|
HC SOM INFLIXIMAB, QUANT
|
Facility
IP
|
$155.31
|
|
|
Service Code
|
CPT 80230
|
| Hospital Charge Code |
900915310
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$28.11 |
| Max. Negotiated Rate |
$116.48 |
| Rate for Payer: Adventist Health Commercial |
$31.06
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$106.70
|
| Rate for Payer: Cash Price |
$69.89
|
| Rate for Payer: Heritage Provider Network Commercial |
$105.14
|
| Rate for Payer: Heritage Provider Network Senior |
$105.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$28.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$38.83
|
| Rate for Payer: Multiplan Commercial |
$116.48
|
|
|
HC SOM INFLIXIMAB, QUANT
|
Facility
OP
|
$155.31
|
|
|
Service Code
|
CPT 80230
|
| Hospital Charge Code |
900915310
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$28.11 |
| Max. Negotiated Rate |
$215.61 |
| Rate for Payer: Adventist Health Commercial |
$31.06
|
| Rate for Payer: Aetna of CA Gatekeeper |
$79.73
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$106.70
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$57.86
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$42.43
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$38.57
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$114.39
|
| Rate for Payer: Blue Shield of California Commercial |
$215.61
|
| Rate for Payer: Blue Shield of California EPN |
$168.55
|
| Rate for Payer: Cash Price |
$69.89
|
| Rate for Payer: Cash Price |
$69.89
|
| Rate for Payer: Cigna of CA HMO/PPO |
$100.95
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$57.86
|
| Rate for Payer: Dignity Health Medi-Cal |
$42.43
|
| Rate for Payer: Dignity Health Senior |
$38.57
|
| Rate for Payer: EPIC Health Plan Commercial |
$100.95
|
| Rate for Payer: EPIC Health Plan Medicare |
$38.57
|
| Rate for Payer: Heritage Provider Network Commercial |
$96.14
|
| Rate for Payer: Heritage Provider Network Senior |
$96.14
|
| Rate for Payer: Humana Medicare |
$38.57
|
| Rate for Payer: IEHP Medi-Cal |
$48.14
|
| Rate for Payer: IEHP Medicare Advantage |
$38.57
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$73.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$28.11
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$45.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$38.83
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$48.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$48.60
|
| Rate for Payer: Multiplan Commercial |
$116.48
|
| Rate for Payer: TriValley Medical Group Commercial |
$38.57
|
| Rate for Payer: TriValley Medical Group Senior |
$38.57
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$41.65
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$41.65
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$57.86
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$42.43
|
| Rate for Payer: Vantage Medical Group Senior |
$38.57
|
|
|
HC SOM INFLUENZA A AB TITER (CF)
|
Facility
OP
|
$14.75
|
|
|
Service Code
|
CPT 86710
|
| Hospital Charge Code |
900911771
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.67 |
| Max. Negotiated Rate |
$115.63 |
| Rate for Payer: Adventist Health Commercial |
$2.95
|
| Rate for Payer: Aetna of CA Gatekeeper |
$39.45
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$10.13
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$20.32
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$14.90
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$13.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$115.63
|
| Rate for Payer: Blue Shield of California Commercial |
$105.87
|
| Rate for Payer: Blue Shield of California EPN |
$82.77
|
| Rate for Payer: Cash Price |
$6.64
|
| Rate for Payer: Cash Price |
$6.64
|
| Rate for Payer: Cigna of CA HMO/PPO |
$9.59
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20.32
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.90
|
| Rate for Payer: Dignity Health Senior |
$13.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.59
|
| Rate for Payer: EPIC Health Plan Medicare |
$13.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$9.13
|
| Rate for Payer: Heritage Provider Network Senior |
$9.13
|
| Rate for Payer: Humana Medicare |
$13.55
|
| Rate for Payer: IEHP Medi-Cal |
$18.80
|
| Rate for Payer: IEHP Medicare Advantage |
$13.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$25.74
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.69
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17.07
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17.07
|
| Rate for Payer: Multiplan Commercial |
$11.06
|
| Rate for Payer: TriValley Medical Group Commercial |
$13.55
|
| Rate for Payer: TriValley Medical Group Senior |
$13.55
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$14.64
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$14.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.90
|
| Rate for Payer: Vantage Medical Group Senior |
$13.55
|
|
|
HC SOM INFLUENZA A AB TITER (CF)
|
Facility
IP
|
$14.75
|
|
|
Service Code
|
CPT 86710
|
| Hospital Charge Code |
900911771
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.67 |
| Max. Negotiated Rate |
$11.06 |
| Rate for Payer: Adventist Health Commercial |
$2.95
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$10.13
|
| Rate for Payer: Cash Price |
$6.64
|
| Rate for Payer: Heritage Provider Network Commercial |
$9.99
|
| Rate for Payer: Heritage Provider Network Senior |
$9.99
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.69
|
| Rate for Payer: Multiplan Commercial |
$11.06
|
|
|
HC SOM INFLUENZA B AB TITER (CF)
|
Facility
OP
|
$7.50
|
|
|
Service Code
|
CPT 86710
|
| Hospital Charge Code |
900911772
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$1.36 |
| Max. Negotiated Rate |
$115.63 |
| Rate for Payer: Adventist Health Commercial |
$1.50
|
| Rate for Payer: Aetna of CA Gatekeeper |
$39.45
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$5.15
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$20.32
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$14.90
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$13.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$115.63
|
| Rate for Payer: Blue Shield of California Commercial |
$105.87
|
| Rate for Payer: Blue Shield of California EPN |
$82.77
|
| Rate for Payer: Cash Price |
$3.38
|
| Rate for Payer: Cash Price |
$3.38
|
| Rate for Payer: Cigna of CA HMO/PPO |
$4.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20.32
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.90
|
| Rate for Payer: Dignity Health Senior |
$13.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.88
|
| Rate for Payer: EPIC Health Plan Medicare |
$13.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$4.64
|
| Rate for Payer: Heritage Provider Network Senior |
$4.64
|
| Rate for Payer: Humana Medicare |
$13.55
|
| Rate for Payer: IEHP Medi-Cal |
$18.80
|
| Rate for Payer: IEHP Medicare Advantage |
$13.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$25.74
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.36
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.88
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17.07
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17.07
|
| Rate for Payer: Multiplan Commercial |
$5.62
|
| Rate for Payer: TriValley Medical Group Commercial |
$13.55
|
| Rate for Payer: TriValley Medical Group Senior |
$13.55
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$14.64
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$14.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.90
|
| Rate for Payer: Vantage Medical Group Senior |
$13.55
|
|
|
HC SOM INFLUENZA B AB TITER (CF)
|
Facility
IP
|
$7.50
|
|
|
Service Code
|
CPT 86710
|
| Hospital Charge Code |
900911772
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$1.36 |
| Max. Negotiated Rate |
$5.62 |
| Rate for Payer: Adventist Health Commercial |
$1.50
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$5.15
|
| Rate for Payer: Cash Price |
$3.38
|
| Rate for Payer: Heritage Provider Network Commercial |
$5.08
|
| Rate for Payer: Heritage Provider Network Senior |
$5.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.88
|
| Rate for Payer: Multiplan Commercial |
$5.62
|
|
|
HC SOM INHIBIN B
|
Facility
IP
|
$50.00
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
900913934
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.05 |
| Max. Negotiated Rate |
$37.50 |
| Rate for Payer: Adventist Health Commercial |
$10.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$34.35
|
| Rate for Payer: Cash Price |
$22.50
|
| 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 INHIBIN B
|
Facility
OP
|
$50.00
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
900913934
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.05 |
| Max. Negotiated Rate |
$108.36 |
| Rate for Payer: Adventist Health Commercial |
$10.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$37.68
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$34.35
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$25.90
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$19.00
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$17.27
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$108.36
|
| Rate for Payer: Blue Shield of California Commercial |
$101.12
|
| Rate for Payer: Blue Shield of California EPN |
$79.05
|
| Rate for Payer: Cash Price |
$22.50
|
| Rate for Payer: Cash Price |
$22.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$32.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$25.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$19.00
|
| Rate for Payer: Dignity Health Senior |
$17.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$32.50
|
| Rate for Payer: EPIC Health Plan Medicare |
$17.27
|
| Rate for Payer: Heritage Provider Network Commercial |
$30.95
|
| Rate for Payer: Heritage Provider Network Senior |
$30.95
|
| Rate for Payer: Humana Medicare |
$17.27
|
| Rate for Payer: IEHP Medi-Cal |
$15.97
|
| Rate for Payer: IEHP Medicare Advantage |
$17.27
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$32.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.05
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$20.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$21.76
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$21.76
|
| Rate for Payer: Multiplan Commercial |
$37.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$17.27
|
| Rate for Payer: TriValley Medical Group Senior |
$17.27
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$18.65
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$18.65
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$25.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.00
|
| Rate for Payer: Vantage Medical Group Senior |
$17.27
|
|
|
HC SOM INSULIN ANTIBODIES QUANTITATIV
|
Facility
OP
|
$32.21
|
|
|
Service Code
|
CPT 86337
|
| Hospital Charge Code |
900911061
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.83 |
| Max. Negotiated Rate |
$167.25 |
| Rate for Payer: Adventist Health Commercial |
$6.44
|
| Rate for Payer: Aetna of CA Gatekeeper |
$62.29
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$22.13
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$32.12
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$23.55
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$21.41
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$152.15
|
| Rate for Payer: Blue Shield of California Commercial |
$167.25
|
| Rate for Payer: Blue Shield of California EPN |
$130.75
|
| Rate for Payer: Cash Price |
$14.49
|
| Rate for Payer: Cash Price |
$14.49
|
| Rate for Payer: Cigna of CA HMO/PPO |
$20.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$32.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$23.55
|
| Rate for Payer: Dignity Health Senior |
$21.41
|
| Rate for Payer: EPIC Health Plan Commercial |
$20.94
|
| Rate for Payer: EPIC Health Plan Medicare |
$21.41
|
| Rate for Payer: Heritage Provider Network Commercial |
$19.94
|
| Rate for Payer: Heritage Provider Network Senior |
$19.94
|
| Rate for Payer: Humana Medicare |
$21.41
|
| Rate for Payer: IEHP Medi-Cal |
$29.69
|
| Rate for Payer: IEHP Medicare Advantage |
$21.41
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$40.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.83
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.05
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$26.98
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$26.98
|
| Rate for Payer: Multiplan Commercial |
$24.16
|
| Rate for Payer: TriValley Medical Group Commercial |
$21.41
|
| Rate for Payer: TriValley Medical Group Senior |
$21.41
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$23.12
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$23.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$32.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$23.55
|
| Rate for Payer: Vantage Medical Group Senior |
$21.41
|
|
|
HC SOM INSULIN ANTIBODIES QUANTITATIV
|
Facility
IP
|
$32.21
|
|
|
Service Code
|
CPT 86337
|
| Hospital Charge Code |
900911061
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.83 |
| Max. Negotiated Rate |
$24.16 |
| Rate for Payer: Adventist Health Commercial |
$6.44
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$22.13
|
| Rate for Payer: Cash Price |
$14.49
|
| Rate for Payer: Heritage Provider Network Commercial |
$21.81
|
| Rate for Payer: Heritage Provider Network Senior |
$21.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.05
|
| Rate for Payer: Multiplan Commercial |
$24.16
|
|
|
HC SOM INSULIN-LIKE GROWTH FACTOR I
|
Facility
IP
|
$20.20
|
|
|
Service Code
|
CPT 84305
|
| Hospital Charge Code |
900911132
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.66 |
| Max. Negotiated Rate |
$15.15 |
| Rate for Payer: Adventist Health Commercial |
$4.04
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$13.88
|
| Rate for Payer: Cash Price |
$9.09
|
| Rate for Payer: Heritage Provider Network Commercial |
$13.68
|
| Rate for Payer: Heritage Provider Network Senior |
$13.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.05
|
| Rate for Payer: Multiplan Commercial |
$15.15
|
|
|
HC SOM INSULIN-LIKE GROWTH FACTOR I
|
Facility
OP
|
$20.20
|
|
|
Service Code
|
CPT 84305
|
| Hospital Charge Code |
900911132
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.66 |
| Max. Negotiated Rate |
$143.61 |
| Rate for Payer: Adventist Health Commercial |
$4.04
|
| Rate for Payer: Aetna of CA Gatekeeper |
$61.85
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$13.88
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$31.89
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$23.39
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$21.26
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$142.34
|
| Rate for Payer: Blue Shield of California Commercial |
$143.61
|
| Rate for Payer: Blue Shield of California EPN |
$112.27
|
| Rate for Payer: Cash Price |
$9.09
|
| Rate for Payer: Cash Price |
$9.09
|
| Rate for Payer: Cigna of CA HMO/PPO |
$13.13
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$31.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$23.39
|
| Rate for Payer: Dignity Health Senior |
$21.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.13
|
| Rate for Payer: EPIC Health Plan Medicare |
$21.26
|
| Rate for Payer: Heritage Provider Network Commercial |
$12.50
|
| Rate for Payer: Heritage Provider Network Senior |
$12.50
|
| Rate for Payer: Humana Medicare |
$21.26
|
| Rate for Payer: IEHP Medi-Cal |
$28.69
|
| Rate for Payer: IEHP Medicare Advantage |
$21.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$40.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.05
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$26.79
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$26.79
|
| Rate for Payer: Multiplan Commercial |
$15.15
|
| Rate for Payer: TriValley Medical Group Commercial |
$21.26
|
| Rate for Payer: TriValley Medical Group Senior |
$21.26
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$22.96
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$22.96
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$31.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$23.39
|
| Rate for Payer: Vantage Medical Group Senior |
$21.26
|
|
|
HC SOM INTERPHASES 100-300
|
Facility
OP
|
$30.00
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
900915276
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$5.43 |
| Max. Negotiated Rate |
$2,190.93 |
| Rate for Payer: Adventist Health Commercial |
$6.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$116.82
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$20.61
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$76.78
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$56.31
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$51.19
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,190.93
|
| Rate for Payer: Blue Shield of California Commercial |
$313.65
|
| Rate for Payer: Blue Shield of California EPN |
$245.20
|
| Rate for Payer: Cash Price |
$13.50
|
| Rate for Payer: Cash Price |
$13.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$19.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$76.78
|
| Rate for Payer: Dignity Health Medi-Cal |
$56.31
|
| Rate for Payer: Dignity Health Senior |
$51.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.50
|
| Rate for Payer: EPIC Health Plan Medicare |
$51.19
|
| Rate for Payer: Heritage Provider Network Commercial |
$18.57
|
| Rate for Payer: Heritage Provider Network Senior |
$18.57
|
| Rate for Payer: Humana Medicare |
$51.19
|
| Rate for Payer: IEHP Medi-Cal |
$49.42
|
| Rate for Payer: IEHP Medicare Advantage |
$51.19
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$97.26
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.43
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$60.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$64.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$64.50
|
| Rate for Payer: Multiplan Commercial |
$22.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$51.19
|
| Rate for Payer: TriValley Medical Group Senior |
$51.19
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$55.28
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$55.28
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$76.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$56.31
|
| Rate for Payer: Vantage Medical Group Senior |
$51.19
|
|
|
HC SOM INTERPHASES 100-300
|
Facility
IP
|
$30.00
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
900915276
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$5.43 |
| Max. Negotiated Rate |
$22.50 |
| Rate for Payer: Adventist Health Commercial |
$6.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$20.61
|
| Rate for Payer: Cash Price |
$13.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$20.31
|
| Rate for Payer: Heritage Provider Network Senior |
$20.31
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.50
|
| Rate for Payer: Multiplan Commercial |
$22.50
|
|
|
HC SOM INTERPHASES 25-99
|
Facility
IP
|
$30.00
|
|
|
Service Code
|
CPT 88274
|
| Hospital Charge Code |
900915275
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$5.43 |
| Max. Negotiated Rate |
$22.50 |
| Rate for Payer: Adventist Health Commercial |
$6.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$20.61
|
| Rate for Payer: Cash Price |
$13.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$20.31
|
| Rate for Payer: Heritage Provider Network Senior |
$20.31
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.50
|
| Rate for Payer: Multiplan Commercial |
$22.50
|
|
|
HC SOM INTERPHASES 25-99
|
Facility
OP
|
$30.00
|
|
|
Service Code
|
CPT 88274
|
| Hospital Charge Code |
900915275
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$5.43 |
| Max. Negotiated Rate |
$1,752.74 |
| Rate for Payer: Adventist Health Commercial |
$6.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$101.28
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$20.61
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$63.57
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$46.62
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$42.38
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,752.74
|
| Rate for Payer: Blue Shield of California Commercial |
$271.84
|
| Rate for Payer: Blue Shield of California EPN |
$212.51
|
| Rate for Payer: Cash Price |
$13.50
|
| Rate for Payer: Cash Price |
$13.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$19.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$63.57
|
| Rate for Payer: Dignity Health Medi-Cal |
$46.62
|
| Rate for Payer: Dignity Health Senior |
$42.38
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.50
|
| Rate for Payer: EPIC Health Plan Medicare |
$42.38
|
| Rate for Payer: Heritage Provider Network Commercial |
$18.57
|
| Rate for Payer: Heritage Provider Network Senior |
$18.57
|
| Rate for Payer: Humana Medicare |
$42.38
|
| Rate for Payer: IEHP Medi-Cal |
$52.88
|
| Rate for Payer: IEHP Medicare Advantage |
$42.38
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$80.52
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.43
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$50.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$53.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$53.40
|
| Rate for Payer: Multiplan Commercial |
$22.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$42.38
|
| Rate for Payer: TriValley Medical Group Senior |
$42.38
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$45.77
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$45.77
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$63.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$46.62
|
| Rate for Payer: Vantage Medical Group Senior |
$42.38
|
|
|
HC SOM INTERPHASES LT 25
|
Facility
OP
|
$30.00
|
|
|
Service Code
|
CPT 88274
|
| Hospital Charge Code |
900915277
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$5.43 |
| Max. Negotiated Rate |
$1,752.74 |
| Rate for Payer: Adventist Health Commercial |
$6.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$101.28
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$20.61
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$63.57
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$46.62
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$42.38
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,752.74
|
| Rate for Payer: Blue Shield of California Commercial |
$271.84
|
| Rate for Payer: Blue Shield of California EPN |
$212.51
|
| Rate for Payer: Cash Price |
$13.50
|
| Rate for Payer: Cash Price |
$13.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$19.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$63.57
|
| Rate for Payer: Dignity Health Medi-Cal |
$46.62
|
| Rate for Payer: Dignity Health Senior |
$42.38
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.50
|
| Rate for Payer: EPIC Health Plan Medicare |
$42.38
|
| Rate for Payer: Heritage Provider Network Commercial |
$18.57
|
| Rate for Payer: Heritage Provider Network Senior |
$18.57
|
| Rate for Payer: Humana Medicare |
$42.38
|
| Rate for Payer: IEHP Medi-Cal |
$52.88
|
| Rate for Payer: IEHP Medicare Advantage |
$42.38
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$80.52
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.43
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$50.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$53.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$53.40
|
| Rate for Payer: Multiplan Commercial |
$22.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$42.38
|
| Rate for Payer: TriValley Medical Group Senior |
$42.38
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$45.77
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$45.77
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$63.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$46.62
|
| Rate for Payer: Vantage Medical Group Senior |
$42.38
|
|
|
HC SOM INTERPHASES LT 25
|
Facility
IP
|
$30.00
|
|
|
Service Code
|
CPT 88274
|
| Hospital Charge Code |
900915277
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$5.43 |
| Max. Negotiated Rate |
$22.50 |
| Rate for Payer: Adventist Health Commercial |
$6.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$20.61
|
| Rate for Payer: Cash Price |
$13.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$20.31
|
| Rate for Payer: Heritage Provider Network Senior |
$20.31
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.50
|
| Rate for Payer: Multiplan Commercial |
$22.50
|
|
|
HC SOM INTRINSIC FACTOR BLOCKING AB
|
Facility
IP
|
$25.00
|
|
|
Service Code
|
CPT 86340
|
| Hospital Charge Code |
900911094
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.52 |
| Max. Negotiated Rate |
$18.75 |
| Rate for Payer: Adventist Health Commercial |
$5.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$17.18
|
| Rate for Payer: Cash Price |
$11.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$16.92
|
| Rate for Payer: Heritage Provider Network Senior |
$16.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.25
|
| Rate for Payer: Multiplan Commercial |
$18.75
|
|
|
HC SOM INTRINSIC FACTOR BLOCKING AB
|
Facility
OP
|
$25.00
|
|
|
Service Code
|
CPT 86340
|
| Hospital Charge Code |
900911094
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.52 |
| Max. Negotiated Rate |
$126.17 |
| Rate for Payer: Adventist Health Commercial |
$5.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$43.85
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$17.18
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$22.62
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$16.59
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$15.08
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$126.17
|
| Rate for Payer: Blue Shield of California Commercial |
$117.73
|
| Rate for Payer: Blue Shield of California EPN |
$92.03
|
| Rate for Payer: Cash Price |
$11.25
|
| Rate for Payer: Cash Price |
$11.25
|
| Rate for Payer: Cigna of CA HMO/PPO |
$16.25
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$22.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$16.59
|
| Rate for Payer: Dignity Health Senior |
$15.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.25
|
| Rate for Payer: EPIC Health Plan Medicare |
$15.08
|
| Rate for Payer: Heritage Provider Network Commercial |
$15.48
|
| Rate for Payer: Heritage Provider Network Senior |
$15.48
|
| Rate for Payer: Humana Medicare |
$15.08
|
| Rate for Payer: IEHP Medi-Cal |
$20.90
|
| Rate for Payer: IEHP Medicare Advantage |
$15.08
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$28.65
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.52
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$17.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$19.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$19.00
|
| Rate for Payer: Multiplan Commercial |
$18.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$15.08
|
| Rate for Payer: TriValley Medical Group Senior |
$15.08
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$16.28
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$16.28
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$22.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$16.59
|
| Rate for Payer: Vantage Medical Group Senior |
$15.08
|
|
|
HC SOM IRON LIVER TISSUE
|
Facility
OP
|
$9.28
|
|
|
Service Code
|
CPT 83540
|
| Hospital Charge Code |
900914805
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$1.68 |
| Max. Negotiated Rate |
$54.21 |
| Rate for Payer: Adventist Health Commercial |
$1.86
|
| Rate for Payer: Aetna of CA Gatekeeper |
$18.85
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$6.38
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$9.70
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$7.12
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$6.47
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$54.21
|
| Rate for Payer: Blue Shield of California Commercial |
$50.59
|
| Rate for Payer: Blue Shield of California EPN |
$39.55
|
| Rate for Payer: Cash Price |
$4.18
|
| Rate for Payer: Cash Price |
$4.18
|
| Rate for Payer: Cigna of CA HMO/PPO |
$6.03
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.12
|
| Rate for Payer: Dignity Health Senior |
$6.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.03
|
| Rate for Payer: EPIC Health Plan Medicare |
$6.47
|
| Rate for Payer: Heritage Provider Network Commercial |
$5.74
|
| Rate for Payer: Heritage Provider Network Senior |
$5.74
|
| Rate for Payer: Humana Medicare |
$6.47
|
| Rate for Payer: IEHP Medi-Cal |
$8.92
|
| Rate for Payer: IEHP Medicare Advantage |
$6.47
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$12.29
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8.15
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8.15
|
| Rate for Payer: Multiplan Commercial |
$6.96
|
| Rate for Payer: TriValley Medical Group Commercial |
$6.47
|
| Rate for Payer: TriValley Medical Group Senior |
$6.47
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$6.98
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$6.98
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$9.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.12
|
| Rate for Payer: Vantage Medical Group Senior |
$6.47
|
|
|
HC SOM IRON LIVER TISSUE
|
Facility
IP
|
$9.28
|
|
|
Service Code
|
CPT 83540
|
| Hospital Charge Code |
900914805
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$1.68 |
| Max. Negotiated Rate |
$6.96 |
| Rate for Payer: Adventist Health Commercial |
$1.86
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$6.38
|
| Rate for Payer: Cash Price |
$4.18
|
| Rate for Payer: Heritage Provider Network Commercial |
$6.28
|
| Rate for Payer: Heritage Provider Network Senior |
$6.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.32
|
| Rate for Payer: Multiplan Commercial |
$6.96
|
|
|
HC SOM ITRACONAZOLE LEVEL
|
Facility
IP
|
$40.00
|
|
|
Service Code
|
CPT 80189
|
| Hospital Charge Code |
900911379
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.24 |
| Max. Negotiated Rate |
$30.00 |
| Rate for Payer: Adventist Health Commercial |
$8.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$27.48
|
| Rate for Payer: Cash Price |
$18.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$27.08
|
| Rate for Payer: Heritage Provider Network Senior |
$27.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.00
|
| Rate for Payer: Multiplan Commercial |
$30.00
|
|
|
HC SOM ITRACONAZOLE LEVEL
|
Facility
OP
|
$40.00
|
|
|
Service Code
|
CPT 80189
|
| Hospital Charge Code |
900911379
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.24 |
| Max. Negotiated Rate |
$151.54 |
| Rate for Payer: Adventist Health Commercial |
$8.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$56.04
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$27.48
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$40.66
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$29.82
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$27.11
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$80.41
|
| Rate for Payer: Blue Shield of California Commercial |
$151.54
|
| Rate for Payer: Blue Shield of California EPN |
$118.47
|
| Rate for Payer: Cash Price |
$18.00
|
| Rate for Payer: Cash Price |
$18.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$26.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$40.66
|
| Rate for Payer: Dignity Health Medi-Cal |
$29.82
|
| Rate for Payer: Dignity Health Senior |
$27.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$27.11
|
| Rate for Payer: Heritage Provider Network Commercial |
$24.76
|
| Rate for Payer: Heritage Provider Network Senior |
$24.76
|
| Rate for Payer: Humana Medicare |
$27.11
|
| Rate for Payer: IEHP Medi-Cal |
$33.84
|
| Rate for Payer: IEHP Medicare Advantage |
$27.11
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$51.51
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7.24
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$31.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$34.16
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$34.16
|
| Rate for Payer: Multiplan Commercial |
$30.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$27.11
|
| Rate for Payer: TriValley Medical Group Senior |
$27.11
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$29.28
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$29.28
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$40.66
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$29.82
|
| Rate for Payer: Vantage Medical Group Senior |
$27.11
|
|
|
HC SOM JAK 2 V617F MUTATION
|
Facility
OP
|
$101.66
|
|
|
Service Code
|
CPT 81270
|
| Hospital Charge Code |
900912994
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$18.40 |
| Max. Negotiated Rate |
$404.77 |
| Rate for Payer: Adventist Health Commercial |
$20.33
|
| Rate for Payer: Aetna of CA Gatekeeper |
$83.99
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$69.84
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$137.49
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$100.83
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$91.66
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$404.77
|
| Rate for Payer: Blue Shield of California Commercial |
$63.13
|
| Rate for Payer: Blue Shield of California EPN |
$59.67
|
| Rate for Payer: Cash Price |
$45.75
|
| Rate for Payer: Cash Price |
$45.75
|
| Rate for Payer: Cigna of CA HMO/PPO |
$66.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$137.49
|
| Rate for Payer: Dignity Health Medi-Cal |
$100.83
|
| Rate for Payer: Dignity Health Senior |
$91.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$66.08
|
| Rate for Payer: EPIC Health Plan Medicare |
$91.66
|
| Rate for Payer: Heritage Provider Network Commercial |
$62.93
|
| Rate for Payer: Heritage Provider Network Senior |
$62.93
|
| Rate for Payer: Humana Medicare |
$91.66
|
| Rate for Payer: IEHP Medi-Cal |
$103.43
|
| Rate for Payer: IEHP Medicare Advantage |
$91.66
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$174.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$18.40
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$108.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.42
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$115.49
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$115.49
|
| Rate for Payer: Multiplan Commercial |
$76.24
|
| Rate for Payer: TriValley Medical Group Commercial |
$91.66
|
| Rate for Payer: TriValley Medical Group Senior |
$91.66
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$98.99
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$98.99
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$137.49
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$100.83
|
| Rate for Payer: Vantage Medical Group Senior |
$91.66
|
|
