|
HC SOM HSV 1 AB IGM IFA
|
Facility
IP
|
$30.97
|
|
|
Service Code
|
CPT 86695
|
| Hospital Charge Code |
900914666
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.61 |
| Max. Negotiated Rate |
$23.23 |
| Rate for Payer: Adventist Health Commercial |
$6.19
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$21.28
|
| Rate for Payer: Cash Price |
$13.94
|
| Rate for Payer: Heritage Provider Network Commercial |
$20.97
|
| Rate for Payer: Heritage Provider Network Senior |
$20.97
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.74
|
| Rate for Payer: Multiplan Commercial |
$23.23
|
|
|
HC SOM HSV 1 AB IGM IFA
|
Facility
OP
|
$30.97
|
|
|
Service Code
|
CPT 86695
|
| Hospital Charge Code |
900914666
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.61 |
| Max. Negotiated Rate |
$110.39 |
| Rate for Payer: Adventist Health Commercial |
$6.19
|
| Rate for Payer: Aetna of CA Gatekeeper |
$38.38
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$21.28
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$19.78
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$14.51
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$13.19
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$110.39
|
| Rate for Payer: Blue Shield of California Commercial |
$103.02
|
| Rate for Payer: Blue Shield of California EPN |
$80.54
|
| Rate for Payer: Cash Price |
$13.94
|
| Rate for Payer: Cash Price |
$13.94
|
| Rate for Payer: Cigna of CA HMO/PPO |
$20.13
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.78
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.51
|
| Rate for Payer: Dignity Health Senior |
$13.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$20.13
|
| Rate for Payer: EPIC Health Plan Medicare |
$13.19
|
| Rate for Payer: Heritage Provider Network Commercial |
$19.17
|
| Rate for Payer: Heritage Provider Network Senior |
$19.17
|
| Rate for Payer: Humana Medicare |
$13.19
|
| Rate for Payer: IEHP Medi-Cal |
$18.28
|
| Rate for Payer: IEHP Medicare Advantage |
$13.19
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$25.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.61
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.74
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16.62
|
| Rate for Payer: Multiplan Commercial |
$23.23
|
| Rate for Payer: TriValley Medical Group Commercial |
$13.19
|
| Rate for Payer: TriValley Medical Group Senior |
$13.19
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$14.24
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$14.24
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.51
|
| Rate for Payer: Vantage Medical Group Senior |
$13.19
|
|
|
HC SOM HSV 2 AB IGM IFA
|
Facility
IP
|
$45.45
|
|
|
Service Code
|
CPT 86696
|
| Hospital Charge Code |
900914667
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.23 |
| Max. Negotiated Rate |
$34.09 |
| Rate for Payer: Adventist Health Commercial |
$9.09
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$31.22
|
| Rate for Payer: Cash Price |
$20.45
|
| Rate for Payer: Heritage Provider Network Commercial |
$30.77
|
| Rate for Payer: Heritage Provider Network Senior |
$30.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.36
|
| Rate for Payer: Multiplan Commercial |
$34.09
|
|
|
HC SOM HSV 2 AB IGM IFA
|
Facility
OP
|
$45.45
|
|
|
Service Code
|
CPT 86696
|
| Hospital Charge Code |
900914667
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.23 |
| Max. Negotiated Rate |
$161.90 |
| Rate for Payer: Adventist Health Commercial |
$9.09
|
| Rate for Payer: Aetna of CA Gatekeeper |
$56.31
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$31.22
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$29.02
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$21.28
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$19.35
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$161.90
|
| Rate for Payer: Blue Shield of California Commercial |
$151.21
|
| Rate for Payer: Blue Shield of California EPN |
$118.21
|
| Rate for Payer: Cash Price |
$20.45
|
| Rate for Payer: Cash Price |
$20.45
|
| Rate for Payer: Cigna of CA HMO/PPO |
$29.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$29.02
|
| Rate for Payer: Dignity Health Medi-Cal |
$21.28
|
| Rate for Payer: Dignity Health Senior |
$19.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$29.54
|
| Rate for Payer: EPIC Health Plan Medicare |
$19.35
|
| Rate for Payer: Heritage Provider Network Commercial |
$28.13
|
| Rate for Payer: Heritage Provider Network Senior |
$28.13
|
| Rate for Payer: Humana Medicare |
$19.35
|
| Rate for Payer: IEHP Medi-Cal |
$26.83
|
| Rate for Payer: IEHP Medicare Advantage |
$19.35
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$36.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.23
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$24.38
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$24.38
|
| Rate for Payer: Multiplan Commercial |
$34.09
|
| Rate for Payer: TriValley Medical Group Commercial |
$19.35
|
| Rate for Payer: TriValley Medical Group Senior |
$19.35
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$20.90
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$20.90
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$29.02
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$21.28
|
| Rate for Payer: Vantage Medical Group Senior |
$19.35
|
|
|
HC SOM HSV TYPE 1 AB, IGG, S
|
Facility
IP
|
$11.75
|
|
|
Service Code
|
CPT 86695
|
| Hospital Charge Code |
900914085
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.13 |
| Max. Negotiated Rate |
$8.81 |
| Rate for Payer: Adventist Health Commercial |
$2.35
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$8.07
|
| Rate for Payer: Cash Price |
$5.29
|
| Rate for Payer: Heritage Provider Network Commercial |
$7.95
|
| Rate for Payer: Heritage Provider Network Senior |
$7.95
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.94
|
| Rate for Payer: Multiplan Commercial |
$8.81
|
|
|
HC SOM HSV TYPE 1 AB, IGG, S
|
Facility
OP
|
$11.75
|
|
|
Service Code
|
CPT 86695
|
| Hospital Charge Code |
900914085
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.13 |
| Max. Negotiated Rate |
$110.39 |
| Rate for Payer: Adventist Health Commercial |
$2.35
|
| Rate for Payer: Aetna of CA Gatekeeper |
$38.38
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$8.07
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$19.78
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$14.51
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$13.19
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$110.39
|
| Rate for Payer: Blue Shield of California Commercial |
$103.02
|
| Rate for Payer: Blue Shield of California EPN |
$80.54
|
| Rate for Payer: Cash Price |
$5.29
|
| Rate for Payer: Cash Price |
$5.29
|
| Rate for Payer: Cigna of CA HMO/PPO |
$7.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.78
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.51
|
| Rate for Payer: Dignity Health Senior |
$13.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.64
|
| Rate for Payer: EPIC Health Plan Medicare |
$13.19
|
| Rate for Payer: Heritage Provider Network Commercial |
$7.27
|
| Rate for Payer: Heritage Provider Network Senior |
$7.27
|
| Rate for Payer: Humana Medicare |
$13.19
|
| Rate for Payer: IEHP Medi-Cal |
$18.28
|
| Rate for Payer: IEHP Medicare Advantage |
$13.19
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$25.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.13
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.94
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16.62
|
| Rate for Payer: Multiplan Commercial |
$8.81
|
| Rate for Payer: TriValley Medical Group Commercial |
$13.19
|
| Rate for Payer: TriValley Medical Group Senior |
$13.19
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$14.24
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$14.24
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.51
|
| Rate for Payer: Vantage Medical Group Senior |
$13.19
|
|
|
HC SOM HSV TYPE 2 AB, IGG, S
|
Facility
OP
|
$17.25
|
|
|
Service Code
|
CPT 86696
|
| Hospital Charge Code |
900914086
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.12 |
| Max. Negotiated Rate |
$161.90 |
| Rate for Payer: Adventist Health Commercial |
$3.45
|
| Rate for Payer: Aetna of CA Gatekeeper |
$56.31
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$11.85
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$29.02
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$21.28
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$19.35
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$161.90
|
| Rate for Payer: Blue Shield of California Commercial |
$151.21
|
| Rate for Payer: Blue Shield of California EPN |
$118.21
|
| Rate for Payer: Cash Price |
$7.76
|
| Rate for Payer: Cash Price |
$7.76
|
| Rate for Payer: Cigna of CA HMO/PPO |
$11.21
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$29.02
|
| Rate for Payer: Dignity Health Medi-Cal |
$21.28
|
| Rate for Payer: Dignity Health Senior |
$19.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.21
|
| Rate for Payer: EPIC Health Plan Medicare |
$19.35
|
| Rate for Payer: Heritage Provider Network Commercial |
$10.68
|
| Rate for Payer: Heritage Provider Network Senior |
$10.68
|
| Rate for Payer: Humana Medicare |
$19.35
|
| Rate for Payer: IEHP Medi-Cal |
$26.83
|
| Rate for Payer: IEHP Medicare Advantage |
$19.35
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$36.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.31
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$24.38
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$24.38
|
| Rate for Payer: Multiplan Commercial |
$12.94
|
| Rate for Payer: TriValley Medical Group Commercial |
$19.35
|
| Rate for Payer: TriValley Medical Group Senior |
$19.35
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$20.90
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$20.90
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$29.02
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$21.28
|
| Rate for Payer: Vantage Medical Group Senior |
$19.35
|
|
|
HC SOM HSV TYPE 2 AB, IGG, S
|
Facility
IP
|
$17.25
|
|
|
Service Code
|
CPT 86696
|
| Hospital Charge Code |
900914086
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.12 |
| Max. Negotiated Rate |
$12.94 |
| Rate for Payer: Adventist Health Commercial |
$3.45
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$11.85
|
| Rate for Payer: Cash Price |
$7.76
|
| Rate for Payer: Heritage Provider Network Commercial |
$11.68
|
| Rate for Payer: Heritage Provider Network Senior |
$11.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.31
|
| Rate for Payer: Multiplan Commercial |
$12.94
|
|
|
HC SOM HTGFN 84432
|
Facility
OP
|
$163.88
|
|
|
Service Code
|
CPT 84432
|
| Hospital Charge Code |
900914871
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.06 |
| Max. Negotiated Rate |
$137.10 |
| Rate for Payer: Adventist Health Commercial |
$32.78
|
| Rate for Payer: Aetna of CA Gatekeeper |
$46.75
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$112.59
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$24.09
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$17.67
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$16.06
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$137.10
|
| Rate for Payer: Blue Shield of California Commercial |
$125.44
|
| Rate for Payer: Blue Shield of California EPN |
$98.06
|
| Rate for Payer: Cash Price |
$73.75
|
| Rate for Payer: Cash Price |
$73.75
|
| Rate for Payer: Cigna of CA HMO/PPO |
$106.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$24.09
|
| Rate for Payer: Dignity Health Medi-Cal |
$17.67
|
| Rate for Payer: Dignity Health Senior |
$16.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$106.52
|
| Rate for Payer: EPIC Health Plan Medicare |
$16.06
|
| Rate for Payer: Heritage Provider Network Commercial |
$101.44
|
| Rate for Payer: Heritage Provider Network Senior |
$101.44
|
| Rate for Payer: Humana Medicare |
$16.06
|
| Rate for Payer: IEHP Medi-Cal |
$22.28
|
| Rate for Payer: IEHP Medicare Advantage |
$16.06
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$30.51
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$29.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$40.97
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$20.24
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$20.24
|
| Rate for Payer: Multiplan Commercial |
$122.91
|
| Rate for Payer: TriValley Medical Group Commercial |
$16.06
|
| Rate for Payer: TriValley Medical Group Senior |
$16.06
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$17.34
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$17.34
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$24.09
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$17.67
|
| Rate for Payer: Vantage Medical Group Senior |
$16.06
|
|
|
HC SOM HTGFN 84432
|
Facility
IP
|
$163.88
|
|
|
Service Code
|
CPT 84432
|
| Hospital Charge Code |
900914871
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$29.66 |
| Max. Negotiated Rate |
$122.91 |
| Rate for Payer: Adventist Health Commercial |
$32.78
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$112.59
|
| Rate for Payer: Cash Price |
$73.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$110.95
|
| Rate for Payer: Heritage Provider Network Senior |
$110.95
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$29.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$40.97
|
| Rate for Payer: Multiplan Commercial |
$122.91
|
|
|
HC SOM HTLV AB CONFIRM
|
Facility
IP
|
$130.00
|
|
|
Service Code
|
CPT 86689
|
| Hospital Charge Code |
900912880
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$23.53 |
| Max. Negotiated Rate |
$97.50 |
| Rate for Payer: Adventist Health Commercial |
$26.00
|
| Rate for Payer: 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 HTLV AB CONFIRM
|
Facility
OP
|
$130.00
|
|
|
Service Code
|
CPT 86689
|
| Hospital Charge Code |
900912880
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$19.35 |
| Max. Negotiated Rate |
$162.01 |
| Rate for Payer: Adventist Health Commercial |
$26.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$56.31
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$89.31
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$29.02
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$21.28
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$19.35
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$162.01
|
| Rate for Payer: Blue Shield of California Commercial |
$151.21
|
| Rate for Payer: Blue Shield of California EPN |
$118.21
|
| 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 |
$29.02
|
| Rate for Payer: Dignity Health Medi-Cal |
$21.28
|
| Rate for Payer: Dignity Health Senior |
$19.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$84.50
|
| Rate for Payer: EPIC Health Plan Medicare |
$19.35
|
| Rate for Payer: Heritage Provider Network Commercial |
$80.47
|
| Rate for Payer: Heritage Provider Network Senior |
$80.47
|
| Rate for Payer: Humana Medicare |
$19.35
|
| Rate for Payer: IEHP Medi-Cal |
$26.83
|
| Rate for Payer: IEHP Medicare Advantage |
$19.35
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$36.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$23.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$32.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$24.38
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$24.38
|
| Rate for Payer: Multiplan Commercial |
$97.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$19.35
|
| Rate for Payer: TriValley Medical Group Senior |
$19.35
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$20.90
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$20.90
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$29.02
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$21.28
|
| Rate for Payer: Vantage Medical Group Senior |
$19.35
|
|
|
HC SOM HTLV AB SCREEN
|
Facility
OP
|
$12.88
|
|
|
Service Code
|
CPT 86790
|
| Hospital Charge Code |
900911034
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.33 |
| Max. Negotiated Rate |
$107.86 |
| Rate for Payer: Adventist Health Commercial |
$2.58
|
| Rate for Payer: Aetna of CA Gatekeeper |
$37.48
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$8.85
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$19.32
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$14.17
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$12.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$107.86
|
| Rate for Payer: Blue Shield of California Commercial |
$100.62
|
| Rate for Payer: Blue Shield of California EPN |
$78.66
|
| Rate for Payer: Cash Price |
$5.80
|
| Rate for Payer: Cash Price |
$5.80
|
| Rate for Payer: Cigna of CA HMO/PPO |
$8.37
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.32
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.17
|
| Rate for Payer: Dignity Health Senior |
$12.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.37
|
| Rate for Payer: EPIC Health Plan Medicare |
$12.88
|
| Rate for Payer: Heritage Provider Network Commercial |
$7.97
|
| Rate for Payer: Heritage Provider Network Senior |
$7.97
|
| Rate for Payer: Humana Medicare |
$12.88
|
| Rate for Payer: IEHP Medi-Cal |
$17.86
|
| Rate for Payer: IEHP Medicare Advantage |
$12.88
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$24.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.33
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.22
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16.23
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16.23
|
| Rate for Payer: Multiplan Commercial |
$9.66
|
| Rate for Payer: TriValley Medical Group Commercial |
$12.88
|
| Rate for Payer: TriValley Medical Group Senior |
$12.88
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$13.91
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$13.91
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.17
|
| Rate for Payer: Vantage Medical Group Senior |
$12.88
|
|
|
HC SOM HTLV AB SCREEN
|
Facility
IP
|
$12.88
|
|
|
Service Code
|
CPT 86790
|
| Hospital Charge Code |
900911034
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.33 |
| Max. Negotiated Rate |
$9.66 |
| Rate for Payer: Adventist Health Commercial |
$2.58
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$8.85
|
| Rate for Payer: Cash Price |
$5.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$8.72
|
| Rate for Payer: Heritage Provider Network Senior |
$8.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.22
|
| Rate for Payer: Multiplan Commercial |
$9.66
|
|
|
HC SOM HUMAN HERPESVIRUS-6 PCR
|
Facility
OP
|
$75.00
|
|
|
Service Code
|
CPT 87532
|
| Hospital Charge Code |
900912711
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$13.58 |
| Max. Negotiated Rate |
$284.23 |
| Rate for Payer: Adventist Health Commercial |
$15.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$102.11
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$51.52
|
| 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 |
$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 |
$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 |
$48.75
|
| Rate for Payer: EPIC Health Plan Medicare |
$35.09
|
| Rate for Payer: Heritage Provider Network Commercial |
$46.42
|
| Rate for Payer: Heritage Provider Network Senior |
$46.42
|
| 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 |
$13.58
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$41.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18.75
|
| 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 |
$56.25
|
| 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 |
$52.64
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$38.60
|
| Rate for Payer: Vantage Medical Group Senior |
$35.09
|
|
|
HC SOM HUMAN HERPESVIRUS-6 PCR
|
Facility
IP
|
$75.00
|
|
|
Service Code
|
CPT 87532
|
| Hospital Charge Code |
900912711
|
|
Hospital Revenue Code
|
306
|
| 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 HYPOGLYCEMIC AGENT SCREEN
|
Facility
OP
|
$90.00
|
|
|
Service Code
|
CPT 80377
|
| Hospital Charge Code |
900912528
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$0.02 |
| Max. Negotiated Rate |
$173.62 |
| Rate for Payer: Adventist Health Commercial |
$18.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$0.02
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$61.83
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$76.50
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$49.50
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$67.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$173.62
|
| Rate for Payer: Cash Price |
$40.50
|
| Rate for Payer: Cash Price |
$40.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$58.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$76.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$76.50
|
| Rate for Payer: Dignity Health Senior |
$76.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$58.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$55.71
|
| Rate for Payer: Heritage Provider Network Senior |
$55.71
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$43.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$16.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.50
|
| Rate for Payer: Multiplan Commercial |
$67.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$76.50
|
| Rate for Payer: Vantage Medical Group Senior |
$76.50
|
|
|
HC SOM HYPOGLYCEMIC AGENT SCREEN
|
Facility
IP
|
$90.00
|
|
|
Service Code
|
CPT 80377
|
| Hospital Charge Code |
900912528
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$16.29 |
| Max. Negotiated Rate |
$67.50 |
| Rate for Payer: Adventist Health Commercial |
$18.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$61.83
|
| Rate for Payer: Cash Price |
$40.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$60.93
|
| Rate for Payer: Heritage Provider Network Senior |
$60.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$16.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.50
|
| Rate for Payer: Multiplan Commercial |
$67.50
|
|
|
HC SOM IA2 AB
|
Facility
OP
|
$55.00
|
|
|
Service Code
|
CPT 86341
|
| Hospital Charge Code |
900914354
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.96 |
| Max. Negotiated Rate |
$129.80 |
| Rate for Payer: Adventist Health Commercial |
$11.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$48.33
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$37.78
|
| 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 |
$24.75
|
| Rate for Payer: Cash Price |
$24.75
|
| Rate for Payer: Cigna of CA HMO/PPO |
$35.75
|
| 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 |
$35.75
|
| Rate for Payer: EPIC Health Plan Medicare |
$23.57
|
| Rate for Payer: Heritage Provider Network Commercial |
$34.04
|
| Rate for Payer: Heritage Provider Network Senior |
$34.04
|
| 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 |
$9.96
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$27.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.75
|
| 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 |
$41.25
|
| 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 IA2 AB
|
Facility
IP
|
$55.00
|
|
|
Service Code
|
CPT 86341
|
| Hospital Charge Code |
900914354
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.96 |
| Max. Negotiated Rate |
$41.25 |
| Rate for Payer: Adventist Health Commercial |
$11.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$37.78
|
| Rate for Payer: Cash Price |
$24.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$37.24
|
| Rate for Payer: Heritage Provider Network Senior |
$37.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.75
|
| Rate for Payer: Multiplan Commercial |
$41.25
|
|
|
HC SOM IGA SUBCLASSES IGA 1
|
Facility
IP
|
$66.00
|
|
|
Service Code
|
CPT 82787
|
| Hospital Charge Code |
900912703
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.95 |
| Max. Negotiated Rate |
$49.50 |
| Rate for Payer: Adventist Health Commercial |
$13.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$45.34
|
| Rate for Payer: Cash Price |
$29.70
|
| Rate for Payer: Heritage Provider Network Commercial |
$44.68
|
| Rate for Payer: Heritage Provider Network Senior |
$44.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.50
|
| Rate for Payer: Multiplan Commercial |
$49.50
|
|
|
HC SOM IGA SUBCLASSES IGA 1
|
Facility
OP
|
$66.00
|
|
|
Service Code
|
CPT 82787
|
| Hospital Charge Code |
900912703
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.02 |
| Max. Negotiated Rate |
$278.82 |
| Rate for Payer: Adventist Health Commercial |
$13.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$23.35
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$45.34
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$12.03
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$8.82
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$8.02
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$278.82
|
| Rate for Payer: Blue Shield of California Commercial |
$62.61
|
| Rate for Payer: Blue Shield of California EPN |
$48.94
|
| Rate for Payer: Cash Price |
$29.70
|
| Rate for Payer: Cash Price |
$29.70
|
| Rate for Payer: Cigna of CA HMO/PPO |
$42.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.03
|
| Rate for Payer: Dignity Health Medi-Cal |
$8.82
|
| Rate for Payer: Dignity Health Senior |
$8.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$42.90
|
| Rate for Payer: EPIC Health Plan Medicare |
$8.02
|
| Rate for Payer: Heritage Provider Network Commercial |
$40.85
|
| Rate for Payer: Heritage Provider Network Senior |
$40.85
|
| Rate for Payer: Humana Medicare |
$8.02
|
| Rate for Payer: IEHP Medi-Cal |
$11.12
|
| Rate for Payer: IEHP Medicare Advantage |
$8.02
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$15.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.95
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.11
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10.11
|
| Rate for Payer: Multiplan Commercial |
$49.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$8.02
|
| Rate for Payer: TriValley Medical Group Senior |
$8.02
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$8.66
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$8.66
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.03
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.82
|
| Rate for Payer: Vantage Medical Group Senior |
$8.02
|
|
|
HC SOM IGA SUBCLASSES IGA 2
|
Facility
OP
|
$67.00
|
|
|
Service Code
|
CPT 82787
|
| Hospital Charge Code |
900912704
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.02 |
| Max. Negotiated Rate |
$278.82 |
| Rate for Payer: Adventist Health Commercial |
$13.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$23.35
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$46.03
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$12.03
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$8.82
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$8.02
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$278.82
|
| Rate for Payer: Blue Shield of California Commercial |
$62.61
|
| Rate for Payer: Blue Shield of California EPN |
$48.94
|
| Rate for Payer: Cash Price |
$30.15
|
| Rate for Payer: Cash Price |
$30.15
|
| Rate for Payer: Cigna of CA HMO/PPO |
$43.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.03
|
| Rate for Payer: Dignity Health Medi-Cal |
$8.82
|
| Rate for Payer: Dignity Health Senior |
$8.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$43.55
|
| Rate for Payer: EPIC Health Plan Medicare |
$8.02
|
| Rate for Payer: Heritage Provider Network Commercial |
$41.47
|
| Rate for Payer: Heritage Provider Network Senior |
$41.47
|
| Rate for Payer: Humana Medicare |
$8.02
|
| Rate for Payer: IEHP Medi-Cal |
$11.12
|
| Rate for Payer: IEHP Medicare Advantage |
$8.02
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$15.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12.13
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.11
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10.11
|
| Rate for Payer: Multiplan Commercial |
$50.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$8.02
|
| Rate for Payer: TriValley Medical Group Senior |
$8.02
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$8.66
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$8.66
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.03
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.82
|
| Rate for Payer: Vantage Medical Group Senior |
$8.02
|
|
|
HC SOM IGA SUBCLASSES IGA 2
|
Facility
IP
|
$67.00
|
|
|
Service Code
|
CPT 82787
|
| Hospital Charge Code |
900912704
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.13 |
| Max. Negotiated Rate |
$50.25 |
| Rate for Payer: Adventist Health Commercial |
$13.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$46.03
|
| Rate for Payer: Cash Price |
$30.15
|
| Rate for Payer: Heritage Provider Network Commercial |
$45.36
|
| Rate for Payer: Heritage Provider Network Senior |
$45.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.75
|
| Rate for Payer: Multiplan Commercial |
$50.25
|
|
|
HC SOM IGA SUBCLASSES TOTAL IGA
|
Facility
OP
|
$67.00
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
900912705
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.30 |
| Max. Negotiated Rate |
$72.61 |
| Rate for Payer: Adventist Health Commercial |
$13.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$19.07
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$46.03
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$13.95
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$10.23
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$9.30
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$64.86
|
| Rate for Payer: Blue Shield of California Commercial |
$72.61
|
| Rate for Payer: Blue Shield of California EPN |
$56.77
|
| Rate for Payer: Cash Price |
$30.15
|
| Rate for Payer: Cash Price |
$30.15
|
| Rate for Payer: Cigna of CA HMO/PPO |
$43.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$10.23
|
| Rate for Payer: Dignity Health Senior |
$9.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$43.55
|
| Rate for Payer: EPIC Health Plan Medicare |
$9.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$41.47
|
| Rate for Payer: Heritage Provider Network Senior |
$41.47
|
| Rate for Payer: Humana Medicare |
$9.30
|
| Rate for Payer: IEHP Medi-Cal |
$9.48
|
| Rate for Payer: IEHP Medicare Advantage |
$9.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$17.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12.13
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11.72
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11.72
|
| Rate for Payer: Multiplan Commercial |
$50.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$9.30
|
| Rate for Payer: TriValley Medical Group Senior |
$9.30
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$10.04
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$10.04
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.23
|
| Rate for Payer: Vantage Medical Group Senior |
$9.30
|
|
