|
HC SOM FRANSICELLA AB
|
Facility
OP
|
$47.50
|
|
|
Service Code
|
CPT 86000
|
| Hospital Charge Code |
900911647
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.98 |
| Max. Negotiated Rate |
$54.50 |
| Rate for Payer: Adventist Health Commercial |
$9.50
|
| Rate for Payer: Aetna of CA Gatekeeper |
$16.69
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$32.63
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$10.47
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$7.68
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$6.98
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$52.74
|
| Rate for Payer: Blue Shield of California Commercial |
$54.50
|
| Rate for Payer: Blue Shield of California EPN |
$42.61
|
| Rate for Payer: Cash Price |
$21.38
|
| Rate for Payer: Cash Price |
$21.38
|
| Rate for Payer: Cigna of CA HMO/PPO |
$30.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.47
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.68
|
| Rate for Payer: Dignity Health Senior |
$6.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$30.88
|
| Rate for Payer: EPIC Health Plan Medicare |
$6.98
|
| Rate for Payer: Heritage Provider Network Commercial |
$29.40
|
| Rate for Payer: Heritage Provider Network Senior |
$29.40
|
| Rate for Payer: Humana Medicare |
$6.98
|
| Rate for Payer: IEHP Medi-Cal |
$8.30
|
| Rate for Payer: IEHP Medicare Advantage |
$6.98
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$13.26
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.60
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.88
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8.79
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8.79
|
| Rate for Payer: Multiplan Commercial |
$35.62
|
| Rate for Payer: TriValley Medical Group Commercial |
$6.98
|
| Rate for Payer: TriValley Medical Group Senior |
$6.98
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$7.54
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$7.54
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10.47
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.68
|
| Rate for Payer: Vantage Medical Group Senior |
$6.98
|
|
|
HC SOM FRANSICELLA AB
|
Facility
IP
|
$47.50
|
|
|
Service Code
|
CPT 86000
|
| Hospital Charge Code |
900911647
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.60 |
| Max. Negotiated Rate |
$35.62 |
| Rate for Payer: Adventist Health Commercial |
$9.50
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$32.63
|
| Rate for Payer: Cash Price |
$21.38
|
| Rate for Payer: Heritage Provider Network Commercial |
$32.16
|
| Rate for Payer: Heritage Provider Network Senior |
$32.16
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.88
|
| Rate for Payer: Multiplan Commercial |
$35.62
|
|
|
HC SOM FREE FATTY ACIDS
|
Facility
IP
|
$32.00
|
|
|
Service Code
|
CPT 82725
|
| Hospital Charge Code |
900914522
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.79 |
| Max. Negotiated Rate |
$24.00 |
| Rate for Payer: Adventist Health Commercial |
$6.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$21.98
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$21.66
|
| Rate for Payer: Heritage Provider Network Senior |
$21.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.00
|
| Rate for Payer: Multiplan Commercial |
$24.00
|
|
|
HC SOM FREE FATTY ACIDS
|
Facility
OP
|
$32.00
|
|
|
Service Code
|
CPT 82725
|
| Hospital Charge Code |
900914522
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.79 |
| Max. Negotiated Rate |
$111.46 |
| Rate for Payer: Adventist Health Commercial |
$6.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$38.75
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$21.98
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$28.16
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$20.65
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$18.77
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$111.46
|
| Rate for Payer: Blue Shield of California Commercial |
$103.97
|
| Rate for Payer: Blue Shield of California EPN |
$81.28
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Cigna of CA HMO/PPO |
$20.80
|
| 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 |
$20.80
|
| Rate for Payer: EPIC Health Plan Medicare |
$18.77
|
| Rate for Payer: Heritage Provider Network Commercial |
$19.81
|
| Rate for Payer: Heritage Provider Network Senior |
$19.81
|
| Rate for Payer: Humana Medicare |
$18.77
|
| Rate for Payer: IEHP Medi-Cal |
$22.62
|
| Rate for Payer: IEHP Medicare Advantage |
$18.77
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$35.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.79
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.00
|
| 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 |
$24.00
|
| 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 FR TYR IDX BIND CAP
|
Facility
IP
|
$9.27
|
|
|
Service Code
|
CPT 84479
|
| Hospital Charge Code |
900912805
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$1.68 |
| Max. Negotiated Rate |
$6.95 |
| Rate for Payer: Adventist Health Commercial |
$1.85
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$6.37
|
| Rate for Payer: Cash Price |
$4.17
|
| Rate for Payer: Heritage Provider Network Commercial |
$6.28
|
| Rate for Payer: Heritage Provider Network Senior |
$6.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.32
|
| Rate for Payer: Multiplan Commercial |
$6.95
|
|
|
HC SOM FR TYR IDX BIND CAP
|
Facility
OP
|
$9.27
|
|
|
Service Code
|
CPT 84479
|
| Hospital Charge Code |
900912805
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$1.68 |
| Max. Negotiated Rate |
$54.15 |
| Rate for Payer: Adventist Health Commercial |
$1.85
|
| Rate for Payer: Aetna of CA Gatekeeper |
$18.83
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$6.37
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$9.70
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$7.12
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$6.47
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$54.15
|
| Rate for Payer: Blue Shield of California Commercial |
$50.53
|
| Rate for Payer: Blue Shield of California EPN |
$39.50
|
| Rate for Payer: Cash Price |
$4.17
|
| Rate for Payer: Cash Price |
$4.17
|
| Rate for Payer: Cigna of CA HMO/PPO |
$6.03
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.12
|
| Rate for Payer: Dignity Health Senior |
$6.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.03
|
| Rate for Payer: EPIC Health Plan Medicare |
$6.47
|
| Rate for Payer: Heritage Provider Network Commercial |
$5.74
|
| Rate for Payer: Heritage Provider Network Senior |
$5.74
|
| Rate for Payer: Humana Medicare |
$6.47
|
| Rate for Payer: IEHP Medi-Cal |
$8.86
|
| Rate for Payer: IEHP Medicare Advantage |
$6.47
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$12.29
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8.15
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8.15
|
| Rate for Payer: Multiplan Commercial |
$6.95
|
| Rate for Payer: TriValley Medical Group Commercial |
$6.47
|
| Rate for Payer: TriValley Medical Group Senior |
$6.47
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$6.98
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$6.98
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$9.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.12
|
| Rate for Payer: Vantage Medical Group Senior |
$6.47
|
|
|
HC SOM FRUCTOSAMINE
|
Facility
OP
|
$16.04
|
|
|
Service Code
|
CPT 82985
|
| Hospital Charge Code |
900913929
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.90 |
| Max. Negotiated Rate |
$126.17 |
| Rate for Payer: Adventist Health Commercial |
$3.21
|
| Rate for Payer: Aetna of CA Gatekeeper |
$43.85
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$11.02
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$25.14
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$18.44
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$16.76
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$126.17
|
| Rate for Payer: Blue Shield of California Commercial |
$117.73
|
| Rate for Payer: Blue Shield of California EPN |
$92.03
|
| Rate for Payer: Cash Price |
$7.22
|
| Rate for Payer: Cash Price |
$7.22
|
| Rate for Payer: Cigna of CA HMO/PPO |
$10.43
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$25.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$18.44
|
| Rate for Payer: Dignity Health Senior |
$16.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.43
|
| Rate for Payer: EPIC Health Plan Medicare |
$16.76
|
| Rate for Payer: Heritage Provider Network Commercial |
$9.93
|
| Rate for Payer: Heritage Provider Network Senior |
$9.93
|
| Rate for Payer: Humana Medicare |
$16.76
|
| Rate for Payer: IEHP Medi-Cal |
$20.92
|
| Rate for Payer: IEHP Medicare Advantage |
$16.76
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$31.84
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$19.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.01
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$21.12
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$21.12
|
| Rate for Payer: Multiplan Commercial |
$12.03
|
| Rate for Payer: TriValley Medical Group Commercial |
$16.76
|
| Rate for Payer: TriValley Medical Group Senior |
$16.76
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$18.10
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$18.10
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$25.14
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$18.44
|
| Rate for Payer: Vantage Medical Group Senior |
$16.76
|
|
|
HC SOM FRUCTOSAMINE
|
Facility
IP
|
$16.04
|
|
|
Service Code
|
CPT 82985
|
| Hospital Charge Code |
900913929
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.90 |
| Max. Negotiated Rate |
$12.03 |
| Rate for Payer: Adventist Health Commercial |
$3.21
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$11.02
|
| Rate for Payer: Cash Price |
$7.22
|
| Rate for Payer: Heritage Provider Network Commercial |
$10.86
|
| Rate for Payer: Heritage Provider Network Senior |
$10.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.01
|
| Rate for Payer: Multiplan Commercial |
$12.03
|
|
|
HC SOM FSUCC 82491
|
Facility
IP
|
$185.00
|
|
|
Service Code
|
CPT 82542
|
| Hospital Charge Code |
900914734
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$33.48 |
| Max. Negotiated Rate |
$138.75 |
| Rate for Payer: Adventist Health Commercial |
$37.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$127.10
|
| Rate for Payer: Cash Price |
$83.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$125.24
|
| Rate for Payer: Heritage Provider Network Senior |
$125.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$33.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$46.25
|
| Rate for Payer: Multiplan Commercial |
$138.75
|
|
|
HC SOM FSUCC 82491
|
Facility
OP
|
$185.00
|
|
|
Service Code
|
CPT 82542
|
| Hospital Charge Code |
900914734
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$23.95 |
| Max. Negotiated Rate |
$150.51 |
| Rate for Payer: Adventist Health Commercial |
$37.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$52.54
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$127.10
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$36.14
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$26.50
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$24.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$150.51
|
| Rate for Payer: Blue Shield of California Commercial |
$141.04
|
| Rate for Payer: Blue Shield of California EPN |
$110.26
|
| Rate for Payer: Cash Price |
$83.25
|
| Rate for Payer: Cash Price |
$83.25
|
| Rate for Payer: Cigna of CA HMO/PPO |
$120.25
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$36.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$26.50
|
| Rate for Payer: Dignity Health Senior |
$24.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$120.25
|
| Rate for Payer: EPIC Health Plan Medicare |
$24.09
|
| Rate for Payer: Heritage Provider Network Commercial |
$114.52
|
| Rate for Payer: Heritage Provider Network Senior |
$114.52
|
| Rate for Payer: Humana Medicare |
$24.09
|
| Rate for Payer: IEHP Medi-Cal |
$23.95
|
| Rate for Payer: IEHP Medicare Advantage |
$24.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$45.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$33.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$28.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$46.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$30.35
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$30.35
|
| Rate for Payer: Multiplan Commercial |
$138.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$24.09
|
| Rate for Payer: TriValley Medical Group Senior |
$24.09
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$26.02
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$26.02
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$36.14
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$26.50
|
| Rate for Payer: Vantage Medical Group Senior |
$24.09
|
|
|
HC SOM FUNGITELL ASSAY
|
Facility
IP
|
$130.00
|
|
|
Service Code
|
CPT 87449
|
| Hospital Charge Code |
900912985
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$23.53 |
| Max. Negotiated Rate |
$97.50 |
| Rate for Payer: Adventist Health Commercial |
$26.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$89.31
|
| Rate for Payer: Cash Price |
$58.50
|
| 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 FUNGITELL ASSAY
|
Facility
OP
|
$130.00
|
|
|
Service Code
|
CPT 87449
|
| Hospital Charge Code |
900912985
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$11.98 |
| Max. Negotiated Rate |
$97.50 |
| Rate for Payer: Adventist Health Commercial |
$26.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$27.02
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$89.31
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$17.97
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$13.18
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$11.98
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$75.23
|
| Rate for Payer: Blue Shield of California Commercial |
$72.56
|
| Rate for Payer: Blue Shield of California EPN |
$56.72
|
| Rate for Payer: Cash Price |
$58.50
|
| Rate for Payer: Cash Price |
$58.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$84.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$17.97
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.18
|
| Rate for Payer: Dignity Health Senior |
$11.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$84.50
|
| Rate for Payer: EPIC Health Plan Medicare |
$11.98
|
| Rate for Payer: Heritage Provider Network Commercial |
$80.47
|
| Rate for Payer: Heritage Provider Network Senior |
$80.47
|
| Rate for Payer: Humana Medicare |
$11.98
|
| Rate for Payer: IEHP Medi-Cal |
$13.10
|
| Rate for Payer: IEHP Medicare Advantage |
$11.98
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$22.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$23.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$32.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$15.09
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$15.09
|
| Rate for Payer: Multiplan Commercial |
$97.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$11.98
|
| Rate for Payer: TriValley Medical Group Senior |
$11.98
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$12.94
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$12.94
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$17.97
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.18
|
| Rate for Payer: Vantage Medical Group Senior |
$11.98
|
|
|
HC SOM GABAPENTIN (NEURONTIN)
|
Facility
OP
|
$19.00
|
|
|
Service Code
|
CPT 80171
|
| Hospital Charge Code |
900910415
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.44 |
| Max. Negotiated Rate |
$101.12 |
| Rate for Payer: Adventist Health Commercial |
$3.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$37.41
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$13.05
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$32.50
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$23.84
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$21.67
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$66.72
|
| Rate for Payer: Blue Shield of California Commercial |
$101.12
|
| Rate for Payer: Blue Shield of California EPN |
$79.05
|
| Rate for Payer: Cash Price |
$8.55
|
| Rate for Payer: Cash Price |
$8.55
|
| Rate for Payer: Cigna of CA HMO/PPO |
$12.35
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$32.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$23.84
|
| Rate for Payer: Dignity Health Senior |
$21.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.35
|
| Rate for Payer: EPIC Health Plan Medicare |
$21.67
|
| Rate for Payer: Heritage Provider Network Commercial |
$11.76
|
| Rate for Payer: Heritage Provider Network Senior |
$11.76
|
| Rate for Payer: Humana Medicare |
$21.67
|
| Rate for Payer: IEHP Medi-Cal |
$22.51
|
| Rate for Payer: IEHP Medicare Advantage |
$21.67
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$41.17
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$27.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$27.30
|
| Rate for Payer: Multiplan Commercial |
$14.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$21.67
|
| Rate for Payer: TriValley Medical Group Senior |
$21.67
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$23.40
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$23.40
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$32.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$23.84
|
| Rate for Payer: Vantage Medical Group Senior |
$21.67
|
|
|
HC SOM GABAPENTIN (NEURONTIN)
|
Facility
IP
|
$19.00
|
|
|
Service Code
|
CPT 80171
|
| Hospital Charge Code |
900910415
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.44 |
| Max. Negotiated Rate |
$14.25 |
| Rate for Payer: Adventist Health Commercial |
$3.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$13.05
|
| Rate for Payer: Cash Price |
$8.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$12.86
|
| Rate for Payer: Heritage Provider Network Senior |
$12.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.75
|
| Rate for Payer: Multiplan Commercial |
$14.25
|
|
|
HC SOM GAD 65 ANTIBODIES
|
Facility
IP
|
$18.08
|
|
|
Service Code
|
CPT 86341
|
| Hospital Charge Code |
900912683
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.27 |
| Max. Negotiated Rate |
$13.56 |
| Rate for Payer: Adventist Health Commercial |
$3.62
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$12.42
|
| Rate for Payer: Cash Price |
$8.14
|
| Rate for Payer: Heritage Provider Network Commercial |
$12.24
|
| Rate for Payer: Heritage Provider Network Senior |
$12.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.52
|
| Rate for Payer: Multiplan Commercial |
$13.56
|
|
|
HC SOM GAD 65 ANTIBODIES
|
Facility
OP
|
$18.08
|
|
|
Service Code
|
CPT 86341
|
| Hospital Charge Code |
900912683
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.27 |
| Max. Negotiated Rate |
$129.80 |
| Rate for Payer: Adventist Health Commercial |
$3.62
|
| Rate for Payer: Aetna of CA Gatekeeper |
$48.33
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$12.42
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$35.36
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$25.93
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$23.57
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$128.71
|
| Rate for Payer: Blue Shield of California Commercial |
$129.80
|
| Rate for Payer: Blue Shield of California EPN |
$101.47
|
| Rate for Payer: Cash Price |
$8.14
|
| Rate for Payer: Cash Price |
$8.14
|
| Rate for Payer: Cigna of CA HMO/PPO |
$11.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$35.36
|
| Rate for Payer: Dignity Health Medi-Cal |
$25.93
|
| Rate for Payer: Dignity Health Senior |
$23.57
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.75
|
| Rate for Payer: EPIC Health Plan Medicare |
$23.57
|
| Rate for Payer: Heritage Provider Network Commercial |
$11.19
|
| Rate for Payer: Heritage Provider Network Senior |
$11.19
|
| Rate for Payer: Humana Medicare |
$23.57
|
| Rate for Payer: IEHP Medi-Cal |
$28.22
|
| Rate for Payer: IEHP Medicare Advantage |
$23.57
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$44.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.27
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$27.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.52
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$29.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$29.70
|
| Rate for Payer: Multiplan Commercial |
$13.56
|
| Rate for Payer: TriValley Medical Group Commercial |
$23.57
|
| Rate for Payer: TriValley Medical Group Senior |
$23.57
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$25.45
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$25.45
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$35.36
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25.93
|
| Rate for Payer: Vantage Medical Group Senior |
$23.57
|
|
|
HC SOM GAL-1-PO4 URIDYL TR
|
Facility
OP
|
$75.00
|
|
|
Service Code
|
CPT 82775
|
| Hospital Charge Code |
900911057
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.58 |
| Max. Negotiated Rate |
$176.38 |
| Rate for Payer: Adventist Health Commercial |
$15.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$61.27
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$51.52
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$31.60
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$23.18
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$21.07
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$176.38
|
| Rate for Payer: Blue Shield of California Commercial |
$164.51
|
| Rate for Payer: Blue Shield of California EPN |
$128.61
|
| Rate for Payer: Cash Price |
$33.75
|
| Rate for Payer: Cash Price |
$33.75
|
| Rate for Payer: Cigna of CA HMO/PPO |
$48.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$31.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$23.18
|
| Rate for Payer: Dignity Health Senior |
$21.07
|
| Rate for Payer: EPIC Health Plan Commercial |
$48.75
|
| Rate for Payer: EPIC Health Plan Medicare |
$21.07
|
| Rate for Payer: Heritage Provider Network Commercial |
$46.42
|
| Rate for Payer: Heritage Provider Network Senior |
$46.42
|
| Rate for Payer: Humana Medicare |
$21.07
|
| Rate for Payer: IEHP Medi-Cal |
$29.22
|
| Rate for Payer: IEHP Medicare Advantage |
$21.07
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$40.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13.58
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$24.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$26.55
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$26.55
|
| Rate for Payer: Multiplan Commercial |
$56.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$21.07
|
| Rate for Payer: TriValley Medical Group Senior |
$21.07
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$22.75
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$22.75
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$31.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$23.18
|
| Rate for Payer: Vantage Medical Group Senior |
$21.07
|
|
|
HC SOM GAL-1-PO4 URIDYL TR
|
Facility
IP
|
$75.00
|
|
|
Service Code
|
CPT 82775
|
| Hospital Charge Code |
900911057
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.58 |
| Max. Negotiated Rate |
$56.25 |
| Rate for Payer: Adventist Health Commercial |
$15.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$51.52
|
| Rate for Payer: Cash Price |
$33.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$50.78
|
| Rate for Payer: Heritage Provider Network Senior |
$50.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18.75
|
| Rate for Payer: Multiplan Commercial |
$56.25
|
|
|
HC SOM GALACTOSE 1 PHOSPHATE ERYTHRO
|
Facility
OP
|
$175.00
|
|
|
Service Code
|
CPT 84378
|
| Hospital Charge Code |
900910746
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.53 |
| Max. Negotiated Rate |
$131.25 |
| Rate for Payer: Adventist Health Commercial |
$35.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$33.54
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$120.22
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$17.30
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$12.68
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$11.53
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$95.97
|
| Rate for Payer: Blue Shield of California Commercial |
$90.00
|
| Rate for Payer: Blue Shield of California EPN |
$70.36
|
| Rate for Payer: Cash Price |
$78.75
|
| Rate for Payer: Cash Price |
$78.75
|
| Rate for Payer: Cigna of CA HMO/PPO |
$113.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$17.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$12.68
|
| Rate for Payer: Dignity Health Senior |
$11.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$113.75
|
| Rate for Payer: EPIC Health Plan Medicare |
$11.53
|
| Rate for Payer: Heritage Provider Network Commercial |
$108.32
|
| Rate for Payer: Heritage Provider Network Senior |
$108.32
|
| Rate for Payer: Humana Medicare |
$11.53
|
| Rate for Payer: IEHP Medi-Cal |
$15.97
|
| Rate for Payer: IEHP Medicare Advantage |
$11.53
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$21.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$31.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$43.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$14.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14.53
|
| Rate for Payer: Multiplan Commercial |
$131.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$11.53
|
| Rate for Payer: TriValley Medical Group Senior |
$11.53
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$12.46
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$12.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$17.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$12.68
|
| Rate for Payer: Vantage Medical Group Senior |
$11.53
|
|
|
HC SOM GALACTOSE 1 PHOSPHATE ERYTHRO
|
Facility
IP
|
$175.00
|
|
|
Service Code
|
CPT 84378
|
| Hospital Charge Code |
900910746
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$31.68 |
| Max. Negotiated Rate |
$131.25 |
| Rate for Payer: Adventist Health Commercial |
$35.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$120.22
|
| Rate for Payer: Cash Price |
$78.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$118.48
|
| Rate for Payer: Heritage Provider Network Senior |
$118.48
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$31.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$43.75
|
| Rate for Payer: Multiplan Commercial |
$131.25
|
|
|
HC SOM GANGLIOSIDE AB IGG ASIALO
|
Facility
IP
|
$20.00
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
900911440
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.62 |
| Max. Negotiated Rate |
$15.00 |
| Rate for Payer: Adventist Health Commercial |
$4.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$13.74
|
| Rate for Payer: Cash Price |
$9.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$13.54
|
| Rate for Payer: Heritage Provider Network Senior |
$13.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.00
|
| Rate for Payer: Multiplan Commercial |
$15.00
|
|
|
HC SOM GANGLIOSIDE AB IGG ASIALO
|
Facility
OP
|
$20.00
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
900911440
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.62 |
| Max. Negotiated Rate |
$195.82 |
| Rate for Payer: Adventist Health Commercial |
$4.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$27.02
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$13.74
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$17.30
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$12.68
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$11.53
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$195.82
|
| Rate for Payer: Blue Shield of California Commercial |
$72.56
|
| Rate for Payer: Blue Shield of California EPN |
$56.72
|
| Rate for Payer: Cash Price |
$9.00
|
| Rate for Payer: Cash Price |
$9.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$13.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$17.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$12.68
|
| Rate for Payer: Dignity Health Senior |
$11.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$11.53
|
| Rate for Payer: Heritage Provider Network Commercial |
$12.38
|
| Rate for Payer: Heritage Provider Network Senior |
$12.38
|
| Rate for Payer: Humana Medicare |
$11.53
|
| Rate for Payer: IEHP Medi-Cal |
$13.42
|
| Rate for Payer: IEHP Medicare Advantage |
$11.53
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$21.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$14.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14.53
|
| Rate for Payer: Multiplan Commercial |
$15.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$11.53
|
| Rate for Payer: TriValley Medical Group Senior |
$11.53
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$12.46
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$12.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$17.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$12.68
|
| Rate for Payer: Vantage Medical Group Senior |
$11.53
|
|
|
HC SOM GANGLIOSIDE AB IGG DISIALO
|
Facility
OP
|
$20.00
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
900912816
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.62 |
| Max. Negotiated Rate |
$195.82 |
| Rate for Payer: Adventist Health Commercial |
$4.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$27.02
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$13.74
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$17.30
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$12.68
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$11.53
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$195.82
|
| Rate for Payer: Blue Shield of California Commercial |
$72.56
|
| Rate for Payer: Blue Shield of California EPN |
$56.72
|
| Rate for Payer: Cash Price |
$9.00
|
| Rate for Payer: Cash Price |
$9.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$13.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$17.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$12.68
|
| Rate for Payer: Dignity Health Senior |
$11.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$11.53
|
| Rate for Payer: Heritage Provider Network Commercial |
$12.38
|
| Rate for Payer: Heritage Provider Network Senior |
$12.38
|
| Rate for Payer: Humana Medicare |
$11.53
|
| Rate for Payer: IEHP Medi-Cal |
$13.42
|
| Rate for Payer: IEHP Medicare Advantage |
$11.53
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$21.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$14.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14.53
|
| Rate for Payer: Multiplan Commercial |
$15.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$11.53
|
| Rate for Payer: TriValley Medical Group Senior |
$11.53
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$12.46
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$12.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$17.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$12.68
|
| Rate for Payer: Vantage Medical Group Senior |
$11.53
|
|
|
HC SOM GANGLIOSIDE AB IGG DISIALO
|
Facility
IP
|
$20.00
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
900912816
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.62 |
| Max. Negotiated Rate |
$15.00 |
| Rate for Payer: Adventist Health Commercial |
$4.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$13.74
|
| Rate for Payer: Cash Price |
$9.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$13.54
|
| Rate for Payer: Heritage Provider Network Senior |
$13.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.00
|
| Rate for Payer: Multiplan Commercial |
$15.00
|
|
|
HC SOM GANGLIOSIDE AB IGG MONO
|
Facility
OP
|
$20.00
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
900911442
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.62 |
| Max. Negotiated Rate |
$195.82 |
| Rate for Payer: Adventist Health Commercial |
$4.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$27.02
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$13.74
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$17.30
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$12.68
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$11.53
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$195.82
|
| Rate for Payer: Blue Shield of California Commercial |
$72.56
|
| Rate for Payer: Blue Shield of California EPN |
$56.72
|
| Rate for Payer: Cash Price |
$9.00
|
| Rate for Payer: Cash Price |
$9.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$13.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$17.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$12.68
|
| Rate for Payer: Dignity Health Senior |
$11.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$11.53
|
| Rate for Payer: Heritage Provider Network Commercial |
$12.38
|
| Rate for Payer: Heritage Provider Network Senior |
$12.38
|
| Rate for Payer: Humana Medicare |
$11.53
|
| Rate for Payer: IEHP Medi-Cal |
$13.42
|
| Rate for Payer: IEHP Medicare Advantage |
$11.53
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$21.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$14.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14.53
|
| Rate for Payer: Multiplan Commercial |
$15.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$11.53
|
| Rate for Payer: TriValley Medical Group Senior |
$11.53
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$12.46
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$12.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$17.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$12.68
|
| Rate for Payer: Vantage Medical Group Senior |
$11.53
|
|
