|
HC SOM HISTOPLAS BLASTOMYC PCR1
|
Facility
OP
|
$148.12
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
900914670
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$26.81 |
| Max. Negotiated Rate |
$284.23 |
| Rate for Payer: Adventist Health Commercial |
$29.62
|
| Rate for Payer: Aetna of CA Gatekeeper |
$102.11
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$101.76
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$52.64
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$38.60
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$35.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$284.23
|
| Rate for Payer: Blue Shield of California Commercial |
$274.13
|
| Rate for Payer: Blue Shield of California EPN |
$214.30
|
| Rate for Payer: Cash Price |
$66.65
|
| Rate for Payer: Cash Price |
$66.65
|
| Rate for Payer: Cigna of CA HMO/PPO |
$96.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$52.64
|
| Rate for Payer: Dignity Health Medi-Cal |
$38.60
|
| Rate for Payer: Dignity Health Senior |
$35.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$96.28
|
| Rate for Payer: EPIC Health Plan Medicare |
$35.09
|
| Rate for Payer: Heritage Provider Network Commercial |
$91.69
|
| Rate for Payer: Heritage Provider Network Senior |
$91.69
|
| Rate for Payer: Humana Medicare |
$35.09
|
| Rate for Payer: IEHP Medi-Cal |
$47.03
|
| Rate for Payer: IEHP Medicare Advantage |
$35.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$66.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$26.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$41.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$37.03
|
| 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 |
$111.09
|
| 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 |
$52.64
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$38.60
|
| Rate for Payer: Vantage Medical Group Senior |
$35.09
|
|
|
HC SOM HISTOPLAS BLASTOMYC PCR2
|
Facility
OP
|
$148.13
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
900914671
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$26.81 |
| Max. Negotiated Rate |
$284.23 |
| Rate for Payer: Adventist Health Commercial |
$29.63
|
| Rate for Payer: Aetna of CA Gatekeeper |
$102.11
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$101.77
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$52.64
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$38.60
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$35.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$284.23
|
| Rate for Payer: Blue Shield of California Commercial |
$274.13
|
| Rate for Payer: Blue Shield of California EPN |
$214.30
|
| Rate for Payer: Cash Price |
$66.66
|
| Rate for Payer: Cash Price |
$66.66
|
| Rate for Payer: Cigna of CA HMO/PPO |
$96.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$52.64
|
| Rate for Payer: Dignity Health Medi-Cal |
$38.60
|
| Rate for Payer: Dignity Health Senior |
$35.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$96.28
|
| Rate for Payer: EPIC Health Plan Medicare |
$35.09
|
| Rate for Payer: Heritage Provider Network Commercial |
$91.69
|
| Rate for Payer: Heritage Provider Network Senior |
$91.69
|
| Rate for Payer: Humana Medicare |
$35.09
|
| Rate for Payer: IEHP Medi-Cal |
$47.03
|
| Rate for Payer: IEHP Medicare Advantage |
$35.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$66.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$26.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$41.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$37.03
|
| 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 |
$111.10
|
| 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 |
$52.64
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$38.60
|
| Rate for Payer: Vantage Medical Group Senior |
$35.09
|
|
|
HC SOM HISTOPLAS BLASTOMYC PCR2
|
Facility
IP
|
$148.13
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
900914671
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$26.81 |
| Max. Negotiated Rate |
$111.10 |
| Rate for Payer: Adventist Health Commercial |
$29.63
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$101.77
|
| Rate for Payer: Cash Price |
$66.66
|
| Rate for Payer: Heritage Provider Network Commercial |
$100.28
|
| Rate for Payer: Heritage Provider Network Senior |
$100.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$26.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$37.03
|
| Rate for Payer: Multiplan Commercial |
$111.10
|
|
|
HC SOM HISTOPLASMA AB IMMUNODIFFUSION
|
Facility
IP
|
$8.52
|
|
|
Service Code
|
CPT 86698
|
| Hospital Charge Code |
900912643
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$1.54 |
| Max. Negotiated Rate |
$6.39 |
| Rate for Payer: Adventist Health Commercial |
$1.70
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$5.85
|
| Rate for Payer: Cash Price |
$3.83
|
| Rate for Payer: Heritage Provider Network Commercial |
$5.77
|
| Rate for Payer: Heritage Provider Network Senior |
$5.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.13
|
| Rate for Payer: Multiplan Commercial |
$6.39
|
|
|
HC SOM HISTOPLASMA AB IMMUNODIFFUSION
|
Facility
OP
|
$8.52
|
|
|
Service Code
|
CPT 86698
|
| Hospital Charge Code |
900912643
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$1.54 |
| Max. Negotiated Rate |
$105.66 |
| Rate for Payer: Adventist Health Commercial |
$1.70
|
| Rate for Payer: Aetna of CA Gatekeeper |
$36.36
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$5.85
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$20.68
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$15.17
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$13.79
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$105.66
|
| Rate for Payer: Blue Shield of California Commercial |
$97.60
|
| Rate for Payer: Blue Shield of California EPN |
$76.30
|
| Rate for Payer: Cash Price |
$3.83
|
| Rate for Payer: Cash Price |
$3.83
|
| Rate for Payer: Cigna of CA HMO/PPO |
$5.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$15.17
|
| Rate for Payer: Dignity Health Senior |
$13.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.54
|
| Rate for Payer: EPIC Health Plan Medicare |
$13.79
|
| Rate for Payer: Heritage Provider Network Commercial |
$5.27
|
| Rate for Payer: Heritage Provider Network Senior |
$5.27
|
| Rate for Payer: Humana Medicare |
$13.79
|
| Rate for Payer: IEHP Medi-Cal |
$17.33
|
| Rate for Payer: IEHP Medicare Advantage |
$13.79
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$26.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.54
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.13
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17.38
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17.38
|
| Rate for Payer: Multiplan Commercial |
$6.39
|
| Rate for Payer: TriValley Medical Group Commercial |
$13.79
|
| Rate for Payer: TriValley Medical Group Senior |
$13.79
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$14.89
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$14.89
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15.17
|
| Rate for Payer: Vantage Medical Group Senior |
$13.79
|
|
|
HC SOM HIV-1 ANTIBODY
|
Facility
OP
|
$29.76
|
|
|
Service Code
|
CPT 86701
|
| Hospital Charge Code |
900915308
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.39 |
| Max. Negotiated Rate |
$74.33 |
| Rate for Payer: Adventist Health Commercial |
$5.95
|
| Rate for Payer: Aetna of CA Gatekeeper |
$25.86
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$20.45
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$13.34
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$9.78
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$8.89
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$74.33
|
| Rate for Payer: Blue Shield of California Commercial |
$69.37
|
| Rate for Payer: Blue Shield of California EPN |
$54.23
|
| Rate for Payer: Cash Price |
$13.39
|
| Rate for Payer: Cash Price |
$13.39
|
| Rate for Payer: Cigna of CA HMO/PPO |
$19.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13.34
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.78
|
| Rate for Payer: Dignity Health Senior |
$8.89
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.34
|
| Rate for Payer: EPIC Health Plan Medicare |
$8.89
|
| Rate for Payer: Heritage Provider Network Commercial |
$18.42
|
| Rate for Payer: Heritage Provider Network Senior |
$18.42
|
| Rate for Payer: Humana Medicare |
$8.89
|
| Rate for Payer: IEHP Medi-Cal |
$12.32
|
| Rate for Payer: IEHP Medicare Advantage |
$8.89
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$16.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.39
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11.20
|
| Rate for Payer: Multiplan Commercial |
$22.32
|
| Rate for Payer: TriValley Medical Group Commercial |
$8.89
|
| Rate for Payer: TriValley Medical Group Senior |
$8.89
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$9.60
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$9.60
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13.34
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.78
|
| Rate for Payer: Vantage Medical Group Senior |
$8.89
|
|
|
HC SOM HIV-1 ANTIBODY
|
Facility
IP
|
$29.76
|
|
|
Service Code
|
CPT 86701
|
| Hospital Charge Code |
900915308
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.39 |
| Max. Negotiated Rate |
$22.32 |
| Rate for Payer: Adventist Health Commercial |
$5.95
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$20.45
|
| Rate for Payer: Cash Price |
$13.39
|
| Rate for Payer: Heritage Provider Network Commercial |
$20.15
|
| Rate for Payer: Heritage Provider Network Senior |
$20.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.44
|
| Rate for Payer: Multiplan Commercial |
$22.32
|
|
|
HC SOM HIV-1 PROVIRAL DNA
|
Facility
OP
|
$50.27
|
|
|
Service Code
|
CPT 87535
|
| Hospital Charge Code |
900914170
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$9.10 |
| Max. Negotiated Rate |
$284.23 |
| Rate for Payer: Adventist Health Commercial |
$10.05
|
| Rate for Payer: Aetna of CA Gatekeeper |
$102.11
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$34.54
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$52.64
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$38.60
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$35.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$284.23
|
| Rate for Payer: Blue Shield of California Commercial |
$274.13
|
| Rate for Payer: Blue Shield of California EPN |
$214.30
|
| Rate for Payer: Cash Price |
$22.62
|
| Rate for Payer: Cash Price |
$22.62
|
| Rate for Payer: Cigna of CA HMO/PPO |
$32.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$52.64
|
| Rate for Payer: Dignity Health Medi-Cal |
$38.60
|
| Rate for Payer: Dignity Health Senior |
$35.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$32.68
|
| Rate for Payer: EPIC Health Plan Medicare |
$35.09
|
| Rate for Payer: Heritage Provider Network Commercial |
$31.12
|
| Rate for Payer: Heritage Provider Network Senior |
$31.12
|
| Rate for Payer: Humana Medicare |
$35.09
|
| Rate for Payer: IEHP Medi-Cal |
$48.66
|
| Rate for Payer: IEHP Medicare Advantage |
$35.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$66.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$41.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.57
|
| 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 |
$37.70
|
| 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 |
$52.64
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$38.60
|
| Rate for Payer: Vantage Medical Group Senior |
$35.09
|
|
|
HC SOM HIV-1 PROVIRAL DNA
|
Facility
IP
|
$50.27
|
|
|
Service Code
|
CPT 87535
|
| Hospital Charge Code |
900914170
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$9.10 |
| Max. Negotiated Rate |
$37.70 |
| Rate for Payer: Adventist Health Commercial |
$10.05
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$34.54
|
| Rate for Payer: Cash Price |
$22.62
|
| Rate for Payer: Heritage Provider Network Commercial |
$34.03
|
| Rate for Payer: Heritage Provider Network Senior |
$34.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.57
|
| Rate for Payer: Multiplan Commercial |
$37.70
|
|
|
HC SOM HIV2 86702
|
Facility
OP
|
$19.37
|
|
|
Service Code
|
CPT 86702
|
| Hospital Charge Code |
900914737
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.51 |
| Max. Negotiated Rate |
$114.96 |
| Rate for Payer: Adventist Health Commercial |
$3.87
|
| Rate for Payer: Aetna of CA Gatekeeper |
$39.35
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$13.31
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$20.28
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$14.87
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$13.52
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$114.96
|
| Rate for Payer: Blue Shield of California Commercial |
$105.54
|
| Rate for Payer: Blue Shield of California EPN |
$82.51
|
| Rate for Payer: Cash Price |
$8.72
|
| Rate for Payer: Cash Price |
$8.72
|
| Rate for Payer: Cigna of CA HMO/PPO |
$12.59
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20.28
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.87
|
| Rate for Payer: Dignity Health Senior |
$13.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.59
|
| Rate for Payer: EPIC Health Plan Medicare |
$13.52
|
| Rate for Payer: Heritage Provider Network Commercial |
$11.99
|
| Rate for Payer: Heritage Provider Network Senior |
$11.99
|
| Rate for Payer: Humana Medicare |
$13.52
|
| Rate for Payer: IEHP Medi-Cal |
$18.42
|
| Rate for Payer: IEHP Medicare Advantage |
$13.52
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$25.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.51
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.84
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17.04
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17.04
|
| Rate for Payer: Multiplan Commercial |
$14.53
|
| Rate for Payer: TriValley Medical Group Commercial |
$13.52
|
| Rate for Payer: TriValley Medical Group Senior |
$13.52
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$14.60
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$14.60
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20.28
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.87
|
| Rate for Payer: Vantage Medical Group Senior |
$13.52
|
|
|
HC SOM HIV2 86702
|
Facility
IP
|
$19.37
|
|
|
Service Code
|
CPT 86702
|
| Hospital Charge Code |
900914737
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.51 |
| Max. Negotiated Rate |
$14.53 |
| Rate for Payer: Adventist Health Commercial |
$3.87
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$13.31
|
| Rate for Payer: Cash Price |
$8.72
|
| Rate for Payer: Heritage Provider Network Commercial |
$13.11
|
| Rate for Payer: Heritage Provider Network Senior |
$13.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.84
|
| Rate for Payer: Multiplan Commercial |
$14.53
|
|
|
HC SOM HIV-2 ANTIBODY
|
Facility
OP
|
$45.24
|
|
|
Service Code
|
CPT 86702
|
| Hospital Charge Code |
900915309
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.19 |
| Max. Negotiated Rate |
$114.96 |
| Rate for Payer: Adventist Health Commercial |
$9.05
|
| Rate for Payer: Aetna of CA Gatekeeper |
$39.35
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$31.08
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$20.28
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$14.87
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$13.52
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$114.96
|
| Rate for Payer: Blue Shield of California Commercial |
$105.54
|
| Rate for Payer: Blue Shield of California EPN |
$82.51
|
| Rate for Payer: Cash Price |
$20.36
|
| Rate for Payer: Cash Price |
$20.36
|
| Rate for Payer: Cigna of CA HMO/PPO |
$29.41
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20.28
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.87
|
| Rate for Payer: Dignity Health Senior |
$13.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$29.41
|
| Rate for Payer: EPIC Health Plan Medicare |
$13.52
|
| Rate for Payer: Heritage Provider Network Commercial |
$28.00
|
| Rate for Payer: Heritage Provider Network Senior |
$28.00
|
| Rate for Payer: Humana Medicare |
$13.52
|
| Rate for Payer: IEHP Medi-Cal |
$18.42
|
| Rate for Payer: IEHP Medicare Advantage |
$13.52
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$25.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.19
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.31
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17.04
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17.04
|
| Rate for Payer: Multiplan Commercial |
$33.93
|
| Rate for Payer: TriValley Medical Group Commercial |
$13.52
|
| Rate for Payer: TriValley Medical Group Senior |
$13.52
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$14.60
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$14.60
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20.28
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.87
|
| Rate for Payer: Vantage Medical Group Senior |
$13.52
|
|
|
HC SOM HIV-2 ANTIBODY
|
Facility
IP
|
$45.24
|
|
|
Service Code
|
CPT 86702
|
| Hospital Charge Code |
900915309
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.19 |
| Max. Negotiated Rate |
$33.93 |
| Rate for Payer: Adventist Health Commercial |
$9.05
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$31.08
|
| Rate for Payer: Cash Price |
$20.36
|
| Rate for Payer: Heritage Provider Network Commercial |
$30.63
|
| Rate for Payer: Heritage Provider Network Senior |
$30.63
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.31
|
| Rate for Payer: Multiplan Commercial |
$33.93
|
|
|
HC SOM HIV 2 CONFIRM
|
Facility
OP
|
$65.00
|
|
|
Service Code
|
CPT 86702
|
| Hospital Charge Code |
900911352
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.76 |
| Max. Negotiated Rate |
$114.96 |
| Rate for Payer: Adventist Health Commercial |
$13.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$39.35
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$44.66
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$20.28
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$14.87
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$13.52
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$114.96
|
| Rate for Payer: Blue Shield of California Commercial |
$105.54
|
| Rate for Payer: Blue Shield of California EPN |
$82.51
|
| Rate for Payer: Cash Price |
$29.25
|
| Rate for Payer: Cash Price |
$29.25
|
| Rate for Payer: Cigna of CA HMO/PPO |
$42.25
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20.28
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.87
|
| Rate for Payer: Dignity Health Senior |
$13.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$42.25
|
| Rate for Payer: EPIC Health Plan Medicare |
$13.52
|
| Rate for Payer: Heritage Provider Network Commercial |
$40.24
|
| Rate for Payer: Heritage Provider Network Senior |
$40.24
|
| Rate for Payer: Humana Medicare |
$13.52
|
| Rate for Payer: IEHP Medi-Cal |
$18.42
|
| Rate for Payer: IEHP Medicare Advantage |
$13.52
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$25.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17.04
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17.04
|
| Rate for Payer: Multiplan Commercial |
$48.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$13.52
|
| Rate for Payer: TriValley Medical Group Senior |
$13.52
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$14.60
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$14.60
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20.28
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.87
|
| Rate for Payer: Vantage Medical Group Senior |
$13.52
|
|
|
HC SOM HIV 2 CONFIRM
|
Facility
IP
|
$19.37
|
|
|
Service Code
|
CPT 86702
|
| Hospital Charge Code |
900911352
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.51 |
| Max. Negotiated Rate |
$14.53 |
| Rate for Payer: Adventist Health Commercial |
$3.87
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$13.31
|
| Rate for Payer: Cash Price |
$8.72
|
| Rate for Payer: Heritage Provider Network Commercial |
$13.11
|
| Rate for Payer: Heritage Provider Network Senior |
$13.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.84
|
| Rate for Payer: Multiplan Commercial |
$14.53
|
|
|
HC SOM HIV DNA (PCR)
|
Facility
OP
|
$85.00
|
|
|
Service Code
|
CPT 87536
|
| Hospital Charge Code |
900911055
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$15.38 |
| Max. Negotiated Rate |
$664.60 |
| Rate for Payer: Adventist Health Commercial |
$17.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$247.58
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$58.40
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$127.65
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$93.61
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$85.10
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$216.56
|
| Rate for Payer: Blue Shield of California Commercial |
$664.60
|
| Rate for Payer: Blue Shield of California EPN |
$519.55
|
| Rate for Payer: Cash Price |
$38.25
|
| Rate for Payer: Cash Price |
$38.25
|
| Rate for Payer: Cigna of CA HMO/PPO |
$55.25
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$127.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$93.61
|
| Rate for Payer: Dignity Health Senior |
$85.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$55.25
|
| Rate for Payer: EPIC Health Plan Medicare |
$85.10
|
| Rate for Payer: Heritage Provider Network Commercial |
$52.62
|
| Rate for Payer: Heritage Provider Network Senior |
$52.62
|
| Rate for Payer: Humana Medicare |
$85.10
|
| Rate for Payer: IEHP Medi-Cal |
$118.00
|
| Rate for Payer: IEHP Medicare Advantage |
$85.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$161.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$15.38
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$100.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$21.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$107.23
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$107.23
|
| Rate for Payer: Multiplan Commercial |
$63.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$85.10
|
| Rate for Payer: TriValley Medical Group Senior |
$85.10
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$91.91
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$91.91
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$127.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$93.61
|
| Rate for Payer: Vantage Medical Group Senior |
$85.10
|
|
|
HC SOM HIV DNA (PCR)
|
Facility
IP
|
$85.00
|
|
|
Service Code
|
CPT 87536
|
| Hospital Charge Code |
900911055
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$15.38 |
| Max. Negotiated Rate |
$63.75 |
| Rate for Payer: Adventist Health Commercial |
$17.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$58.40
|
| Rate for Payer: Cash Price |
$38.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$57.54
|
| Rate for Payer: Heritage Provider Network Senior |
$57.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$15.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$21.25
|
| Rate for Payer: Multiplan Commercial |
$63.75
|
|
|
HC SOM HIVE 86703
|
Facility
OP
|
$114.45
|
|
|
Service Code
|
CPT 86703
|
| Hospital Charge Code |
900914736
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.71 |
| Max. Negotiated Rate |
$118.28 |
| Rate for Payer: Adventist Health Commercial |
$22.89
|
| Rate for Payer: Aetna of CA Gatekeeper |
$39.91
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$78.63
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$20.56
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$15.08
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$13.71
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$118.28
|
| Rate for Payer: Blue Shield of California Commercial |
$107.16
|
| Rate for Payer: Blue Shield of California EPN |
$83.77
|
| Rate for Payer: Cash Price |
$51.50
|
| Rate for Payer: Cash Price |
$51.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$74.39
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20.56
|
| Rate for Payer: Dignity Health Medi-Cal |
$15.08
|
| Rate for Payer: Dignity Health Senior |
$13.71
|
| Rate for Payer: EPIC Health Plan Commercial |
$74.39
|
| Rate for Payer: EPIC Health Plan Medicare |
$13.71
|
| Rate for Payer: Heritage Provider Network Commercial |
$70.84
|
| Rate for Payer: Heritage Provider Network Senior |
$70.84
|
| Rate for Payer: Humana Medicare |
$13.71
|
| Rate for Payer: IEHP Medi-Cal |
$18.66
|
| Rate for Payer: IEHP Medicare Advantage |
$13.71
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$26.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$20.72
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$28.61
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17.27
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17.27
|
| Rate for Payer: Multiplan Commercial |
$85.84
|
| Rate for Payer: TriValley Medical Group Commercial |
$13.71
|
| Rate for Payer: TriValley Medical Group Senior |
$13.71
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$14.81
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$14.81
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20.56
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15.08
|
| Rate for Payer: Vantage Medical Group Senior |
$13.71
|
|
|
HC SOM HIVE 86703
|
Facility
IP
|
$114.45
|
|
|
Service Code
|
CPT 86703
|
| Hospital Charge Code |
900914736
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$20.72 |
| Max. Negotiated Rate |
$85.84 |
| Rate for Payer: Adventist Health Commercial |
$22.89
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$78.63
|
| Rate for Payer: Cash Price |
$51.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$77.48
|
| Rate for Payer: Heritage Provider Network Senior |
$77.48
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$20.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$28.61
|
| Rate for Payer: Multiplan Commercial |
$85.84
|
|
|
HC SOM HOMOCYSTEINE
|
Facility
OP
|
$17.92
|
|
|
Service Code
|
CPT 83090
|
| Hospital Charge Code |
900911404
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.24 |
| Max. Negotiated Rate |
$141.10 |
| Rate for Payer: Adventist Health Commercial |
$3.58
|
| Rate for Payer: Aetna of CA Gatekeeper |
$49.08
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$12.31
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$26.88
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$19.71
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$17.92
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$141.10
|
| Rate for Payer: Blue Shield of California Commercial |
$131.76
|
| Rate for Payer: Blue Shield of California EPN |
$103.00
|
| Rate for Payer: Cash Price |
$8.06
|
| Rate for Payer: Cash Price |
$8.06
|
| Rate for Payer: Cigna of CA HMO/PPO |
$11.65
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$26.88
|
| Rate for Payer: Dignity Health Medi-Cal |
$19.71
|
| Rate for Payer: Dignity Health Senior |
$17.92
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.65
|
| Rate for Payer: EPIC Health Plan Medicare |
$17.92
|
| Rate for Payer: Heritage Provider Network Commercial |
$11.09
|
| Rate for Payer: Heritage Provider Network Senior |
$11.09
|
| Rate for Payer: Humana Medicare |
$17.92
|
| Rate for Payer: IEHP Medi-Cal |
$23.38
|
| Rate for Payer: IEHP Medicare Advantage |
$17.92
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$34.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.24
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.48
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$22.58
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$22.58
|
| Rate for Payer: Multiplan Commercial |
$13.44
|
| Rate for Payer: TriValley Medical Group Commercial |
$17.92
|
| Rate for Payer: TriValley Medical Group Senior |
$17.92
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$19.36
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$19.36
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$26.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.71
|
| Rate for Payer: Vantage Medical Group Senior |
$17.92
|
|
|
HC SOM HOMOCYSTEINE
|
Facility
IP
|
$17.92
|
|
|
Service Code
|
CPT 83090
|
| Hospital Charge Code |
900911404
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.24 |
| Max. Negotiated Rate |
$13.44 |
| Rate for Payer: Adventist Health Commercial |
$3.58
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$12.31
|
| Rate for Payer: Cash Price |
$8.06
|
| Rate for Payer: Heritage Provider Network Commercial |
$12.13
|
| Rate for Payer: Heritage Provider Network Senior |
$12.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.48
|
| Rate for Payer: Multiplan Commercial |
$13.44
|
|
|
HC SOM HPV
|
Facility
IP
|
$45.00
|
|
|
Service Code
|
CPT 87624
|
| Hospital Charge Code |
900915272
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$8.14 |
| Max. Negotiated Rate |
$33.75 |
| Rate for Payer: Adventist Health Commercial |
$9.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$30.92
|
| Rate for Payer: Cash Price |
$20.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$30.46
|
| Rate for Payer: Heritage Provider Network Senior |
$30.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.25
|
| Rate for Payer: Multiplan Commercial |
$33.75
|
|
|
HC SOM HPV
|
Facility
OP
|
$45.00
|
|
|
Service Code
|
CPT 87624
|
| Hospital Charge Code |
900915272
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$8.14 |
| Max. Negotiated Rate |
$266.98 |
| Rate for Payer: Adventist Health Commercial |
$9.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$98.75
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$30.92
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$52.64
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$38.60
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$35.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$220.33
|
| Rate for Payer: Blue Shield of California Commercial |
$266.98
|
| Rate for Payer: Blue Shield of California EPN |
$208.71
|
| Rate for Payer: Cash Price |
$20.25
|
| Rate for Payer: Cash Price |
$20.25
|
| Rate for Payer: Cigna of CA HMO/PPO |
$29.25
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$52.64
|
| Rate for Payer: Dignity Health Medi-Cal |
$38.60
|
| Rate for Payer: Dignity Health Senior |
$35.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$29.25
|
| Rate for Payer: EPIC Health Plan Medicare |
$35.09
|
| Rate for Payer: Heritage Provider Network Commercial |
$27.86
|
| Rate for Payer: Heritage Provider Network Senior |
$27.86
|
| Rate for Payer: Humana Medicare |
$35.09
|
| Rate for Payer: IEHP Medi-Cal |
$48.66
|
| Rate for Payer: IEHP Medicare Advantage |
$35.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$66.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$41.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.25
|
| 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 |
$33.75
|
| 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 |
$52.64
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$38.60
|
| Rate for Payer: Vantage Medical Group Senior |
$35.09
|
|
|
HC SOM HROMOSOME ANALYSIS AMNIO
|
Facility
IP
|
$400.00
|
|
|
Service Code
|
CPT 88291
|
| Hospital Charge Code |
900910739
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$72.40 |
| Max. Negotiated Rate |
$300.00 |
| Rate for Payer: Adventist Health Commercial |
$80.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$274.80
|
| Rate for Payer: Cash Price |
$180.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$270.80
|
| Rate for Payer: Heritage Provider Network Senior |
$270.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$72.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$100.00
|
| Rate for Payer: Multiplan Commercial |
$300.00
|
|
|
HC SOM HROMOSOME ANALYSIS AMNIO
|
Facility
OP
|
$400.00
|
|
|
Service Code
|
CPT 88291
|
| Hospital Charge Code |
900910739
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$21.25 |
| Max. Negotiated Rate |
$340.00 |
| Rate for Payer: Adventist Health Commercial |
$80.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$61.73
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$274.80
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$340.00
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$220.00
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$300.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$156.37
|
| Rate for Payer: Blue Shield of California Commercial |
$248.40
|
| Rate for Payer: Blue Shield of California EPN |
$234.80
|
| Rate for Payer: Cash Price |
$180.00
|
| Rate for Payer: Cash Price |
$180.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$260.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$340.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$340.00
|
| Rate for Payer: Dignity Health Senior |
$340.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$260.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$247.60
|
| Rate for Payer: Heritage Provider Network Senior |
$247.60
|
| Rate for Payer: IEHP Medi-Cal |
$21.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$192.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$72.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$100.00
|
| Rate for Payer: Multiplan Commercial |
$300.00
|
| 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 Medi-Cal |
$340.00
|
| Rate for Payer: Vantage Medical Group Senior |
$340.00
|
|
