiated Rate |
$5.60 |
| Rate for Payer: Adventist Health Commercial |
$1.49
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$5.13
|
| Rate for Payer: Cash Price |
$3.36
|
| Rate for Payer: Heritage Provider Network Commercial |
$5.06
|
| Rate for Payer: Heritage Provider Network Senior |
$5.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.87
|
| Rate for Payer: Multiplan Commercial |
$5.60
|
|
|
HC SOM CHLORDIAZEPOXIDE (LIBRIUM)
|
Facility
OP
|
$280.10
|
|
|
Service Code
|
CPT 80346
|
| Hospital Charge Code |
900911081
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$0.02 |
| Max. Negotiated Rate |
$238.08 |
| Rate for Payer: Adventist Health Commercial |
$56.02
|
| Rate for Payer: Aetna of CA Gatekeeper |
$0.02
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$192.43
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$238.08
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$154.06
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$210.08
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$148.48
|
| Rate for Payer: Cash Price |
$126.05
|
| Rate for Payer: Cash Price |
$126.05
|
| Rate for Payer: Cigna of CA HMO/PPO |
$182.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$238.08
|
| Rate for Payer: Dignity Health Medi-Cal |
$238.08
|
| Rate for Payer: Dignity Health Senior |
$238.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$182.06
|
| Rate for Payer: Heritage Provider Network Commercial |
$173.38
|
| Rate for Payer: Heritage Provider Network Senior |
$173.38
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$135.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$50.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$70.02
|
| Rate for Payer: Multiplan Commercial |
$210.08
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$238.08
|
| Rate for Payer: Vantage Medical Group Senior |
$238.08
|
|
|
HC SOM CHLORDIAZEPOXIDE (LIBRIUM)
|
Facility
IP
|
$280.10
|
|
|
Service Code
|
CPT 80346
|
| Hospital Charge Code |
900911081
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$50.70 |
| Max. Negotiated Rate |
$210.08 |
| Rate for Payer: Adventist Health Commercial |
$56.02
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$192.43
|
| Rate for Payer: Cash Price |
$126.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$189.63
|
| Rate for Payer: Heritage Provider Network Senior |
$189.63
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$50.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$70.02
|
| Rate for Payer: Multiplan Commercial |
$210.08
|
|
|
HC SOM CHLORIDE BF
|
Facility
OP
|
$7.01
|
|
|
Service Code
|
CPT 82438
|
| Hospital Charge Code |
900914683
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$1.27 |
| Max. Negotiated Rate |
$40.91 |
| Rate for Payer: Adventist Health Commercial |
$1.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$14.23
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$4.82
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$7.50
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$5.50
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$5.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$40.91
|
| Rate for Payer: Blue Shield of California Commercial |
$38.18
|
| Rate for Payer: Blue Shield of California EPN |
$29.85
|
| Rate for Payer: Cash Price |
$3.15
|
| Rate for Payer: Cash Price |
$3.15
|
| Rate for Payer: Cigna of CA HMO/PPO |
$4.56
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.50
|
| Rate for Payer: Dignity Health Senior |
$5.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.56
|
| Rate for Payer: EPIC Health Plan Medicare |
$5.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$4.34
|
| Rate for Payer: Heritage Provider Network Senior |
$4.34
|
| Rate for Payer: Humana Medicare |
$5.00
|
| Rate for Payer: IEHP Medi-Cal |
$6.77
|
| Rate for Payer: IEHP Medicare Advantage |
$5.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$9.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.27
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.30
|
| Rate for Payer: Multiplan Commercial |
$5.26
|
| Rate for Payer: TriValley Medical Group Commercial |
$5.00
|
| Rate for Payer: TriValley Medical Group Senior |
$5.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$5.40
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$5.40
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.50
|
| Rate for Payer: Vantage Medical Group Senior |
$5.00
|
|
|
HC SOM CHLORIDE BF
|
Facility
IP
|
$7.01
|
|
|
Service Code
|
CPT 82438
|
| Hospital Charge Code |
900914683
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$1.27 |
| Max. Negotiated Rate |
$5.26 |
| Rate for Payer: Adventist Health Commercial |
$1.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$4.82
|
| Rate for Payer: Cash Price |
$3.15
|
| Rate for Payer: Heritage Provider Network Commercial |
$4.75
|
| Rate for Payer: Heritage Provider Network Senior |
$4.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.75
|
| Rate for Payer: Multiplan Commercial |
$5.26
|
|
|
HC SOM CHOLESTEROL BF
|
Facility
OP
|
$165.00
|
|
|
Service Code
|
CPT 84311
|
| Hospital Charge Code |
900914682
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.10 |
| Max. Negotiated Rate |
$123.75 |
| Rate for Payer: Adventist Health Commercial |
$33.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$20.33
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$113.36
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$12.15
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$8.91
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$8.10
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$58.55
|
| Rate for Payer: Blue Shield of California Commercial |
$54.61
|
| Rate for Payer: Blue Shield of California EPN |
$42.69
|
| Rate for Payer: Cash Price |
$74.25
|
| Rate for Payer: Cash Price |
$74.25
|
| Rate for Payer: Cigna of CA HMO/PPO |
$107.25
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$8.91
|
| Rate for Payer: Dignity Health Senior |
$8.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$107.25
|
| Rate for Payer: EPIC Health Plan Medicare |
$8.10
|
| Rate for Payer: Heritage Provider Network Commercial |
$102.14
|
| Rate for Payer: Heritage Provider Network Senior |
$102.14
|
| Rate for Payer: Humana Medicare |
$8.10
|
| Rate for Payer: IEHP Medi-Cal |
$10.11
|
| Rate for Payer: IEHP Medicare Advantage |
$8.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$15.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$29.86
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$41.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.21
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10.21
|
| Rate for Payer: Multiplan Commercial |
$123.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$8.10
|
| Rate for Payer: TriValley Medical Group Senior |
$8.10
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$8.75
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$8.75
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.91
|
| Rate for Payer: Vantage Medical Group Senior |
$8.10
|
|
|
HC SOM CHOLESTEROL BF
|
Facility
IP
|
$165.00
|
|
|
Service Code
|
CPT 84311
|
| Hospital Charge Code |
900914682
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$29.86 |
| Max. Negotiated Rate |
$123.75 |
| Rate for Payer: Adventist Health Commercial |
$33.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$113.36
|
| Rate for Payer: Cash Price |
$74.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$111.70
|
| Rate for Payer: Heritage Provider Network Senior |
$111.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$29.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$41.25
|
| Rate for Payer: Multiplan Commercial |
$123.75
|
|
|
HC SOM CHOLINESTERASE PSEUDO
|
Facility
IP
|
$107.03
|
|
|
Service Code
|
CPT 82480
|
| Hospital Charge Code |
900911160
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$19.37 |
| Max. Negotiated Rate |
$80.27 |
| Rate for Payer: Adventist Health Commercial |
$21.41
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$73.53
|
| Rate for Payer: Cash Price |
$48.16
|
| Rate for Payer: Heritage Provider Network Commercial |
$72.46
|
| Rate for Payer: Heritage Provider Network Senior |
$72.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$19.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$26.76
|
| Rate for Payer: Multiplan Commercial |
$80.27
|
|
|
HC SOM CHOLINESTERASE PSEUDO
|
Facility
OP
|
$107.03
|
|
|
Service Code
|
CPT 82480
|
| Hospital Charge Code |
900911160
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.87 |
| Max. Negotiated Rate |
$80.27 |
| Rate for Payer: Adventist Health Commercial |
$21.41
|
| Rate for Payer: Aetna of CA Gatekeeper |
$22.94
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$73.53
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$11.80
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$8.66
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$7.87
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$65.93
|
| Rate for Payer: Blue Shield of California Commercial |
$61.55
|
| Rate for Payer: Blue Shield of California EPN |
$48.11
|
| Rate for Payer: Cash Price |
$48.16
|
| Rate for Payer: Cash Price |
$48.16
|
| Rate for Payer: Cigna of CA HMO/PPO |
$69.57
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$8.66
|
| Rate for Payer: Dignity Health Senior |
$7.87
|
| Rate for Payer: EPIC Health Plan Commercial |
$69.57
|
| Rate for Payer: EPIC Health Plan Medicare |
$7.87
|
| Rate for Payer: Heritage Provider Network Commercial |
$66.25
|
| Rate for Payer: Heritage Provider Network Senior |
$66.25
|
| Rate for Payer: Humana Medicare |
$7.87
|
| Rate for Payer: IEHP Medi-Cal |
$10.92
|
| Rate for Payer: IEHP Medicare Advantage |
$7.87
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$14.95
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$19.37
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$26.76
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9.92
|
| Rate for Payer: Multiplan Commercial |
$80.27
|
| Rate for Payer: TriValley Medical Group Commercial |
$7.87
|
| Rate for Payer: TriValley Medical Group Senior |
$7.87
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$8.50
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$8.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.66
|
| Rate for Payer: Vantage Medical Group Senior |
$7.87
|
|
|
HC SOM CHRAF CULTURE 03
|
Facility
OP
|
$140.02
|
|
|
Service Code
|
CPT 88235
|
| Hospital Charge Code |
900915285
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$25.34 |
| Max. Negotiated Rate |
$1,150.09 |
| Rate for Payer: Adventist Health Commercial |
$28.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$428.43
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$96.19
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$225.45
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$165.33
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$150.30
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$924.16
|
| Rate for Payer: Blue Shield of California Commercial |
$1,150.09
|
| Rate for Payer: Blue Shield of California EPN |
$899.08
|
| Rate for Payer: Cash Price |
$63.01
|
| Rate for Payer: Cash Price |
$63.01
|
| Rate for Payer: Cigna of CA HMO/PPO |
$91.01
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$225.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$165.33
|
| Rate for Payer: Dignity Health Senior |
$150.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$91.01
|
| Rate for Payer: EPIC Health Plan Medicare |
$150.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$86.67
|
| Rate for Payer: Heritage Provider Network Senior |
$86.67
|
| Rate for Payer: Humana Medicare |
$150.30
|
| Rate for Payer: IEHP Medi-Cal |
$117.05
|
| Rate for Payer: IEHP Medicare Advantage |
$150.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$285.57
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$25.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$177.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$35.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$189.38
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$189.38
|
| Rate for Payer: Multiplan Commercial |
$105.02
|
| Rate for Payer: TriValley Medical Group Commercial |
$150.30
|
| Rate for Payer: TriValley Medical Group Senior |
$150.30
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$162.32
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$162.32
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$225.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$165.33
|
| Rate for Payer: Vantage Medical Group Senior |
$150.30
|
|
|
HC SOM CHRAF CULTURE 03
|
Facility
IP
|
$140.02
|
|
|
Service Code
|
CPT 88235
|
| Hospital Charge Code |
900915285
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$25.34 |
| Max. Negotiated Rate |
$105.02 |
| Rate for Payer: Adventist Health Commercial |
$28.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$96.19
|
| Rate for Payer: Cash Price |
$63.01
|
| Rate for Payer: Heritage Provider Network Commercial |
$94.79
|
| Rate for Payer: Heritage Provider Network Senior |
$94.79
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$25.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$35.00
|
| Rate for Payer: Multiplan Commercial |
$105.02
|
|
|
HC SOM CHRBM CULTURE 04
|
Facility
OP
|
$102.19
|
|
|
Service Code
|
CPT 88237
|
| Hospital Charge Code |
900915318
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$18.50 |
| Max. Negotiated Rate |
$986.47 |
| Rate for Payer: Adventist Health Commercial |
$20.44
|
| Rate for Payer: Aetna of CA Gatekeeper |
$367.47
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$70.20
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$215.62
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$158.12
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$143.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$897.50
|
| Rate for Payer: Blue Shield of California Commercial |
$986.47
|
| Rate for Payer: Blue Shield of California EPN |
$771.17
|
| Rate for Payer: Cash Price |
$45.99
|
| Rate for Payer: Cash Price |
$45.99
|
| Rate for Payer: Cigna of CA HMO/PPO |
$66.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$215.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$158.12
|
| Rate for Payer: Dignity Health Senior |
$143.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$66.42
|
| Rate for Payer: EPIC Health Plan Medicare |
$143.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$63.26
|
| Rate for Payer: Heritage Provider Network Senior |
$63.26
|
| Rate for Payer: Humana Medicare |
$143.75
|
| Rate for Payer: IEHP Medi-Cal |
$155.44
|
| Rate for Payer: IEHP Medicare Advantage |
$143.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$273.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$18.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$169.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.55
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$181.12
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$181.12
|
| Rate for Payer: Multiplan Commercial |
$76.64
|
| Rate for Payer: TriValley Medical Group Commercial |
$143.75
|
| Rate for Payer: TriValley Medical Group Senior |
$143.75
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$155.26
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$155.26
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$215.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$158.12
|
| Rate for Payer: Vantage Medical Group Senior |
$143.75
|
|
