|
HC SOM MIRA VISTA HC HISTOPLASMA AG
|
Facility
OP
|
$140.00
|
|
|
Service Code
|
CPT 87385
|
| Hospital Charge Code |
900913883
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$13.25 |
| Max. Negotiated Rate |
$105.00 |
| Rate for Payer: Adventist Health Commercial |
$28.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$27.02
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$96.18
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$19.88
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$14.58
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$13.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$75.23
|
| Rate for Payer: Blue Shield of California Commercial |
$72.56
|
| Rate for Payer: Blue Shield of California EPN |
$56.72
|
| Rate for Payer: Cash Price |
$63.00
|
| Rate for Payer: Cash Price |
$63.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$91.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.88
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.58
|
| Rate for Payer: Dignity Health Senior |
$13.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$91.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$13.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$86.66
|
| Rate for Payer: Heritage Provider Network Senior |
$86.66
|
| Rate for Payer: Humana Medicare |
$13.25
|
| Rate for Payer: IEHP Medi-Cal |
$15.76
|
| Rate for Payer: IEHP Medicare Advantage |
$13.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$25.18
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$25.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$35.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16.70
|
| Rate for Payer: Multiplan Commercial |
$105.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$13.25
|
| Rate for Payer: TriValley Medical Group Senior |
$13.25
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$14.32
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$14.32
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.58
|
| Rate for Payer: Vantage Medical Group Senior |
$13.25
|
|
|
HC SOM MITOCHONDRIAL ANTIBO
|
Facility
IP
|
$10.82
|
|
|
Service Code
|
CPT 86381
|
| Hospital Charge Code |
900911178
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$1.96 |
| Max. Negotiated Rate |
$8.12 |
| Rate for Payer: Adventist Health Commercial |
$2.16
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$7.43
|
| Rate for Payer: Cash Price |
$4.87
|
| Rate for Payer: Heritage Provider Network Commercial |
$7.33
|
| Rate for Payer: Heritage Provider Network Senior |
$7.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.70
|
| Rate for Payer: Multiplan Commercial |
$8.12
|
|
|
HC SOM MITOCHONDRIAL ANTIBO
|
Facility
OP
|
$10.82
|
|
|
Service Code
|
CPT 86381
|
| Hospital Charge Code |
900911178
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$1.96 |
| Max. Negotiated Rate |
$142.27 |
| Rate for Payer: Adventist Health Commercial |
$2.16
|
| Rate for Payer: Aetna of CA Gatekeeper |
$52.61
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$7.43
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$38.18
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$28.00
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$25.45
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$85.09
|
| Rate for Payer: Blue Shield of California Commercial |
$142.27
|
| Rate for Payer: Blue Shield of California EPN |
$111.22
|
| Rate for Payer: Cash Price |
$4.87
|
| Rate for Payer: Cash Price |
$4.87
|
| Rate for Payer: Cigna of CA HMO/PPO |
$7.03
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$38.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$28.00
|
| Rate for Payer: Dignity Health Senior |
$25.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.03
|
| Rate for Payer: EPIC Health Plan Medicare |
$25.45
|
| Rate for Payer: Heritage Provider Network Commercial |
$6.70
|
| Rate for Payer: Heritage Provider Network Senior |
$6.70
|
| Rate for Payer: Humana Medicare |
$25.45
|
| Rate for Payer: IEHP Medi-Cal |
$39.70
|
| Rate for Payer: IEHP Medicare Advantage |
$25.45
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$48.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.96
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$30.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.70
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$32.07
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$32.07
|
| Rate for Payer: Multiplan Commercial |
$8.12
|
| Rate for Payer: TriValley Medical Group Commercial |
$25.45
|
| Rate for Payer: TriValley Medical Group Senior |
$25.45
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$27.49
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$27.49
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$38.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$28.00
|
| Rate for Payer: Vantage Medical Group Senior |
$25.45
|
|
|
HC SOM MMRV 86735
|
Facility
IP
|
$100.43
|
|
|
Service Code
|
CPT 86735
|
| Hospital Charge Code |
900914957
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$18.18 |
| Max. Negotiated Rate |
$75.32 |
| Rate for Payer: Adventist Health Commercial |
$20.09
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$69.00
|
| Rate for Payer: Cash Price |
$45.19
|
| Rate for Payer: Heritage Provider Network Commercial |
$67.99
|
| Rate for Payer: Heritage Provider Network Senior |
$67.99
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$18.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.11
|
| Rate for Payer: Multiplan Commercial |
$75.32
|
|
|
HC SOM MMRV 86735
|
Facility
OP
|
$100.43
|
|
|
Service Code
|
CPT 86735
|
| Hospital Charge Code |
900914957
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.05 |
| Max. Negotiated Rate |
$110.39 |
| Rate for Payer: Adventist Health Commercial |
$20.09
|
| Rate for Payer: Aetna of CA Gatekeeper |
$37.97
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$69.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$19.58
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$14.36
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$13.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$110.39
|
| Rate for Payer: Blue Shield of California Commercial |
$101.91
|
| Rate for Payer: Blue Shield of California EPN |
$79.67
|
| Rate for Payer: Cash Price |
$45.19
|
| Rate for Payer: Cash Price |
$45.19
|
| Rate for Payer: Cigna of CA HMO/PPO |
$65.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.58
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.36
|
| Rate for Payer: Dignity Health Senior |
$13.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$65.28
|
| Rate for Payer: EPIC Health Plan Medicare |
$13.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$62.17
|
| Rate for Payer: Heritage Provider Network Senior |
$62.17
|
| Rate for Payer: Humana Medicare |
$13.05
|
| Rate for Payer: IEHP Medi-Cal |
$18.08
|
| Rate for Payer: IEHP Medicare Advantage |
$13.05
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$24.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$18.18
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.11
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16.44
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16.44
|
| Rate for Payer: Multiplan Commercial |
$75.32
|
| Rate for Payer: TriValley Medical Group Commercial |
$13.05
|
| Rate for Payer: TriValley Medical Group Senior |
$13.05
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$14.10
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$14.10
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.58
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.36
|
| Rate for Payer: Vantage Medical Group Senior |
$13.05
|
|
|
HC SOM MMRV 86762
|
Facility
IP
|
$70.05
|
|
|
Service Code
|
CPT 86762
|
| Hospital Charge Code |
900914958
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.68 |
| Max. Negotiated Rate |
$52.54 |
| Rate for Payer: Adventist Health Commercial |
$14.01
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$48.12
|
| Rate for Payer: Cash Price |
$31.52
|
| Rate for Payer: Heritage Provider Network Commercial |
$47.42
|
| Rate for Payer: Heritage Provider Network Senior |
$47.42
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$17.51
|
| Rate for Payer: Multiplan Commercial |
$52.54
|
|
|
HC SOM MMRV 86762
|
Facility
OP
|
$70.05
|
|
|
Service Code
|
CPT 86762
|
| Hospital Charge Code |
900914958
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.68 |
| Max. Negotiated Rate |
$120.08 |
| Rate for Payer: Adventist Health Commercial |
$14.01
|
| Rate for Payer: Aetna of CA Gatekeeper |
$41.86
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$48.12
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$21.58
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$15.83
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$14.39
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$120.08
|
| Rate for Payer: Blue Shield of California Commercial |
$112.41
|
| Rate for Payer: Blue Shield of California EPN |
$87.88
|
| Rate for Payer: Cash Price |
$31.52
|
| Rate for Payer: Cash Price |
$31.52
|
| Rate for Payer: Cigna of CA HMO/PPO |
$45.53
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21.58
|
| Rate for Payer: Dignity Health Medi-Cal |
$15.83
|
| Rate for Payer: Dignity Health Senior |
$14.39
|
| Rate for Payer: EPIC Health Plan Commercial |
$45.53
|
| Rate for Payer: EPIC Health Plan Medicare |
$14.39
|
| Rate for Payer: Heritage Provider Network Commercial |
$43.36
|
| Rate for Payer: Heritage Provider Network Senior |
$43.36
|
| Rate for Payer: Humana Medicare |
$14.39
|
| Rate for Payer: IEHP Medi-Cal |
$19.95
|
| Rate for Payer: IEHP Medicare Advantage |
$14.39
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$27.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$17.51
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18.13
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18.13
|
| Rate for Payer: Multiplan Commercial |
$52.54
|
| Rate for Payer: TriValley Medical Group Commercial |
$14.39
|
| Rate for Payer: TriValley Medical Group Senior |
$14.39
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$15.54
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$15.54
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21.58
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15.83
|
| Rate for Payer: Vantage Medical Group Senior |
$14.39
|
|
|
HC SOM MMRV 86765
|
Facility
OP
|
$17.90
|
|
|
Service Code
|
CPT 86765
|
| Hospital Charge Code |
900914956
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.24 |
| Max. Negotiated Rate |
$107.86 |
| Rate for Payer: Adventist Health Commercial |
$3.58
|
| Rate for Payer: Aetna of CA Gatekeeper |
$37.48
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$12.30
|
| 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 |
$8.06
|
| Rate for Payer: Cash Price |
$8.06
|
| Rate for Payer: Cigna of CA HMO/PPO |
$11.64
|
| 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 |
$11.64
|
| Rate for Payer: EPIC Health Plan Medicare |
$12.88
|
| Rate for Payer: Heritage Provider Network Commercial |
$11.08
|
| Rate for Payer: Heritage Provider Network Senior |
$11.08
|
| 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 |
$3.24
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.48
|
| 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 |
$13.42
|
| 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 MMRV 86765
|
Facility
IP
|
$17.90
|
|
|
Service Code
|
CPT 86765
|
| Hospital Charge Code |
900914956
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.24 |
| Max. Negotiated Rate |
$13.42 |
| Rate for Payer: Adventist Health Commercial |
$3.58
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$12.30
|
| Rate for Payer: Cash Price |
$8.06
|
| Rate for Payer: Heritage Provider Network Commercial |
$12.12
|
| Rate for Payer: Heritage Provider Network Senior |
$12.12
|
| 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 |
$13.42
|
|
|
HC SOM MMRV 86787
|
Facility
IP
|
$29.73
|
|
|
Service Code
|
CPT 86787
|
| Hospital Charge Code |
900914959
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.38 |
| Max. Negotiated Rate |
$22.30 |
| Rate for Payer: Adventist Health Commercial |
$5.95
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$20.42
|
| Rate for Payer: Cash Price |
$13.38
|
| Rate for Payer: Heritage Provider Network Commercial |
$20.13
|
| Rate for Payer: Heritage Provider Network Senior |
$20.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.43
|
| Rate for Payer: Multiplan Commercial |
$22.30
|
|
|
HC SOM MMRV 86787
|
Facility
OP
|
$29.73
|
|
|
Service Code
|
CPT 86787
|
| Hospital Charge Code |
900914959
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.38 |
| Max. Negotiated Rate |
$107.86 |
| Rate for Payer: Adventist Health Commercial |
$5.95
|
| Rate for Payer: Aetna of CA Gatekeeper |
$37.48
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$20.42
|
| 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 |
$13.38
|
| Rate for Payer: Cash Price |
$13.38
|
| Rate for Payer: Cigna of CA HMO/PPO |
$19.32
|
| 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 |
$19.32
|
| Rate for Payer: EPIC Health Plan Medicare |
$12.88
|
| Rate for Payer: Heritage Provider Network Commercial |
$18.40
|
| Rate for Payer: Heritage Provider Network Senior |
$18.40
|
| Rate for Payer: Humana Medicare |
$12.88
|
| Rate for Payer: IEHP Medi-Cal |
$17.75
|
| 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 |
$5.38
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.43
|
| 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 |
$22.30
|
| 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 MONKEYPOX DNA PCR
|
Facility
OP
|
$90.00
|
|
|
Service Code
|
CPT 87593
|
| Hospital Charge Code |
900915425
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$16.29 |
| Max. Negotiated Rate |
$124.80 |
| Rate for Payer: Adventist Health Commercial |
$18.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$124.80
|
| 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: Blue Shield of California Commercial |
$55.89
|
| Rate for Payer: Blue Shield of California EPN |
$52.83
|
| 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: IEHP Medi-Cal |
$54.74
|
| 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: United Healthcare All Other HMO/non HMO |
$55.26
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$55.26
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$76.50
|
| Rate for Payer: Vantage Medical Group Senior |
$76.50
|
|
|
HC SOM MONKEYPOX DNA PCR
|
Facility
IP
|
$90.00
|
|
|
Service Code
|
CPT 87593
|
| Hospital Charge Code |
900915425
|
|
Hospital Revenue Code
|
300
|
| 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 M PNEUMONIAE AB IGM S IFA
|
Facility
IP
|
$47.00
|
|
|
Service Code
|
CPT 86738
|
| Hospital Charge Code |
900913940
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.51 |
| Max. Negotiated Rate |
$35.25 |
| Rate for Payer: Adventist Health Commercial |
$9.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$32.29
|
| Rate for Payer: Cash Price |
$21.15
|
| Rate for Payer: Heritage Provider Network Commercial |
$31.82
|
| Rate for Payer: Heritage Provider Network Senior |
$31.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.75
|
| Rate for Payer: Multiplan Commercial |
$35.25
|
|
|
HC SOM M PNEUMONIAE AB IGM S IFA
|
Facility
OP
|
$47.00
|
|
|
Service Code
|
CPT 86738
|
| Hospital Charge Code |
900913940
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.51 |
| Max. Negotiated Rate |
$110.39 |
| Rate for Payer: Adventist Health Commercial |
$9.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$38.53
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$32.29
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$19.86
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$14.56
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$13.24
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$110.39
|
| Rate for Payer: Blue Shield of California Commercial |
$103.47
|
| Rate for Payer: Blue Shield of California EPN |
$80.89
|
| Rate for Payer: Cash Price |
$21.15
|
| Rate for Payer: Cash Price |
$21.15
|
| Rate for Payer: Cigna of CA HMO/PPO |
$30.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.86
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.56
|
| Rate for Payer: Dignity Health Senior |
$13.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$30.55
|
| Rate for Payer: EPIC Health Plan Medicare |
$13.24
|
| Rate for Payer: Heritage Provider Network Commercial |
$29.09
|
| Rate for Payer: Heritage Provider Network Senior |
$29.09
|
| Rate for Payer: Humana Medicare |
$13.24
|
| Rate for Payer: IEHP Medi-Cal |
$18.36
|
| Rate for Payer: IEHP Medicare Advantage |
$13.24
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$25.16
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.51
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16.68
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16.68
|
| Rate for Payer: Multiplan Commercial |
$35.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$13.24
|
| Rate for Payer: TriValley Medical Group Senior |
$13.24
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$14.30
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$14.30
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.86
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.56
|
| Rate for Payer: Vantage Medical Group Senior |
$13.24
|
|
|
HC SOM M PROTEIN MASS FIX
|
Facility
OP
|
$50.00
|
|
|
Service Code
|
CPT 0077U
|
| Hospital Charge Code |
900915454
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$9.05 |
| Max. Negotiated Rate |
$219.77 |
| Rate for Payer: Adventist Health Commercial |
$10.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$48.74
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$34.35
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$65.14
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$47.77
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$43.43
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$219.77
|
| 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 |
$65.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$47.77
|
| Rate for Payer: Dignity Health Senior |
$43.43
|
| Rate for Payer: EPIC Health Plan Commercial |
$32.50
|
| Rate for Payer: EPIC Health Plan Medicare |
$43.43
|
| Rate for Payer: Heritage Provider Network Commercial |
$30.95
|
| Rate for Payer: Heritage Provider Network Senior |
$30.95
|
| Rate for Payer: Humana Medicare |
$43.43
|
| Rate for Payer: IEHP Medi-Cal |
$54.19
|
| Rate for Payer: IEHP Medicare Advantage |
$43.43
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$82.52
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.05
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$51.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$54.72
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$54.72
|
| Rate for Payer: Multiplan Commercial |
$37.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$43.43
|
| Rate for Payer: TriValley Medical Group Senior |
$43.43
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$46.91
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$46.91
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$65.14
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$47.77
|
| Rate for Payer: Vantage Medical Group Senior |
$43.43
|
|
|
HC SOM M PROTEIN MASS FIX
|
Facility
IP
|
$50.00
|
|
|
Service Code
|
CPT 0077U
|
| Hospital Charge Code |
900915454
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$9.05 |
| Max. Negotiated Rate |
$37.50 |
| Rate for Payer: Adventist Health Commercial |
$10.00
|
| Rate for Payer: 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 MTB PCR COMPLEX SPUTUM
|
Facility
IP
|
$243.39
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
900915433
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$44.05 |
| Max. Negotiated Rate |
$182.54 |
| Rate for Payer: Adventist Health Commercial |
$48.68
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$167.21
|
| Rate for Payer: Cash Price |
$109.53
|
| Rate for Payer: Heritage Provider Network Commercial |
$164.78
|
| Rate for Payer: Heritage Provider Network Senior |
$164.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$44.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$60.85
|
| Rate for Payer: Multiplan Commercial |
$182.54
|
|
|
HC SOM MTB PCR COMPLEX SPUTUM
|
Facility
OP
|
$243.39
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
900915433
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$35.09 |
| Max. Negotiated Rate |
$284.23 |
| Rate for Payer: Adventist Health Commercial |
$48.68
|
| Rate for Payer: Aetna of CA Gatekeeper |
$102.11
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$167.21
|
| 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 |
$109.53
|
| Rate for Payer: Cash Price |
$109.53
|
| Rate for Payer: Cigna of CA HMO/PPO |
$158.20
|
| 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 |
$158.20
|
| Rate for Payer: EPIC Health Plan Medicare |
$35.09
|
| Rate for Payer: Heritage Provider Network Commercial |
$150.66
|
| Rate for Payer: Heritage Provider Network Senior |
$150.66
|
| Rate for Payer: 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 |
$44.05
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$41.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$60.85
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$44.21
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$44.21
|
| Rate for Payer: Multiplan Commercial |
$182.54
|
| Rate for Payer: TriValley Medical Group Commercial |
$35.09
|
| Rate for Payer: TriValley Medical Group Senior |
$35.09
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$37.90
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$37.90
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$52.64
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$38.60
|
| Rate for Payer: Vantage Medical Group Senior |
$35.09
|
|
|
HC SOM MTB PCR SPUTUM
|
Facility
IP
|
$289.11
|
|
|
Service Code
|
CPT 87556
|
| Hospital Charge Code |
900915432
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$52.33 |
| Max. Negotiated Rate |
$216.83 |
| Rate for Payer: Adventist Health Commercial |
$57.82
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$198.62
|
| Rate for Payer: Cash Price |
$130.10
|
| Rate for Payer: Heritage Provider Network Commercial |
$195.73
|
| Rate for Payer: Heritage Provider Network Senior |
$195.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$52.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$72.28
|
| Rate for Payer: Multiplan Commercial |
$216.83
|
|
|
HC SOM MTB PCR SPUTUM
|
Facility
OP
|
$289.11
|
|
|
Service Code
|
CPT 87556
|
| Hospital Charge Code |
900915432
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$41.68 |
| Max. Negotiated Rate |
$284.23 |
| Rate for Payer: Adventist Health Commercial |
$57.82
|
| Rate for Payer: Aetna of CA Gatekeeper |
$102.11
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$198.62
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$62.52
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$45.85
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$41.68
|
| 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 |
$130.10
|
| Rate for Payer: Cash Price |
$130.10
|
| Rate for Payer: Cigna of CA HMO/PPO |
$187.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$62.52
|
| Rate for Payer: Dignity Health Medi-Cal |
$45.85
|
| Rate for Payer: Dignity Health Senior |
$41.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$187.92
|
| Rate for Payer: EPIC Health Plan Medicare |
$41.68
|
| Rate for Payer: Heritage Provider Network Commercial |
$178.96
|
| Rate for Payer: Heritage Provider Network Senior |
$178.96
|
| Rate for Payer: Humana Medicare |
$41.68
|
| Rate for Payer: IEHP Medi-Cal |
$52.01
|
| Rate for Payer: IEHP Medicare Advantage |
$41.68
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$79.19
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$52.33
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$49.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$72.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$52.52
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$52.52
|
| Rate for Payer: Multiplan Commercial |
$216.83
|
| Rate for Payer: TriValley Medical Group Commercial |
$41.68
|
| Rate for Payer: TriValley Medical Group Senior |
$41.68
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$45.01
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$45.01
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$62.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$45.85
|
| Rate for Payer: Vantage Medical Group Senior |
$41.68
|
|
|
HC SOM MTHFR MUTATION DETECTION
|
Facility
IP
|
$190.00
|
|
|
Service Code
|
CPT 81291
|
| Hospital Charge Code |
900914663
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$34.39 |
| Max. Negotiated Rate |
$142.50 |
| Rate for Payer: Adventist Health Commercial |
$38.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$130.53
|
| Rate for Payer: Cash Price |
$85.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$128.63
|
| Rate for Payer: Heritage Provider Network Senior |
$128.63
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$34.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$47.50
|
| Rate for Payer: Multiplan Commercial |
$142.50
|
|
|
HC SOM MTHFR MUTATION DETECTION
|
Facility
OP
|
$190.00
|
|
|
Service Code
|
CPT 81291
|
| Hospital Charge Code |
900914663
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$34.39 |
| Max. Negotiated Rate |
$382.68 |
| Rate for Payer: Adventist Health Commercial |
$38.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$113.10
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$130.53
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$98.01
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$71.87
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$65.34
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$382.68
|
| Rate for Payer: Blue Shield of California Commercial |
$117.99
|
| Rate for Payer: Blue Shield of California EPN |
$111.53
|
| Rate for Payer: Cash Price |
$85.50
|
| Rate for Payer: Cash Price |
$85.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$123.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$98.01
|
| Rate for Payer: Dignity Health Medi-Cal |
$71.87
|
| Rate for Payer: Dignity Health Senior |
$65.34
|
| Rate for Payer: EPIC Health Plan Commercial |
$123.50
|
| Rate for Payer: EPIC Health Plan Medicare |
$65.34
|
| Rate for Payer: Heritage Provider Network Commercial |
$117.61
|
| Rate for Payer: Heritage Provider Network Senior |
$117.61
|
| Rate for Payer: Humana Medicare |
$65.34
|
| Rate for Payer: IEHP Medicare Advantage |
$65.34
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$124.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$34.39
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$77.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$47.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$82.33
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$82.33
|
| Rate for Payer: Multiplan Commercial |
$142.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$65.34
|
| Rate for Payer: TriValley Medical Group Senior |
$65.34
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$70.57
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$70.57
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$98.01
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$71.87
|
| Rate for Payer: Vantage Medical Group Senior |
$65.34
|
|
|
HC SOM M. TUBERCULOSIS PCR
|
Facility
IP
|
$75.00
|
|
|
Service Code
|
CPT 87556
|
| Hospital Charge Code |
900912875
|
|
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 M. TUBERCULOSIS PCR
|
Facility
OP
|
$75.00
|
|
|
Service Code
|
CPT 87556
|
| Hospital Charge Code |
900912875
|
|
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 |
$62.52
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$45.85
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$41.68
|
| 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 |
$62.52
|
| Rate for Payer: Dignity Health Medi-Cal |
$45.85
|
| Rate for Payer: Dignity Health Senior |
$41.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$48.75
|
| Rate for Payer: EPIC Health Plan Medicare |
$41.68
|
| Rate for Payer: Heritage Provider Network Commercial |
$46.42
|
| Rate for Payer: Heritage Provider Network Senior |
$46.42
|
| Rate for Payer: Humana Medicare |
$41.68
|
| Rate for Payer: IEHP Medi-Cal |
$52.01
|
| Rate for Payer: IEHP Medicare Advantage |
$41.68
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$79.19
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13.58
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$49.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$52.52
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$52.52
|
| Rate for Payer: Multiplan Commercial |
$56.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$41.68
|
| Rate for Payer: TriValley Medical Group Senior |
$41.68
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$45.01
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$45.01
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$62.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$45.85
|
| Rate for Payer: Vantage Medical Group Senior |
$41.68
|
|
