|
HC SOM Q FEVER AB SCREEN
|
Facility
|
OP
|
$40.10
|
|
|
Service Code
|
CPT 86638
|
| Hospital Charge Code |
900915440
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$7.26 |
| Max. Negotiated Rate |
$115.24 |
| Rate for Payer: Adventist Health Commercial |
$8.02
|
| Rate for Payer: Aetna of CA Gatekeeper |
$21.43
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$27.55
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$18.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13.33
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$115.24
|
| Rate for Payer: Blue Shield of California Commercial |
$97.57
|
| Rate for Payer: Blue Shield of California EPN |
$78.26
|
| Rate for Payer: Cash Price |
$40.10
|
| Rate for Payer: Cash Price |
$40.10
|
| Rate for Payer: Cigna of CA HMO/PPO |
$26.07
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$18.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.33
|
| Rate for Payer: Dignity Health Senior |
$12.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.07
|
| Rate for Payer: EPIC Health Plan Medicare |
$12.12
|
| Rate for Payer: Heritage Provider Network Commercial |
$24.82
|
| Rate for Payer: Heritage Provider Network Senior |
$24.82
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$17.46
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$12.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$19.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7.26
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.03
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$15.27
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$15.27
|
| Rate for Payer: Multiplan Commercial |
$30.07
|
| Rate for Payer: TriValley Medical Group Commercial |
$12.12
|
| Rate for Payer: TriValley Medical Group Senior |
$12.12
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$13.09
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$13.09
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$18.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.33
|
| Rate for Payer: Vantage Medical Group Senior |
$12.12
|
|
|
HC SOM Q FEVER IGG PHAS I
|
Facility
|
OP
|
$10.02
|
|
|
Service Code
|
CPT 86638
|
| Hospital Charge Code |
900914336
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$1.81 |
| Max. Negotiated Rate |
$115.24 |
| Rate for Payer: Adventist Health Commercial |
$2.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$5.36
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$6.88
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$18.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13.33
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$115.24
|
| Rate for Payer: Blue Shield of California Commercial |
$97.57
|
| Rate for Payer: Blue Shield of California EPN |
$78.26
|
| Rate for Payer: Cash Price |
$10.02
|
| Rate for Payer: Cash Price |
$10.02
|
| Rate for Payer: Cigna of CA HMO/PPO |
$6.51
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$18.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.33
|
| Rate for Payer: Dignity Health Senior |
$12.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.51
|
| Rate for Payer: EPIC Health Plan Medicare |
$12.12
|
| Rate for Payer: Heritage Provider Network Commercial |
$6.20
|
| Rate for Payer: Heritage Provider Network Senior |
$6.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$17.46
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$12.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$4.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$15.27
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$15.27
|
| Rate for Payer: Multiplan Commercial |
$7.51
|
| Rate for Payer: TriValley Medical Group Commercial |
$12.12
|
| Rate for Payer: TriValley Medical Group Senior |
$12.12
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$13.09
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$13.09
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$18.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.33
|
| Rate for Payer: Vantage Medical Group Senior |
$12.12
|
|
|
HC SOM Q FEVER IGG PHAS I
|
Facility
|
IP
|
$10.02
|
|
|
Service Code
|
CPT 86638
|
| Hospital Charge Code |
900914336
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$1.81 |
| Max. Negotiated Rate |
$7.51 |
| Rate for Payer: Adventist Health Commercial |
$2.00
|
| Rate for Payer: Cash Price |
$10.02
|
| Rate for Payer: Heritage Provider Network Commercial |
$6.78
|
| Rate for Payer: Heritage Provider Network Senior |
$6.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.50
|
| Rate for Payer: Multiplan Commercial |
$7.51
|
|
|
HC SOM Q FEVER IGG PHAS II
|
Facility
|
IP
|
$10.02
|
|
|
Service Code
|
CPT 86638
|
| Hospital Charge Code |
900914334
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$1.81 |
| Max. Negotiated Rate |
$7.51 |
| Rate for Payer: Adventist Health Commercial |
$2.00
|
| Rate for Payer: Cash Price |
$10.02
|
| Rate for Payer: Heritage Provider Network Commercial |
$6.78
|
| Rate for Payer: Heritage Provider Network Senior |
$6.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.50
|
| Rate for Payer: Multiplan Commercial |
$7.51
|
|
|
HC SOM Q FEVER IGG PHAS II
|
Facility
|
OP
|
$10.02
|
|
|
Service Code
|
CPT 86638
|
| Hospital Charge Code |
900914334
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$1.81 |
| Max. Negotiated Rate |
$115.24 |
| Rate for Payer: Adventist Health Commercial |
$2.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$5.36
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$6.88
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$18.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13.33
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$115.24
|
| Rate for Payer: Blue Shield of California Commercial |
$97.57
|
| Rate for Payer: Blue Shield of California EPN |
$78.26
|
| Rate for Payer: Cash Price |
$10.02
|
| Rate for Payer: Cash Price |
$10.02
|
| Rate for Payer: Cigna of CA HMO/PPO |
$6.51
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$18.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.33
|
| Rate for Payer: Dignity Health Senior |
$12.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.51
|
| Rate for Payer: EPIC Health Plan Medicare |
$12.12
|
| Rate for Payer: Heritage Provider Network Commercial |
$6.20
|
| Rate for Payer: Heritage Provider Network Senior |
$6.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$17.46
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$12.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$4.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$15.27
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$15.27
|
| Rate for Payer: Multiplan Commercial |
$7.51
|
| Rate for Payer: TriValley Medical Group Commercial |
$12.12
|
| Rate for Payer: TriValley Medical Group Senior |
$12.12
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$13.09
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$13.09
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$18.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.33
|
| Rate for Payer: Vantage Medical Group Senior |
$12.12
|
|
|
HC SOM Q FEVER IGM PHAS I
|
Facility
|
OP
|
$10.03
|
|
|
Service Code
|
CPT 86638
|
| Hospital Charge Code |
900914337
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$1.82 |
| Max. Negotiated Rate |
$115.24 |
| Rate for Payer: Adventist Health Commercial |
$2.01
|
| Rate for Payer: Aetna of CA Gatekeeper |
$5.36
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$6.89
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$18.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13.33
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$115.24
|
| Rate for Payer: Blue Shield of California Commercial |
$97.57
|
| Rate for Payer: Blue Shield of California EPN |
$78.26
|
| Rate for Payer: Cash Price |
$10.03
|
| Rate for Payer: Cash Price |
$10.03
|
| Rate for Payer: Cigna of CA HMO/PPO |
$6.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$18.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.33
|
| Rate for Payer: Dignity Health Senior |
$12.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.52
|
| Rate for Payer: EPIC Health Plan Medicare |
$12.12
|
| Rate for Payer: Heritage Provider Network Commercial |
$6.21
|
| Rate for Payer: Heritage Provider Network Senior |
$6.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$17.46
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$12.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$4.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.51
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$15.27
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$15.27
|
| Rate for Payer: Multiplan Commercial |
$7.52
|
| Rate for Payer: TriValley Medical Group Commercial |
$12.12
|
| Rate for Payer: TriValley Medical Group Senior |
$12.12
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$13.09
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$13.09
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$18.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.33
|
| Rate for Payer: Vantage Medical Group Senior |
$12.12
|
|
|
HC SOM Q FEVER IGM PHAS I
|
Facility
|
IP
|
$10.03
|
|
|
Service Code
|
CPT 86638
|
| Hospital Charge Code |
900914337
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$1.82 |
| Max. Negotiated Rate |
$7.52 |
| Rate for Payer: Adventist Health Commercial |
$2.01
|
| Rate for Payer: Cash Price |
$10.03
|
| Rate for Payer: Heritage Provider Network Commercial |
$6.79
|
| Rate for Payer: Heritage Provider Network Senior |
$6.79
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.51
|
| Rate for Payer: Multiplan Commercial |
$7.52
|
|
|
HC SOM Q FEVER IGM PHAS II
|
Facility
|
IP
|
$10.03
|
|
|
Service Code
|
CPT 86638
|
| Hospital Charge Code |
900914335
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$1.82 |
| Max. Negotiated Rate |
$7.52 |
| Rate for Payer: Adventist Health Commercial |
$2.01
|
| Rate for Payer: Cash Price |
$10.03
|
| Rate for Payer: Heritage Provider Network Commercial |
$6.79
|
| Rate for Payer: Heritage Provider Network Senior |
$6.79
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.51
|
| Rate for Payer: Multiplan Commercial |
$7.52
|
|
|
HC SOM Q FEVER IGM PHAS II
|
Facility
|
OP
|
$10.03
|
|
|
Service Code
|
CPT 86638
|
| Hospital Charge Code |
900914335
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$1.82 |
| Max. Negotiated Rate |
$115.24 |
| Rate for Payer: Adventist Health Commercial |
$2.01
|
| Rate for Payer: Aetna of CA Gatekeeper |
$5.36
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$6.89
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$18.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13.33
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$115.24
|
| Rate for Payer: Blue Shield of California Commercial |
$97.57
|
| Rate for Payer: Blue Shield of California EPN |
$78.26
|
| Rate for Payer: Cash Price |
$10.03
|
| Rate for Payer: Cash Price |
$10.03
|
| Rate for Payer: Cigna of CA HMO/PPO |
$6.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$18.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.33
|
| Rate for Payer: Dignity Health Senior |
$12.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.52
|
| Rate for Payer: EPIC Health Plan Medicare |
$12.12
|
| Rate for Payer: Heritage Provider Network Commercial |
$6.21
|
| Rate for Payer: Heritage Provider Network Senior |
$6.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$17.46
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$12.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$4.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.51
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$15.27
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$15.27
|
| Rate for Payer: Multiplan Commercial |
$7.52
|
| Rate for Payer: TriValley Medical Group Commercial |
$12.12
|
| Rate for Payer: TriValley Medical Group Senior |
$12.12
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$13.09
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$13.09
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$18.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.33
|
| Rate for Payer: Vantage Medical Group Senior |
$12.12
|
|
|
HC SOM QUANTIFERON TB GOLD
|
Facility
|
OP
|
$40.00
|
|
|
Service Code
|
CPT 86480
|
| Hospital Charge Code |
900912882
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$7.24 |
| Max. Negotiated Rate |
$553.47 |
| Rate for Payer: Adventist Health Commercial |
$8.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$21.38
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$27.48
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$92.97
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$68.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$61.98
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$553.47
|
| Rate for Payer: Blue Shield of California Commercial |
$498.76
|
| Rate for Payer: Blue Shield of California EPN |
$400.05
|
| Rate for Payer: Cash Price |
$40.00
|
| Rate for Payer: Cash Price |
$40.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$26.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$92.97
|
| Rate for Payer: Dignity Health Medi-Cal |
$68.18
|
| Rate for Payer: Dignity Health Senior |
$61.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$61.98
|
| Rate for Payer: Heritage Provider Network Commercial |
$24.76
|
| Rate for Payer: Heritage Provider Network Senior |
$24.76
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$70.29
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$61.98
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$19.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7.24
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$71.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$78.09
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$78.09
|
| Rate for Payer: Multiplan Commercial |
$30.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$61.98
|
| Rate for Payer: TriValley Medical Group Senior |
$61.98
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$66.94
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$66.94
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$92.97
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$68.18
|
| Rate for Payer: Vantage Medical Group Senior |
$61.98
|
|
|
HC SOM QUANTIFERON TB GOLD
|
Facility
|
IP
|
$40.00
|
|
|
Service Code
|
CPT 86480
|
| Hospital Charge Code |
900912882
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$7.24 |
| Max. Negotiated Rate |
$30.00 |
| Rate for Payer: Adventist Health Commercial |
$8.00
|
| Rate for Payer: Cash Price |
$40.00
|
| 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 RENIN ACT PLASMA
|
Facility
|
IP
|
$13.72
|
|
|
Service Code
|
CPT 84244
|
| Hospital Charge Code |
900910955
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.48 |
| Max. Negotiated Rate |
$10.29 |
| Rate for Payer: Adventist Health Commercial |
$2.74
|
| Rate for Payer: Cash Price |
$13.72
|
| Rate for Payer: Heritage Provider Network Commercial |
$9.29
|
| Rate for Payer: Heritage Provider Network Senior |
$9.29
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.43
|
| Rate for Payer: Multiplan Commercial |
$10.29
|
|
|
HC SOM RENIN ACT PLASMA
|
Facility
|
OP
|
$13.72
|
|
|
Service Code
|
CPT 84244
|
| Hospital Charge Code |
900910955
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.48 |
| Max. Negotiated Rate |
$200.80 |
| Rate for Payer: Adventist Health Commercial |
$2.74
|
| Rate for Payer: Aetna of CA Gatekeeper |
$7.33
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$9.43
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$32.98
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$24.19
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$21.99
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$200.80
|
| Rate for Payer: Blue Shield of California Commercial |
$177.00
|
| Rate for Payer: Blue Shield of California EPN |
$141.97
|
| Rate for Payer: Cash Price |
$13.72
|
| Rate for Payer: Cash Price |
$13.72
|
| Rate for Payer: Cigna of CA HMO/PPO |
$8.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$32.98
|
| Rate for Payer: Dignity Health Medi-Cal |
$24.19
|
| Rate for Payer: Dignity Health Senior |
$21.99
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.92
|
| Rate for Payer: EPIC Health Plan Medicare |
$21.99
|
| Rate for Payer: Heritage Provider Network Commercial |
$8.49
|
| Rate for Payer: Heritage Provider Network Senior |
$8.49
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$31.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$21.99
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$6.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.43
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$27.71
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$27.71
|
| Rate for Payer: Multiplan Commercial |
$10.29
|
| Rate for Payer: TriValley Medical Group Commercial |
$21.99
|
| Rate for Payer: TriValley Medical Group Senior |
$21.99
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$23.75
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$23.75
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$32.98
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$24.19
|
| Rate for Payer: Vantage Medical Group Senior |
$21.99
|
|
|
HC SOM REPTILASE TIME
|
Facility
|
IP
|
$40.00
|
|
|
Service Code
|
CPT 85635
|
| Hospital Charge Code |
900910114
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$7.24 |
| Max. Negotiated Rate |
$30.00 |
| Rate for Payer: Adventist Health Commercial |
$8.00
|
| Rate for Payer: Cash Price |
$40.00
|
| 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 REPTILASE TIME
|
Facility
|
OP
|
$40.00
|
|
|
Service Code
|
CPT 85635
|
| Hospital Charge Code |
900910114
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$7.24 |
| Max. Negotiated Rate |
$89.92 |
| Rate for Payer: Adventist Health Commercial |
$8.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$21.38
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$27.48
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$14.78
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10.84
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9.85
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$89.92
|
| Rate for Payer: Blue Shield of California Commercial |
$79.26
|
| Rate for Payer: Blue Shield of California EPN |
$63.57
|
| Rate for Payer: Cash Price |
$40.00
|
| Rate for Payer: Cash Price |
$40.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$26.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$14.78
|
| Rate for Payer: Dignity Health Medi-Cal |
$10.84
|
| Rate for Payer: Dignity Health Senior |
$9.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$9.85
|
| Rate for Payer: Heritage Provider Network Commercial |
$24.76
|
| Rate for Payer: Heritage Provider Network Senior |
$24.76
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$14.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$9.85
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$19.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7.24
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$11.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$12.41
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$12.41
|
| Rate for Payer: Multiplan Commercial |
$30.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$9.85
|
| Rate for Payer: TriValley Medical Group Senior |
$9.85
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$10.64
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$10.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$14.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.84
|
| Rate for Payer: Vantage Medical Group Senior |
$9.85
|
|
|
HC SOM RESPIRATORY PANEL VARIES
|
Facility
|
IP
|
$350.00
|
|
|
Service Code
|
CPT 0202U
|
| Hospital Charge Code |
900915466
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$63.35 |
| Max. Negotiated Rate |
$262.50 |
| Rate for Payer: Adventist Health Commercial |
$70.00
|
| Rate for Payer: Cash Price |
$350.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$236.95
|
| Rate for Payer: Heritage Provider Network Senior |
$236.95
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$63.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$87.50
|
| Rate for Payer: Multiplan Commercial |
$262.50
|
|
|
HC SOM RESPIRATORY PANEL VARIES
|
Facility
|
OP
|
$350.00
|
|
|
Service Code
|
CPT 0202U
|
| Hospital Charge Code |
900915466
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$63.35 |
| Max. Negotiated Rate |
$2,400.65 |
| Rate for Payer: Adventist Health Commercial |
$70.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$187.07
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$240.45
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$625.17
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$458.46
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$416.78
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,291.09
|
| Rate for Payer: Blue Shield of California Commercial |
$2,400.65
|
| Rate for Payer: Blue Shield of California EPN |
$1,925.52
|
| Rate for Payer: Cash Price |
$350.00
|
| Rate for Payer: Cash Price |
$350.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$227.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$625.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$458.46
|
| Rate for Payer: Dignity Health Senior |
$416.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$227.50
|
| Rate for Payer: EPIC Health Plan Medicare |
$416.78
|
| Rate for Payer: Heritage Provider Network Commercial |
$216.65
|
| Rate for Payer: Heritage Provider Network Senior |
$216.65
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$540.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$416.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$166.95
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$63.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$479.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$87.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$525.14
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$525.14
|
| Rate for Payer: Multiplan Commercial |
$262.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$416.78
|
| Rate for Payer: TriValley Medical Group Senior |
$416.78
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$450.12
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$450.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$625.17
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$458.46
|
| Rate for Payer: Vantage Medical Group Senior |
$416.78
|
|
|
HC SOM RIBOSOMAL P AB
|
Facility
|
IP
|
$30.00
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
900911367
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.43 |
| Max. Negotiated Rate |
$22.50 |
| Rate for Payer: Adventist Health Commercial |
$6.00
|
| Rate for Payer: Cash Price |
$30.00
|
| 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 RIBOSOMAL P AB
|
Facility
|
OP
|
$30.00
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
900911367
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.43 |
| Max. Negotiated Rate |
$213.58 |
| Rate for Payer: Adventist Health Commercial |
$6.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$16.04
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$20.61
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$17.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$12.68
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11.53
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$213.58
|
| Rate for Payer: Blue Shield of California Commercial |
$74.76
|
| Rate for Payer: Blue Shield of California EPN |
$59.97
|
| Rate for Payer: Cash Price |
$30.00
|
| Rate for Payer: Cash Price |
$30.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$19.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$17.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$12.68
|
| Rate for Payer: Dignity Health Senior |
$11.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.50
|
| Rate for Payer: EPIC Health Plan Medicare |
$11.53
|
| Rate for Payer: Heritage Provider Network Commercial |
$18.57
|
| Rate for Payer: Heritage Provider Network Senior |
$18.57
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$13.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$11.53
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$14.31
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.43
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$14.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14.53
|
| Rate for Payer: Multiplan Commercial |
$22.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$11.53
|
| Rate for Payer: TriValley Medical Group Senior |
$11.53
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$12.46
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$12.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$17.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$12.68
|
| Rate for Payer: Vantage Medical Group Senior |
$11.53
|
|
|
HC SOM RISPERIDONE
|
Facility
|
IP
|
$85.96
|
|
|
Service Code
|
CPT 80342
|
| Hospital Charge Code |
900910787
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.56 |
| Max. Negotiated Rate |
$64.47 |
| Rate for Payer: Adventist Health Commercial |
$17.19
|
| Rate for Payer: Cash Price |
$85.96
|
| Rate for Payer: Heritage Provider Network Commercial |
$58.19
|
| Rate for Payer: Heritage Provider Network Senior |
$58.19
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$15.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$21.49
|
| Rate for Payer: Multiplan Commercial |
$64.47
|
|
|
HC SOM RISPERIDONE
|
Facility
|
OP
|
$85.96
|
|
|
Service Code
|
CPT 80342
|
| Hospital Charge Code |
900910787
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.56 |
| Max. Negotiated Rate |
$136.39 |
| Rate for Payer: Adventist Health Commercial |
$17.19
|
| Rate for Payer: Aetna of CA Gatekeeper |
$45.95
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$59.05
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$73.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$47.28
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$64.47
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$136.39
|
| Rate for Payer: Cash Price |
$85.96
|
| Rate for Payer: Cash Price |
$85.96
|
| Rate for Payer: Cigna of CA HMO/PPO |
$55.87
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$73.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$73.07
|
| Rate for Payer: Dignity Health Senior |
$73.07
|
| Rate for Payer: EPIC Health Plan Commercial |
$55.87
|
| Rate for Payer: Heritage Provider Network Commercial |
$53.21
|
| Rate for Payer: Heritage Provider Network Senior |
$53.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$41.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$15.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$21.49
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$60.17
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$60.17
|
| Rate for Payer: Multiplan Commercial |
$64.47
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$42.98
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$42.98
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$73.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$73.07
|
| Rate for Payer: Vantage Medical Group Senior |
$73.07
|
|
|
HC SOM RISTOCETIN-WILLEBRAND FACTOR
|
Facility
|
IP
|
$40.00
|
|
|
Service Code
|
CPT 85245
|
| Hospital Charge Code |
900911282
|
|
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: Cash Price |
$40.00
|
| 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 RISTOCETIN-WILLEBRAND FACTOR
|
Facility
|
OP
|
$40.00
|
|
|
Service Code
|
CPT 85245
|
| Hospital Charge Code |
900911282
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.24 |
| Max. Negotiated Rate |
$209.47 |
| Rate for Payer: Adventist Health Commercial |
$8.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$21.38
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$27.48
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$34.41
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$25.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$22.94
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$209.47
|
| Rate for Payer: Blue Shield of California Commercial |
$184.67
|
| Rate for Payer: Blue Shield of California EPN |
$148.12
|
| Rate for Payer: Cash Price |
$40.00
|
| Rate for Payer: Cash Price |
$40.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$26.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$34.41
|
| Rate for Payer: Dignity Health Medi-Cal |
$25.23
|
| Rate for Payer: Dignity Health Senior |
$22.94
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$22.94
|
| Rate for Payer: Heritage Provider Network Commercial |
$24.76
|
| Rate for Payer: Heritage Provider Network Senior |
$24.76
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$33.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$22.94
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$19.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7.24
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$26.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$28.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$28.90
|
| Rate for Payer: Multiplan Commercial |
$30.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$22.94
|
| Rate for Payer: TriValley Medical Group Senior |
$22.94
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$24.78
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$24.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$34.41
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25.23
|
| Rate for Payer: Vantage Medical Group Senior |
$22.94
|
|
|
HC SOM SACCHAROMY CEREVI AB, IGA
|
Facility
|
IP
|
$18.54
|
|
|
Service Code
|
CPT 86671
|
| Hospital Charge Code |
900913806
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.36 |
| Max. Negotiated Rate |
$13.90 |
| Rate for Payer: Adventist Health Commercial |
$3.71
|
| Rate for Payer: Cash Price |
$18.54
|
| Rate for Payer: Heritage Provider Network Commercial |
$12.55
|
| Rate for Payer: Heritage Provider Network Senior |
$12.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.63
|
| Rate for Payer: Multiplan Commercial |
$13.90
|
|
|
HC SOM SACCHAROMY CEREVI AB, IGA
|
Facility
|
OP
|
$169.30
|
|
|
Service Code
|
CPT 86671
|
| Hospital Charge Code |
900913805
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.25 |
| Max. Negotiated Rate |
$126.97 |
| Rate for Payer: Adventist Health Commercial |
$33.86
|
| Rate for Payer: Aetna of CA Gatekeeper |
$90.49
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$116.31
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$18.38
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13.47
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$117.64
|
| Rate for Payer: Blue Shield of California Commercial |
$98.67
|
| Rate for Payer: Blue Shield of California EPN |
$79.14
|
| Rate for Payer: Cash Price |
$169.30
|
| Rate for Payer: Cash Price |
$169.30
|
| Rate for Payer: Cigna of CA HMO/PPO |
$110.05
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$18.38
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.47
|
| Rate for Payer: Dignity Health Senior |
$12.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$110.05
|
| Rate for Payer: EPIC Health Plan Medicare |
$12.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$104.80
|
| Rate for Payer: Heritage Provider Network Senior |
$104.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$17.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$12.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$80.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$30.64
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$42.33
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$15.44
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$15.44
|
| Rate for Payer: Multiplan Commercial |
$126.97
|
| Rate for Payer: TriValley Medical Group Commercial |
$12.25
|
| Rate for Payer: TriValley Medical Group Senior |
$12.25
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$13.24
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$13.24
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$18.38
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.47
|
| Rate for Payer: Vantage Medical Group Senior |
$12.25
|
|
