|
HC SOM MONKEYPOX DNA PCR
|
Facility
|
OP
|
$120.00
|
|
|
Service Code
|
CPT 87593
|
| Hospital Charge Code |
900915425
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$21.72 |
| Max. Negotiated Rate |
$90.00 |
| Rate for Payer: Adventist Health Commercial |
$24.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$64.14
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$82.44
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$76.97
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$56.44
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$51.31
|
| Rate for Payer: Cash Price |
$120.00
|
| Rate for Payer: Cash Price |
$120.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$78.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$76.97
|
| Rate for Payer: Dignity Health Medi-Cal |
$56.44
|
| Rate for Payer: Dignity Health Senior |
$51.31
|
| Rate for Payer: EPIC Health Plan Commercial |
$78.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$51.31
|
| Rate for Payer: Heritage Provider Network Commercial |
$74.28
|
| Rate for Payer: Heritage Provider Network Senior |
$74.28
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$56.85
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$51.31
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$57.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$21.72
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$59.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$30.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$64.65
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$64.65
|
| Rate for Payer: Multiplan Commercial |
$90.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$51.31
|
| Rate for Payer: TriValley Medical Group Senior |
$51.31
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$55.26
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$55.26
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$76.97
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$56.44
|
| Rate for Payer: Vantage Medical Group Senior |
$51.31
|
|
|
HC SOM M PNEUMONIAE AB IGM S IFA
|
Facility
|
IP
|
$47.00
|
|
|
Service Code
|
CPT 86738
|
| Hospital Charge Code |
900913940
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.51 |
| Max. Negotiated Rate |
$35.25 |
| Rate for Payer: Adventist Health Commercial |
$9.40
|
| Rate for Payer: Cash Price |
$47.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$31.82
|
| Rate for Payer: Heritage Provider Network Senior |
$31.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.75
|
| Rate for Payer: Multiplan Commercial |
$35.25
|
|
|
HC SOM M PNEUMONIAE AB IGM S IFA
|
Facility
|
OP
|
$47.00
|
|
|
Service Code
|
CPT 86738
|
| Hospital Charge Code |
900913940
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.51 |
| Max. Negotiated Rate |
$120.41 |
| Rate for Payer: Adventist Health Commercial |
$9.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$25.12
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$32.29
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19.86
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.56
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13.24
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$120.41
|
| Rate for Payer: Blue Shield of California Commercial |
$106.62
|
| Rate for Payer: Blue Shield of California EPN |
$85.52
|
| Rate for Payer: Cash Price |
$47.00
|
| Rate for Payer: Cash Price |
$47.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$30.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.86
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.56
|
| Rate for Payer: Dignity Health Senior |
$13.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$30.55
|
| Rate for Payer: EPIC Health Plan Medicare |
$13.24
|
| Rate for Payer: Heritage Provider Network Commercial |
$29.09
|
| Rate for Payer: Heritage Provider Network Senior |
$29.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$19.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13.24
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$22.42
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.51
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16.68
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16.68
|
| Rate for Payer: Multiplan Commercial |
$35.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$13.24
|
| Rate for Payer: TriValley Medical Group Senior |
$13.24
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$14.30
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$14.30
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.86
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.56
|
| Rate for Payer: Vantage Medical Group Senior |
$13.24
|
|
|
HC SOM M PNEUMONIAE PCR
|
Facility
|
OP
|
$175.00
|
|
|
Service Code
|
CPT 87581
|
| Hospital Charge Code |
900915468
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$31.68 |
| Max. Negotiated Rate |
$310.02 |
| Rate for Payer: Adventist Health Commercial |
$35.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$93.54
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$120.22
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$52.63
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$38.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$35.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$310.02
|
| Rate for Payer: Blue Shield of California Commercial |
$282.47
|
| Rate for Payer: Blue Shield of California EPN |
$226.56
|
| Rate for Payer: Cash Price |
$175.00
|
| Rate for Payer: Cash Price |
$175.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$113.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$52.63
|
| Rate for Payer: Dignity Health Medi-Cal |
$38.60
|
| Rate for Payer: Dignity Health Senior |
$35.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$113.75
|
| Rate for Payer: EPIC Health Plan Medicare |
$35.09
|
| Rate for Payer: Heritage Provider Network Commercial |
$108.33
|
| Rate for Payer: Heritage Provider Network Senior |
$108.33
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$50.53
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$35.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$83.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$31.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$40.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$43.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$44.21
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$44.21
|
| Rate for Payer: Multiplan Commercial |
$131.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$35.09
|
| Rate for Payer: TriValley Medical Group Senior |
$35.09
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$37.90
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$37.90
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$52.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$38.60
|
| Rate for Payer: Vantage Medical Group Senior |
$35.09
|
|
|
HC SOM M PNEUMONIAE PCR
|
Facility
|
IP
|
$175.00
|
|
|
Service Code
|
CPT 87581
|
| Hospital Charge Code |
900915468
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$31.68 |
| Max. Negotiated Rate |
$131.25 |
| Rate for Payer: Adventist Health Commercial |
$35.00
|
| Rate for Payer: Cash Price |
$175.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$118.47
|
| Rate for Payer: Heritage Provider Network Senior |
$118.47
|
| 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 M PROTEIN MASS FIX
|
Facility
|
OP
|
$50.00
|
|
|
Service Code
|
CPT 0077U
|
| Hospital Charge Code |
900915454
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$9.05 |
| Max. Negotiated Rate |
$239.71 |
| Rate for Payer: Adventist Health Commercial |
$10.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$26.73
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$34.35
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$65.14
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$47.77
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$43.43
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$239.71
|
| Rate for Payer: Cash Price |
$50.00
|
| Rate for Payer: Cash Price |
$50.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$32.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$65.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$47.77
|
| Rate for Payer: Dignity Health Senior |
$43.43
|
| Rate for Payer: EPIC Health Plan Commercial |
$32.50
|
| Rate for Payer: EPIC Health Plan Medicare |
$43.43
|
| Rate for Payer: Heritage Provider Network Commercial |
$30.95
|
| Rate for Payer: Heritage Provider Network Senior |
$30.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$56.28
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$43.43
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$23.85
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.05
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$49.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$54.72
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$54.72
|
| Rate for Payer: Multiplan Commercial |
$37.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$43.43
|
| Rate for Payer: TriValley Medical Group Senior |
$43.43
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$46.91
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$46.91
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$65.14
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$47.77
|
| Rate for Payer: Vantage Medical Group Senior |
$43.43
|
|
|
HC SOM M PROTEIN MASS FIX
|
Facility
|
IP
|
$50.00
|
|
|
Service Code
|
CPT 0077U
|
| Hospital Charge Code |
900915454
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$9.05 |
| Max. Negotiated Rate |
$37.50 |
| Rate for Payer: Adventist Health Commercial |
$10.00
|
| Rate for Payer: Cash Price |
$50.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$33.85
|
| Rate for Payer: Heritage Provider Network Senior |
$33.85
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.50
|
| Rate for Payer: Multiplan Commercial |
$37.50
|
|
|
HC SOM MTB PCR COMPLEX SPUTUM
|
Facility
|
IP
|
$243.39
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
900915433
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$44.05 |
| Max. Negotiated Rate |
$182.54 |
| Rate for Payer: Adventist Health Commercial |
$48.68
|
| Rate for Payer: Cash Price |
$243.39
|
| Rate for Payer: Heritage Provider Network Commercial |
$164.78
|
| Rate for Payer: Heritage Provider Network Senior |
$164.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$44.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$60.85
|
| Rate for Payer: Multiplan Commercial |
$182.54
|
|
|
HC SOM MTB PCR COMPLEX SPUTUM
|
Facility
|
OP
|
$243.39
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
900915433
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$35.09 |
| Max. Negotiated Rate |
$310.02 |
| Rate for Payer: Adventist Health Commercial |
$48.68
|
| Rate for Payer: Aetna of CA Gatekeeper |
$130.09
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$167.21
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$52.63
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$38.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$35.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$310.02
|
| Rate for Payer: Blue Shield of California Commercial |
$282.47
|
| Rate for Payer: Blue Shield of California EPN |
$226.56
|
| Rate for Payer: Cash Price |
$243.39
|
| Rate for Payer: Cash Price |
$243.39
|
| Rate for Payer: Cigna of CA HMO/PPO |
$158.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$52.63
|
| Rate for Payer: Dignity Health Medi-Cal |
$38.60
|
| Rate for Payer: Dignity Health Senior |
$35.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$158.20
|
| Rate for Payer: EPIC Health Plan Medicare |
$35.09
|
| Rate for Payer: Heritage Provider Network Commercial |
$150.66
|
| Rate for Payer: Heritage Provider Network Senior |
$150.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$48.84
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$35.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$116.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$44.05
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$40.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$60.85
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$44.21
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$44.21
|
| Rate for Payer: Multiplan Commercial |
$182.54
|
| Rate for Payer: TriValley Medical Group Commercial |
$35.09
|
| Rate for Payer: TriValley Medical Group Senior |
$35.09
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$37.90
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$37.90
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$52.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$38.60
|
| Rate for Payer: Vantage Medical Group Senior |
$35.09
|
|
|
HC SOM MTB PCR SPUTUM
|
Facility
|
OP
|
$289.11
|
|
|
Service Code
|
CPT 87556
|
| Hospital Charge Code |
900915432
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$41.68 |
| Max. Negotiated Rate |
$310.02 |
| Rate for Payer: Adventist Health Commercial |
$57.82
|
| Rate for Payer: Aetna of CA Gatekeeper |
$154.53
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$198.62
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$62.52
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$45.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$41.68
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$310.02
|
| Rate for Payer: Blue Shield of California Commercial |
$282.47
|
| Rate for Payer: Blue Shield of California EPN |
$226.56
|
| Rate for Payer: Cash Price |
$289.11
|
| Rate for Payer: Cash Price |
$289.11
|
| Rate for Payer: Cigna of CA HMO/PPO |
$187.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$62.52
|
| Rate for Payer: Dignity Health Medi-Cal |
$45.85
|
| Rate for Payer: Dignity Health Senior |
$41.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$187.92
|
| Rate for Payer: EPIC Health Plan Medicare |
$41.68
|
| Rate for Payer: Heritage Provider Network Commercial |
$178.96
|
| Rate for Payer: Heritage Provider Network Senior |
$178.96
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$54.01
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$41.68
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$137.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$52.33
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$47.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$72.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$52.52
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$52.52
|
| Rate for Payer: Multiplan Commercial |
$216.83
|
| Rate for Payer: TriValley Medical Group Commercial |
$41.68
|
| Rate for Payer: TriValley Medical Group Senior |
$41.68
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$45.01
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$45.01
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$62.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$45.85
|
| Rate for Payer: Vantage Medical Group Senior |
$41.68
|
|
|
HC SOM MTB PCR SPUTUM
|
Facility
|
IP
|
$289.11
|
|
|
Service Code
|
CPT 87556
|
| Hospital Charge Code |
900915432
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$52.33 |
| Max. Negotiated Rate |
$216.83 |
| Rate for Payer: Adventist Health Commercial |
$57.82
|
| Rate for Payer: Cash Price |
$289.11
|
| Rate for Payer: Heritage Provider Network Commercial |
$195.73
|
| Rate for Payer: Heritage Provider Network Senior |
$195.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$52.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$72.28
|
| Rate for Payer: Multiplan Commercial |
$216.83
|
|
|
HC SOM MTHFR MUTATION DETECTION
|
Facility
|
IP
|
$190.00
|
|
|
Service Code
|
CPT 81291
|
| Hospital Charge Code |
900914663
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$34.39 |
| Max. Negotiated Rate |
$142.50 |
| Rate for Payer: Adventist Health Commercial |
$38.00
|
| Rate for Payer: Cash Price |
$190.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$128.63
|
| Rate for Payer: Heritage Provider Network Senior |
$128.63
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$34.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$47.50
|
| Rate for Payer: Multiplan Commercial |
$142.50
|
|
|
HC SOM MTHFR MUTATION DETECTION
|
Facility
|
OP
|
$190.00
|
|
|
Service Code
|
CPT 81291
|
| Hospital Charge Code |
900914663
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$34.39 |
| Max. Negotiated Rate |
$417.40 |
| Rate for Payer: Adventist Health Commercial |
$38.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$101.56
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$130.53
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$98.01
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$71.87
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$65.34
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$417.40
|
| Rate for Payer: Blue Shield of California Commercial |
$115.90
|
| Rate for Payer: Blue Shield of California EPN |
$92.72
|
| Rate for Payer: Cash Price |
$190.00
|
| Rate for Payer: Cash Price |
$190.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$123.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$98.01
|
| Rate for Payer: Dignity Health Medi-Cal |
$71.87
|
| Rate for Payer: Dignity Health Senior |
$65.34
|
| Rate for Payer: EPIC Health Plan Commercial |
$123.50
|
| Rate for Payer: EPIC Health Plan Medicare |
$65.34
|
| Rate for Payer: Heritage Provider Network Commercial |
$117.61
|
| Rate for Payer: Heritage Provider Network Senior |
$117.61
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$65.34
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$90.63
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$34.39
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$75.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$47.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$82.33
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$82.33
|
| Rate for Payer: Multiplan Commercial |
$142.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$65.34
|
| Rate for Payer: TriValley Medical Group Senior |
$65.34
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$70.57
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$70.57
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$98.01
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$71.87
|
| Rate for Payer: Vantage Medical Group Senior |
$65.34
|
|
|
HC SOM M. TUBERCULOSIS PCR
|
Facility
|
OP
|
$75.00
|
|
|
Service Code
|
CPT 87556
|
| Hospital Charge Code |
900912875
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$13.57 |
| Max. Negotiated Rate |
$310.02 |
| Rate for Payer: Adventist Health Commercial |
$15.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$40.09
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$51.52
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$62.52
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$45.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$41.68
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$310.02
|
| Rate for Payer: Blue Shield of California Commercial |
$282.47
|
| Rate for Payer: Blue Shield of California EPN |
$226.56
|
| Rate for Payer: Cash Price |
$75.00
|
| Rate for Payer: Cash Price |
$75.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$48.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$62.52
|
| Rate for Payer: Dignity Health Medi-Cal |
$45.85
|
| Rate for Payer: Dignity Health Senior |
$41.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$48.75
|
| Rate for Payer: EPIC Health Plan Medicare |
$41.68
|
| Rate for Payer: Heritage Provider Network Commercial |
$46.42
|
| Rate for Payer: Heritage Provider Network Senior |
$46.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$54.01
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$41.68
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$35.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$47.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$52.52
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$52.52
|
| Rate for Payer: Multiplan Commercial |
$56.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$41.68
|
| Rate for Payer: TriValley Medical Group Senior |
$41.68
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$45.01
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$45.01
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$62.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$45.85
|
| Rate for Payer: Vantage Medical Group Senior |
$41.68
|
|
|
HC SOM M. TUBERCULOSIS PCR
|
Facility
|
IP
|
$75.00
|
|
|
Service Code
|
CPT 87556
|
| Hospital Charge Code |
900912875
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$13.57 |
| Max. Negotiated Rate |
$56.25 |
| Rate for Payer: Adventist Health Commercial |
$15.00
|
| Rate for Payer: Cash Price |
$75.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$50.77
|
| Rate for Payer: Heritage Provider Network Senior |
$50.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18.75
|
| Rate for Payer: Multiplan Commercial |
$56.25
|
|
|
HC SOM MUMPS AB IGG CSF
|
Facility
|
OP
|
$25.00
|
|
|
Service Code
|
CPT 86735
|
| Hospital Charge Code |
900911356
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.53 |
| Max. Negotiated Rate |
$120.41 |
| Rate for Payer: Adventist Health Commercial |
$5.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$13.36
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$17.18
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.36
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$120.41
|
| Rate for Payer: Blue Shield of California Commercial |
$105.00
|
| Rate for Payer: Blue Shield of California EPN |
$84.22
|
| Rate for Payer: Cash Price |
$25.00
|
| Rate for Payer: Cash Price |
$25.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$16.25
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.57
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.36
|
| Rate for Payer: Dignity Health Senior |
$13.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.25
|
| Rate for Payer: EPIC Health Plan Medicare |
$13.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$15.47
|
| Rate for Payer: Heritage Provider Network Senior |
$15.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$18.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13.05
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$11.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16.44
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16.44
|
| Rate for Payer: Multiplan Commercial |
$18.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$13.05
|
| Rate for Payer: TriValley Medical Group Senior |
$13.05
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$14.10
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$14.10
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.36
|
| Rate for Payer: Vantage Medical Group Senior |
$13.05
|
|
|
HC SOM MUMPS AB IGG CSF
|
Facility
|
IP
|
$25.00
|
|
|
Service Code
|
CPT 86735
|
| Hospital Charge Code |
900911356
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.53 |
| Max. Negotiated Rate |
$18.75 |
| Rate for Payer: Adventist Health Commercial |
$5.00
|
| Rate for Payer: Cash Price |
$25.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$16.93
|
| Rate for Payer: Heritage Provider Network Senior |
$16.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.25
|
| Rate for Payer: Multiplan Commercial |
$18.75
|
|
|
HC SOM MUMPS AB IGM CSF
|
Facility
|
IP
|
$25.00
|
|
|
Service Code
|
CPT 86735
|
| Hospital Charge Code |
900912679
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.53 |
| Max. Negotiated Rate |
$18.75 |
| Rate for Payer: Adventist Health Commercial |
$5.00
|
| Rate for Payer: Cash Price |
$25.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$16.93
|
| Rate for Payer: Heritage Provider Network Senior |
$16.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.25
|
| Rate for Payer: Multiplan Commercial |
$18.75
|
|
|
HC SOM MUMPS AB IGM CSF
|
Facility
|
OP
|
$25.00
|
|
|
Service Code
|
CPT 86735
|
| Hospital Charge Code |
900912679
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.53 |
| Max. Negotiated Rate |
$120.41 |
| Rate for Payer: Adventist Health Commercial |
$5.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$13.36
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$17.18
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.36
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$120.41
|
| Rate for Payer: Blue Shield of California Commercial |
$105.00
|
| Rate for Payer: Blue Shield of California EPN |
$84.22
|
| Rate for Payer: Cash Price |
$25.00
|
| Rate for Payer: Cash Price |
$25.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$16.25
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.57
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.36
|
| Rate for Payer: Dignity Health Senior |
$13.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.25
|
| Rate for Payer: EPIC Health Plan Medicare |
$13.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$15.47
|
| Rate for Payer: Heritage Provider Network Senior |
$15.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$18.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13.05
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$11.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16.44
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16.44
|
| Rate for Payer: Multiplan Commercial |
$18.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$13.05
|
| Rate for Payer: TriValley Medical Group Senior |
$13.05
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$14.10
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$14.10
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.36
|
| Rate for Payer: Vantage Medical Group Senior |
$13.05
|
|
|
HC SOM MUR 85549
|
Facility
|
OP
|
$26.87
|
|
|
Service Code
|
CPT 85549
|
| Hospital Charge Code |
900914739
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.86 |
| Max. Negotiated Rate |
$171.24 |
| Rate for Payer: Adventist Health Commercial |
$5.37
|
| Rate for Payer: Aetna of CA Gatekeeper |
$14.36
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$18.46
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$28.12
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$20.62
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$18.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$171.24
|
| Rate for Payer: Blue Shield of California Commercial |
$150.97
|
| Rate for Payer: Blue Shield of California EPN |
$121.09
|
| Rate for Payer: Cash Price |
$26.87
|
| Rate for Payer: Cash Price |
$26.87
|
| Rate for Payer: Cigna of CA HMO/PPO |
$17.47
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$28.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$20.62
|
| Rate for Payer: Dignity Health Senior |
$18.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$17.47
|
| Rate for Payer: EPIC Health Plan Medicare |
$18.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$16.63
|
| Rate for Payer: Heritage Provider Network Senior |
$16.63
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$27.01
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$18.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$12.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.86
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.72
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$23.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$23.62
|
| Rate for Payer: Multiplan Commercial |
$20.15
|
| Rate for Payer: TriValley Medical Group Commercial |
$18.75
|
| Rate for Payer: TriValley Medical Group Senior |
$18.75
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$20.26
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$20.26
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$28.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$20.62
|
| Rate for Payer: Vantage Medical Group Senior |
$18.75
|
|
|
HC SOM MUR 85549
|
Facility
|
IP
|
$26.87
|
|
|
Service Code
|
CPT 85549
|
| Hospital Charge Code |
900914739
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.86 |
| Max. Negotiated Rate |
$20.15 |
| Rate for Payer: Adventist Health Commercial |
$5.37
|
| Rate for Payer: Cash Price |
$26.87
|
| Rate for Payer: Heritage Provider Network Commercial |
$18.19
|
| Rate for Payer: Heritage Provider Network Senior |
$18.19
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.72
|
| Rate for Payer: Multiplan Commercial |
$20.15
|
|
|
HC SOM MURAMIDASE SERUM
|
Facility
|
OP
|
$20.00
|
|
|
Service Code
|
CPT 85549
|
| Hospital Charge Code |
900911063
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$3.62 |
| Max. Negotiated Rate |
$171.24 |
| Rate for Payer: Adventist Health Commercial |
$4.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$10.69
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$13.74
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$28.12
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$20.62
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$18.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$171.24
|
| Rate for Payer: Blue Shield of California Commercial |
$150.97
|
| Rate for Payer: Blue Shield of California EPN |
$121.09
|
| Rate for Payer: Cash Price |
$20.00
|
| Rate for Payer: Cash Price |
$20.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$13.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$28.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$20.62
|
| Rate for Payer: Dignity Health Senior |
$18.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$18.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$12.38
|
| Rate for Payer: Heritage Provider Network Senior |
$12.38
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$27.01
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$18.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$9.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$23.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$23.62
|
| Rate for Payer: Multiplan Commercial |
$15.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$18.75
|
| Rate for Payer: TriValley Medical Group Senior |
$18.75
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$20.26
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$20.26
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$28.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$20.62
|
| Rate for Payer: Vantage Medical Group Senior |
$18.75
|
|
|
HC SOM MURAMIDASE SERUM
|
Facility
|
IP
|
$20.00
|
|
|
Service Code
|
CPT 85549
|
| Hospital Charge Code |
900911063
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$3.62 |
| Max. Negotiated Rate |
$15.00 |
| Rate for Payer: Adventist Health Commercial |
$4.00
|
| Rate for Payer: Cash Price |
$20.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$13.54
|
| Rate for Payer: Heritage Provider Network Senior |
$13.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.00
|
| Rate for Payer: Multiplan Commercial |
$15.00
|
|
|
HC SOM MYCOPHENOLIC ACID
|
Facility
|
IP
|
$22.00
|
|
|
Service Code
|
CPT 80180
|
| Hospital Charge Code |
900910761
|
|
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 MYCOPHENOLIC ACID
|
Facility
|
OP
|
$22.00
|
|
|
Service Code
|
CPT 80180
|
| Hospital Charge Code |
900910761
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.98 |
| Max. Negotiated Rate |
$141.87 |
| 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 |
$27.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$18.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$99.14
|
| Rate for Payer: Blue Shield of California Commercial |
$141.87
|
| Rate for Payer: Blue Shield of California EPN |
$113.79
|
| 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 |
$27.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$19.86
|
| Rate for Payer: Dignity Health Senior |
$18.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.30
|
| Rate for Payer: EPIC Health Plan Medicare |
$18.05
|
| 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 |
$25.98
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$18.05
|
| 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 |
$20.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$22.74
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$22.74
|
| Rate for Payer: Multiplan Commercial |
$16.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$18.05
|
| Rate for Payer: TriValley Medical Group Senior |
$18.05
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$19.50
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$19.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$27.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.86
|
| Rate for Payer: Vantage Medical Group Senior |
$18.05
|
|
