|
HC SOM LYME DISEASE AB IGM
|
Facility
|
IP
|
$15.00
|
|
|
Service Code
|
CPT 86617
|
| Hospital Charge Code |
900912696
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.71 |
| Max. Negotiated Rate |
$11.25 |
| Rate for Payer: Adventist Health Commercial |
$3.00
|
| Rate for Payer: Cash Price |
$15.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$10.15
|
| Rate for Payer: Heritage Provider Network Senior |
$10.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.75
|
| Rate for Payer: Multiplan Commercial |
$11.25
|
|
|
HC SOM LYME DISEASE AB IGM
|
Facility
|
OP
|
$15.00
|
|
|
Service Code
|
CPT 86617
|
| Hospital Charge Code |
900912696
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.71 |
| Max. Negotiated Rate |
$197.17 |
| Rate for Payer: Adventist Health Commercial |
$3.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$8.02
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$10.30
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$23.23
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$17.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$15.49
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$197.17
|
| Rate for Payer: Blue Shield of California Commercial |
$124.65
|
| Rate for Payer: Blue Shield of California EPN |
$99.98
|
| Rate for Payer: Cash Price |
$15.00
|
| Rate for Payer: Cash Price |
$15.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$9.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$23.23
|
| Rate for Payer: Dignity Health Medi-Cal |
$17.04
|
| Rate for Payer: Dignity Health Senior |
$15.49
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.75
|
| Rate for Payer: EPIC Health Plan Medicare |
$15.49
|
| Rate for Payer: Heritage Provider Network Commercial |
$9.29
|
| Rate for Payer: Heritage Provider Network Senior |
$9.29
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$22.31
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$15.49
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$7.16
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.71
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$17.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$19.52
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$19.52
|
| Rate for Payer: Multiplan Commercial |
$11.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$15.49
|
| Rate for Payer: TriValley Medical Group Senior |
$15.49
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$16.73
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$16.73
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$23.23
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$17.04
|
| Rate for Payer: Vantage Medical Group Senior |
$15.49
|
|
|
HC SOM LYME DISEASE AB SERUM
|
Facility
|
IP
|
$16.30
|
|
|
Service Code
|
CPT 86618
|
| Hospital Charge Code |
900912568
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.95 |
| Max. Negotiated Rate |
$12.22 |
| Rate for Payer: Adventist Health Commercial |
$3.26
|
| Rate for Payer: Cash Price |
$16.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$11.04
|
| Rate for Payer: Heritage Provider Network Senior |
$11.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.08
|
| Rate for Payer: Multiplan Commercial |
$12.22
|
|
|
HC SOM LYME DISEASE AB SERUM
|
Facility
|
OP
|
$16.30
|
|
|
Service Code
|
CPT 86618
|
| Hospital Charge Code |
900912568
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.95 |
| Max. Negotiated Rate |
$147.08 |
| Rate for Payer: Adventist Health Commercial |
$3.26
|
| Rate for Payer: Aetna of CA Gatekeeper |
$8.71
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$11.20
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$25.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$18.73
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$17.03
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$147.08
|
| Rate for Payer: Blue Shield of California Commercial |
$137.09
|
| Rate for Payer: Blue Shield of California EPN |
$109.96
|
| Rate for Payer: Cash Price |
$16.30
|
| Rate for Payer: Cash Price |
$16.30
|
| Rate for Payer: Cigna of CA HMO/PPO |
$10.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$25.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$18.73
|
| Rate for Payer: Dignity Health Senior |
$17.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.60
|
| Rate for Payer: EPIC Health Plan Medicare |
$17.03
|
| Rate for Payer: Heritage Provider Network Commercial |
$10.09
|
| Rate for Payer: Heritage Provider Network Senior |
$10.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$24.53
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$17.03
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$7.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.95
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$19.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.08
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$21.46
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$21.46
|
| Rate for Payer: Multiplan Commercial |
$12.22
|
| Rate for Payer: TriValley Medical Group Commercial |
$17.03
|
| Rate for Payer: TriValley Medical Group Senior |
$17.03
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$18.40
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$18.40
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$25.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$18.73
|
| Rate for Payer: Vantage Medical Group Senior |
$17.03
|
|
|
HC SOM LYME SERUM AND CSF ANAL
|
Facility
|
IP
|
$130.00
|
|
|
Service Code
|
CPT 86317
|
| Hospital Charge Code |
900914676
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$23.53 |
| Max. Negotiated Rate |
$97.50 |
| Rate for Payer: Adventist Health Commercial |
$26.00
|
| Rate for Payer: Cash Price |
$130.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$88.01
|
| Rate for Payer: Heritage Provider Network Senior |
$88.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$23.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$32.50
|
| Rate for Payer: Multiplan Commercial |
$97.50
|
|
|
HC SOM LYME SERUM AND CSF ANAL
|
Facility
|
OP
|
$130.00
|
|
|
Service Code
|
CPT 86317
|
| Hospital Charge Code |
900914676
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$14.99 |
| Max. Negotiated Rate |
$136.88 |
| Rate for Payer: Adventist Health Commercial |
$26.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$69.48
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$89.31
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$22.48
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$16.49
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14.99
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$136.88
|
| Rate for Payer: Blue Shield of California Commercial |
$120.67
|
| Rate for Payer: Blue Shield of California EPN |
$96.79
|
| Rate for Payer: Cash Price |
$130.00
|
| Rate for Payer: Cash Price |
$130.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$84.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$22.48
|
| Rate for Payer: Dignity Health Medi-Cal |
$16.49
|
| Rate for Payer: Dignity Health Senior |
$14.99
|
| Rate for Payer: EPIC Health Plan Commercial |
$84.50
|
| Rate for Payer: EPIC Health Plan Medicare |
$14.99
|
| Rate for Payer: Heritage Provider Network Commercial |
$80.47
|
| Rate for Payer: Heritage Provider Network Senior |
$80.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$16.99
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$14.99
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$62.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$23.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$17.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$32.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18.89
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18.89
|
| Rate for Payer: Multiplan Commercial |
$97.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$14.99
|
| Rate for Payer: TriValley Medical Group Senior |
$14.99
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$16.19
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$16.19
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$22.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$16.49
|
| Rate for Payer: Vantage Medical Group Senior |
$14.99
|
|
|
HC SOM LYSO 86003
|
Facility
|
IP
|
$7.47
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
900914738
|
|
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: Cash Price |
$7.47
|
| 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 LYSO 86003
|
Facility
|
OP
|
$7.47
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
900914738
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$1.35 |
| Max. Negotiated Rate |
$144.32 |
| Rate for Payer: Adventist Health Commercial |
$1.49
|
| Rate for Payer: Aetna of CA Gatekeeper |
$3.99
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$5.13
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.83
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.74
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$144.32
|
| Rate for Payer: Blue Shield of California Commercial |
$42.05
|
| Rate for Payer: Blue Shield of California EPN |
$33.73
|
| Rate for Payer: Cash Price |
$7.47
|
| Rate for Payer: Cash Price |
$7.47
|
| 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: Inland Empire Health Plan (IEHP) Medi-Cal |
$7.52
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$3.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6.00
|
| 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 MAGNESIUM RANDOM UR
|
Facility
|
OP
|
$7.41
|
|
|
Service Code
|
CPT 83735
|
| Hospital Charge Code |
900913941
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$1.34 |
| Max. Negotiated Rate |
$60.79 |
| Rate for Payer: Adventist Health Commercial |
$1.48
|
| Rate for Payer: Aetna of CA Gatekeeper |
$3.96
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$5.09
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.37
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$60.79
|
| Rate for Payer: Blue Shield of California Commercial |
$53.91
|
| Rate for Payer: Blue Shield of California EPN |
$43.24
|
| Rate for Payer: Cash Price |
$7.41
|
| Rate for Payer: Cash Price |
$7.41
|
| Rate for Payer: Cigna of CA HMO/PPO |
$4.82
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.37
|
| Rate for Payer: Dignity Health Senior |
$6.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.82
|
| Rate for Payer: EPIC Health Plan Medicare |
$6.70
|
| Rate for Payer: Heritage Provider Network Commercial |
$4.59
|
| Rate for Payer: Heritage Provider Network Senior |
$4.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$9.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$3.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.85
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8.44
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8.44
|
| Rate for Payer: Multiplan Commercial |
$5.56
|
| Rate for Payer: TriValley Medical Group Commercial |
$6.70
|
| Rate for Payer: TriValley Medical Group Senior |
$6.70
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$7.24
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$7.24
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.37
|
| Rate for Payer: Vantage Medical Group Senior |
$6.70
|
|
|
HC SOM MAGNESIUM RANDOM UR
|
Facility
|
IP
|
$7.41
|
|
|
Service Code
|
CPT 83735
|
| Hospital Charge Code |
900913941
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$1.34 |
| Max. Negotiated Rate |
$5.56 |
| Rate for Payer: Adventist Health Commercial |
$1.48
|
| Rate for Payer: Cash Price |
$7.41
|
| Rate for Payer: Heritage Provider Network Commercial |
$5.02
|
| Rate for Payer: Heritage Provider Network Senior |
$5.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.85
|
| Rate for Payer: Multiplan Commercial |
$5.56
|
|
|
HC SOM MAGNESIUM, URINE
|
Facility
|
IP
|
$22.00
|
|
|
Service Code
|
CPT 83735
|
| Hospital Charge Code |
900910757
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.98 |
| Max. Negotiated Rate |
$16.50 |
| Rate for Payer: Adventist Health Commercial |
$4.40
|
| Rate for Payer: Cash Price |
$22.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$14.89
|
| Rate for Payer: Heritage Provider Network Senior |
$14.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.50
|
| Rate for Payer: Multiplan Commercial |
$16.50
|
|
|
HC SOM MAGNESIUM, URINE
|
Facility
|
OP
|
$22.00
|
|
|
Service Code
|
CPT 83735
|
| Hospital Charge Code |
900910757
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.98 |
| Max. Negotiated Rate |
$60.79 |
| Rate for Payer: Adventist Health Commercial |
$4.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$11.76
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$15.11
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.37
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$60.79
|
| Rate for Payer: Blue Shield of California Commercial |
$53.91
|
| Rate for Payer: Blue Shield of California EPN |
$43.24
|
| Rate for Payer: Cash Price |
$22.00
|
| Rate for Payer: Cash Price |
$22.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$14.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.37
|
| Rate for Payer: Dignity Health Senior |
$6.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.30
|
| Rate for Payer: EPIC Health Plan Medicare |
$6.70
|
| Rate for Payer: Heritage Provider Network Commercial |
$13.62
|
| Rate for Payer: Heritage Provider Network Senior |
$13.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$9.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$10.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8.44
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8.44
|
| Rate for Payer: Multiplan Commercial |
$16.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$6.70
|
| Rate for Payer: TriValley Medical Group Senior |
$6.70
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$7.24
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$7.24
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.37
|
| Rate for Payer: Vantage Medical Group Senior |
$6.70
|
|
|
HC SOM MANGANESE
|
Facility
|
OP
|
$26.65
|
|
|
Service Code
|
CPT 83785
|
| Hospital Charge Code |
900911066
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.82 |
| Max. Negotiated Rate |
$224.46 |
| Rate for Payer: Adventist Health Commercial |
$5.33
|
| Rate for Payer: Aetna of CA Gatekeeper |
$14.24
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$18.31
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$39.98
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$29.32
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$26.65
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$224.46
|
| Rate for Payer: Blue Shield of California Commercial |
$197.91
|
| Rate for Payer: Blue Shield of California EPN |
$158.74
|
| Rate for Payer: Cash Price |
$26.65
|
| Rate for Payer: Cash Price |
$26.65
|
| Rate for Payer: Cigna of CA HMO/PPO |
$17.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$39.98
|
| Rate for Payer: Dignity Health Medi-Cal |
$29.32
|
| Rate for Payer: Dignity Health Senior |
$26.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$17.32
|
| Rate for Payer: EPIC Health Plan Medicare |
$26.65
|
| Rate for Payer: Heritage Provider Network Commercial |
$16.50
|
| Rate for Payer: Heritage Provider Network Senior |
$16.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$35.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$26.65
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$12.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$30.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.66
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$33.58
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$33.58
|
| Rate for Payer: Multiplan Commercial |
$19.99
|
| Rate for Payer: TriValley Medical Group Commercial |
$26.65
|
| Rate for Payer: TriValley Medical Group Senior |
$26.65
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$28.79
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$28.79
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$39.98
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$29.32
|
| Rate for Payer: Vantage Medical Group Senior |
$26.65
|
|
|
HC SOM MANGANESE
|
Facility
|
IP
|
$26.65
|
|
|
Service Code
|
CPT 83785
|
| Hospital Charge Code |
900911066
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.82 |
| Max. Negotiated Rate |
$19.99 |
| Rate for Payer: Adventist Health Commercial |
$5.33
|
| Rate for Payer: Cash Price |
$26.65
|
| Rate for Payer: Heritage Provider Network Commercial |
$18.04
|
| Rate for Payer: Heritage Provider Network Senior |
$18.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.66
|
| Rate for Payer: Multiplan Commercial |
$19.99
|
|
|
HC SOM MATERNAL CELL CONTAM
|
Facility
|
OP
|
$460.00
|
|
|
Service Code
|
CPT 81265
|
| Hospital Charge Code |
900915281
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$83.26 |
| Max. Negotiated Rate |
$2,177.63 |
| Rate for Payer: Adventist Health Commercial |
$92.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$245.87
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$316.02
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$349.61
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$256.38
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$233.07
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,177.63
|
| Rate for Payer: Blue Shield of California Commercial |
$280.60
|
| Rate for Payer: Blue Shield of California EPN |
$224.48
|
| Rate for Payer: Cash Price |
$460.00
|
| Rate for Payer: Cash Price |
$460.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$299.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$349.61
|
| Rate for Payer: Dignity Health Medi-Cal |
$256.38
|
| Rate for Payer: Dignity Health Senior |
$233.07
|
| Rate for Payer: EPIC Health Plan Commercial |
$299.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$233.07
|
| Rate for Payer: Heritage Provider Network Commercial |
$284.74
|
| Rate for Payer: Heritage Provider Network Senior |
$284.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$309.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$233.07
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$219.42
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$83.26
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$268.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$115.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$293.67
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$293.67
|
| Rate for Payer: Multiplan Commercial |
$345.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$233.07
|
| Rate for Payer: TriValley Medical Group Senior |
$233.07
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$251.71
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$251.71
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$349.61
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$256.38
|
| Rate for Payer: Vantage Medical Group Senior |
$233.07
|
|
|
HC SOM MATERNAL CELL CONTAM
|
Facility
|
IP
|
$460.00
|
|
|
Service Code
|
CPT 81265
|
| Hospital Charge Code |
900915281
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$83.26 |
| Max. Negotiated Rate |
$345.00 |
| Rate for Payer: Adventist Health Commercial |
$92.00
|
| Rate for Payer: Cash Price |
$460.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$311.42
|
| Rate for Payer: Heritage Provider Network Senior |
$311.42
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$83.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$115.00
|
| Rate for Payer: Multiplan Commercial |
$345.00
|
|
|
HC SOM MATRIX METALLOPROTEINASE 7
|
Facility
|
IP
|
$362.00
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
900915509
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$65.52 |
| Max. Negotiated Rate |
$271.50 |
| Rate for Payer: Adventist Health Commercial |
$72.40
|
| Rate for Payer: Cash Price |
$362.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$245.07
|
| Rate for Payer: Heritage Provider Network Senior |
$245.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$65.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$90.50
|
| Rate for Payer: Multiplan Commercial |
$271.50
|
|
|
HC SOM MATRIX METALLOPROTEINASE 7
|
Facility
|
OP
|
$362.00
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
900915509
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$16.59 |
| Max. Negotiated Rate |
$271.50 |
| Rate for Payer: Adventist Health Commercial |
$72.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$193.49
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$248.69
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$25.91
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$17.27
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$118.19
|
| Rate for Payer: Blue Shield of California Commercial |
$104.20
|
| Rate for Payer: Blue Shield of California EPN |
$83.58
|
| Rate for Payer: Cash Price |
$362.00
|
| Rate for Payer: Cash Price |
$362.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$235.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$25.91
|
| Rate for Payer: Dignity Health Medi-Cal |
$19.00
|
| Rate for Payer: Dignity Health Senior |
$17.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$235.30
|
| Rate for Payer: EPIC Health Plan Medicare |
$17.27
|
| Rate for Payer: Heritage Provider Network Commercial |
$224.08
|
| Rate for Payer: Heritage Provider Network Senior |
$224.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$16.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$17.27
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$172.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$65.52
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$19.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$90.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$21.76
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$21.76
|
| Rate for Payer: Multiplan Commercial |
$271.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$17.27
|
| Rate for Payer: TriValley Medical Group Senior |
$17.27
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$18.65
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$18.65
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$25.91
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.00
|
| Rate for Payer: Vantage Medical Group Senior |
$17.27
|
|
|
HC SOM MBCR 88271 SOM
|
Facility
|
IP
|
$51.34
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
900914721
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$9.29 |
| Max. Negotiated Rate |
$38.51 |
| Rate for Payer: Adventist Health Commercial |
$10.27
|
| Rate for Payer: Cash Price |
$51.34
|
| Rate for Payer: Heritage Provider Network Commercial |
$34.76
|
| Rate for Payer: Heritage Provider Network Senior |
$34.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.84
|
| Rate for Payer: Multiplan Commercial |
$38.51
|
|
|
HC SOM MBCR 88271 SOM
|
Facility
|
OP
|
$51.34
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
900914721
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$9.29 |
| Max. Negotiated Rate |
$1,548.87 |
| Rate for Payer: Adventist Health Commercial |
$10.27
|
| Rate for Payer: Aetna of CA Gatekeeper |
$27.44
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$35.27
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$32.13
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$23.56
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$21.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,548.87
|
| Rate for Payer: Blue Shield of California Commercial |
$172.40
|
| Rate for Payer: Blue Shield of California EPN |
$138.28
|
| Rate for Payer: Cash Price |
$51.34
|
| Rate for Payer: Cash Price |
$51.34
|
| Rate for Payer: Cigna of CA HMO/PPO |
$33.37
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$32.13
|
| Rate for Payer: Dignity Health Medi-Cal |
$23.56
|
| Rate for Payer: Dignity Health Senior |
$21.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$33.37
|
| Rate for Payer: EPIC Health Plan Medicare |
$21.42
|
| Rate for Payer: Heritage Provider Network Commercial |
$31.78
|
| Rate for Payer: Heritage Provider Network Senior |
$31.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$27.22
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$21.42
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$24.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.29
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$24.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.84
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$26.99
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$26.99
|
| Rate for Payer: Multiplan Commercial |
$38.51
|
| Rate for Payer: TriValley Medical Group Commercial |
$21.42
|
| Rate for Payer: TriValley Medical Group Senior |
$21.42
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$23.14
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$23.14
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$32.13
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$23.56
|
| Rate for Payer: Vantage Medical Group Senior |
$21.42
|
|
|
HC SOM MBCR 88275 SOM
|
Facility
|
OP
|
$62.47
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
900914722
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$11.31 |
| Max. Negotiated Rate |
$2,389.68 |
| Rate for Payer: Adventist Health Commercial |
$12.49
|
| Rate for Payer: Aetna of CA Gatekeeper |
$33.39
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$42.92
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$76.78
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$56.31
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$51.19
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,389.68
|
| Rate for Payer: Blue Shield of California Commercial |
$323.19
|
| Rate for Payer: Blue Shield of California EPN |
$259.23
|
| Rate for Payer: Cash Price |
$62.47
|
| Rate for Payer: Cash Price |
$62.47
|
| Rate for Payer: Cigna of CA HMO/PPO |
$40.61
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$76.78
|
| Rate for Payer: Dignity Health Medi-Cal |
$56.31
|
| Rate for Payer: Dignity Health Senior |
$51.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$40.61
|
| Rate for Payer: EPIC Health Plan Medicare |
$51.19
|
| Rate for Payer: Heritage Provider Network Commercial |
$38.67
|
| Rate for Payer: Heritage Provider Network Senior |
$38.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$51.32
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$51.19
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$29.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.31
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$58.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.62
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$64.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$64.50
|
| Rate for Payer: Multiplan Commercial |
$46.85
|
| Rate for Payer: TriValley Medical Group Commercial |
$51.19
|
| Rate for Payer: TriValley Medical Group Senior |
$51.19
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$55.28
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$55.28
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$76.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$56.31
|
| Rate for Payer: Vantage Medical Group Senior |
$51.19
|
|
|
HC SOM MBCR 88275 SOM
|
Facility
|
IP
|
$62.47
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
900914722
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$11.31 |
| Max. Negotiated Rate |
$46.85 |
| Rate for Payer: Adventist Health Commercial |
$12.49
|
| Rate for Payer: Cash Price |
$62.47
|
| Rate for Payer: Heritage Provider Network Commercial |
$42.29
|
| Rate for Payer: Heritage Provider Network Senior |
$42.29
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.62
|
| Rate for Payer: Multiplan Commercial |
$46.85
|
|
|
HC SOM MBCR 88291 SOM
|
Facility
|
OP
|
$26.19
|
|
|
Service Code
|
CPT 88291
|
| Hospital Charge Code |
900914723
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$4.74 |
| Max. Negotiated Rate |
$170.56 |
| Rate for Payer: Adventist Health Commercial |
$5.24
|
| Rate for Payer: Aetna of CA Gatekeeper |
$14.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$17.99
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$22.26
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$19.64
|
| 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 |
$26.19
|
| Rate for Payer: Cash Price |
$26.19
|
| Rate for Payer: Cigna of CA HMO/PPO |
$17.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$22.26
|
| Rate for Payer: Dignity Health Medi-Cal |
$22.26
|
| Rate for Payer: Dignity Health Senior |
$22.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$17.02
|
| Rate for Payer: Heritage Provider Network Commercial |
$16.21
|
| Rate for Payer: Heritage Provider Network Senior |
$16.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$22.06
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$12.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.55
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18.33
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18.33
|
| Rate for Payer: Multiplan Commercial |
$19.64
|
| 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 |
$22.26
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$22.26
|
| Rate for Payer: Vantage Medical Group Senior |
$22.26
|
|
|
HC SOM MBCR 88291 SOM
|
Facility
|
IP
|
$26.19
|
|
|
Service Code
|
CPT 88291
|
| Hospital Charge Code |
900914723
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$4.74 |
| Max. Negotiated Rate |
$19.64 |
| Rate for Payer: Adventist Health Commercial |
$5.24
|
| Rate for Payer: Cash Price |
$26.19
|
| Rate for Payer: Heritage Provider Network Commercial |
$17.73
|
| Rate for Payer: Heritage Provider Network Senior |
$17.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.55
|
| Rate for Payer: Multiplan Commercial |
$19.64
|
|
|
HC SOM MCLON IFE U
|
Facility
|
OP
|
$28.86
|
|
|
Service Code
|
CPT 86335
|
| Hospital Charge Code |
900912768
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.22 |
| Max. Negotiated Rate |
$236.16 |
| Rate for Payer: Adventist Health Commercial |
$5.77
|
| Rate for Payer: Aetna of CA Gatekeeper |
$15.43
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$19.83
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$44.02
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$32.28
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$29.35
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$127.04
|
| Rate for Payer: Blue Shield of California Commercial |
$236.16
|
| Rate for Payer: Blue Shield of California EPN |
$189.42
|
| Rate for Payer: Cash Price |
$28.86
|
| Rate for Payer: Cash Price |
$28.86
|
| Rate for Payer: Cigna of CA HMO/PPO |
$18.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$44.02
|
| Rate for Payer: Dignity Health Medi-Cal |
$32.28
|
| Rate for Payer: Dignity Health Senior |
$29.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$18.76
|
| Rate for Payer: EPIC Health Plan Medicare |
$29.35
|
| Rate for Payer: Heritage Provider Network Commercial |
$17.86
|
| Rate for Payer: Heritage Provider Network Senior |
$17.86
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$42.27
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$29.35
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$13.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.22
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$33.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.21
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$36.98
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$36.98
|
| Rate for Payer: Multiplan Commercial |
$21.64
|
| Rate for Payer: TriValley Medical Group Commercial |
$29.35
|
| Rate for Payer: TriValley Medical Group Senior |
$29.35
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$31.70
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$31.70
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$44.02
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$32.28
|
| Rate for Payer: Vantage Medical Group Senior |
$29.35
|
|
