|
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: 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 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 |
$195.82 |
| Rate for Payer: Adventist Health Commercial |
$6.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$27.02
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$20.61
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$17.30
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$12.68
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$11.53
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$195.82
|
| 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 |
$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 |
$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: Humana Medicare |
$11.53
|
| Rate for Payer: IEHP Medi-Cal |
$13.42
|
| Rate for Payer: IEHP Medicare Advantage |
$11.53
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$21.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.43
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13.61
|
| 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 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: 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 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 |
$192.04 |
| Rate for Payer: Adventist Health Commercial |
$8.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$66.77
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$27.48
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$34.41
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$25.23
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$22.94
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$192.04
|
| Rate for Payer: Blue Shield of California Commercial |
$179.22
|
| Rate for Payer: Blue Shield of California EPN |
$140.10
|
| 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 |
$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: Humana Medicare |
$22.94
|
| Rate for Payer: IEHP Medi-Cal |
$31.81
|
| Rate for Payer: IEHP Medicare Advantage |
$22.94
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$43.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7.24
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$27.07
|
| 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
OP
|
$18.54
|
|
|
Service Code
|
CPT 86671
|
| Hospital Charge Code |
900913806
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.36 |
| Max. Negotiated Rate |
$107.86 |
| Rate for Payer: Adventist Health Commercial |
$3.71
|
| Rate for Payer: Aetna of CA Gatekeeper |
$35.66
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$12.74
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$18.38
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$13.48
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$12.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$107.86
|
| Rate for Payer: Blue Shield of California Commercial |
$95.76
|
| Rate for Payer: Blue Shield of California EPN |
$74.86
|
| Rate for Payer: Cash Price |
$8.34
|
| Rate for Payer: Cash Price |
$8.34
|
| Rate for Payer: Cigna of CA HMO/PPO |
$12.05
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$18.38
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.48
|
| Rate for Payer: Dignity Health Senior |
$12.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.05
|
| Rate for Payer: EPIC Health Plan Medicare |
$12.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$11.48
|
| Rate for Payer: Heritage Provider Network Senior |
$11.48
|
| Rate for Payer: Humana Medicare |
$12.25
|
| Rate for Payer: IEHP Medi-Cal |
$16.99
|
| Rate for Payer: IEHP Medicare Advantage |
$12.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$23.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.36
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.64
|
| 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 |
$13.90
|
| 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 |
$13.48
|
| Rate for Payer: Vantage Medical Group Senior |
$12.25
|
|
|
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: Aetna of CA Non-Gatekeeper |
$12.74
|
| Rate for Payer: Cash Price |
$8.34
|
| 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 |
$4.64
|
| Rate for Payer: Multiplan Commercial |
$13.90
|
|
|
HC SOM SACCHAROMY CEREVI AB, IGA
|
Facility
IP
|
$169.30
|
|
|
Service Code
|
CPT 86671
|
| Hospital Charge Code |
900913805
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$30.64 |
| Max. Negotiated Rate |
$126.98 |
| Rate for Payer: Adventist Health Commercial |
$33.86
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$116.31
|
| Rate for Payer: Cash Price |
$76.19
|
| Rate for Payer: Heritage Provider Network Commercial |
$114.62
|
| Rate for Payer: Heritage Provider Network Senior |
$114.62
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$30.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$42.32
|
| Rate for Payer: Multiplan Commercial |
$126.98
|
|
|
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 |
$126.98 |
| Rate for Payer: Adventist Health Commercial |
$33.86
|
| Rate for Payer: Aetna of CA Gatekeeper |
$35.66
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$116.31
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$18.38
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$13.48
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$12.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$107.86
|
| Rate for Payer: Blue Shield of California Commercial |
$95.76
|
| Rate for Payer: Blue Shield of California EPN |
$74.86
|
| Rate for Payer: Cash Price |
$76.19
|
| Rate for Payer: Cash Price |
$76.19
|
| Rate for Payer: Cigna of CA HMO/PPO |
$110.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$18.38
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.48
|
| Rate for Payer: Dignity Health Senior |
$12.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$110.04
|
| 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: Humana Medicare |
$12.25
|
| Rate for Payer: IEHP Medi-Cal |
$16.99
|
| Rate for Payer: IEHP Medicare Advantage |
$12.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$23.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$30.64
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$42.32
|
| 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 |
$126.98
|
| 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 |
$13.48
|
| Rate for Payer: Vantage Medical Group Senior |
$12.25
|
|
|
HC SOM SAL 86606
|
Facility
IP
|
$21.57
|
|
|
Service Code
|
CPT 86606
|
| Hospital Charge Code |
900914751
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.90 |
| Max. Negotiated Rate |
$16.18 |
| Rate for Payer: Adventist Health Commercial |
$4.31
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$14.82
|
| Rate for Payer: Cash Price |
$9.71
|
| Rate for Payer: Heritage Provider Network Commercial |
$14.60
|
| Rate for Payer: Heritage Provider Network Senior |
$14.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.39
|
| Rate for Payer: Multiplan Commercial |
$16.18
|
|
|
HC SOM SAL 86606
|
Facility
OP
|
$21.57
|
|
|
Service Code
|
CPT 86606
|
| Hospital Charge Code |
900914751
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.90 |
| Max. Negotiated Rate |
$126.00 |
| Rate for Payer: Adventist Health Commercial |
$4.31
|
| Rate for Payer: Aetna of CA Gatekeeper |
$43.81
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$14.82
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$22.58
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$16.56
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$15.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$126.00
|
| Rate for Payer: Blue Shield of California Commercial |
$117.56
|
| Rate for Payer: Blue Shield of California EPN |
$91.90
|
| Rate for Payer: Cash Price |
$9.71
|
| Rate for Payer: Cash Price |
$9.71
|
| Rate for Payer: Cigna of CA HMO/PPO |
$14.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$22.58
|
| Rate for Payer: Dignity Health Medi-Cal |
$16.56
|
| Rate for Payer: Dignity Health Senior |
$15.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.02
|
| Rate for Payer: EPIC Health Plan Medicare |
$15.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$13.35
|
| Rate for Payer: Heritage Provider Network Senior |
$13.35
|
| Rate for Payer: Humana Medicare |
$15.05
|
| Rate for Payer: IEHP Medi-Cal |
$20.87
|
| Rate for Payer: IEHP Medicare Advantage |
$15.05
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$28.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$17.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.39
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18.96
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18.96
|
| Rate for Payer: Multiplan Commercial |
$16.18
|
| Rate for Payer: TriValley Medical Group Commercial |
$15.05
|
| Rate for Payer: TriValley Medical Group Senior |
$15.05
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$16.26
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$16.26
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$22.58
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$16.56
|
| Rate for Payer: Vantage Medical Group Senior |
$15.05
|
|
|
HC SOM SAL 86671A
|
Facility
OP
|
$17.55
|
|
|
Service Code
|
CPT 86671
|
| Hospital Charge Code |
900914749
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.18 |
| Max. Negotiated Rate |
$107.86 |
| Rate for Payer: Adventist Health Commercial |
$3.51
|
| Rate for Payer: Aetna of CA Gatekeeper |
$35.66
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$12.06
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$18.38
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$13.48
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$12.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$107.86
|
| Rate for Payer: Blue Shield of California Commercial |
$95.76
|
| Rate for Payer: Blue Shield of California EPN |
$74.86
|
| Rate for Payer: Cash Price |
$7.90
|
| Rate for Payer: Cash Price |
$7.90
|
| Rate for Payer: Cigna of CA HMO/PPO |
$11.41
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$18.38
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.48
|
| Rate for Payer: Dignity Health Senior |
$12.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.41
|
| Rate for Payer: EPIC Health Plan Medicare |
$12.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$10.86
|
| Rate for Payer: Heritage Provider Network Senior |
$10.86
|
| Rate for Payer: Humana Medicare |
$12.25
|
| Rate for Payer: IEHP Medi-Cal |
$16.99
|
| Rate for Payer: IEHP Medicare Advantage |
$12.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$23.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.18
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.39
|
| 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 |
$13.16
|
| 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 |
$13.48
|
| Rate for Payer: Vantage Medical Group Senior |
$12.25
|
|
|
HC SOM SAL 86671A
|
Facility
IP
|
$17.55
|
|
|
Service Code
|
CPT 86671
|
| Hospital Charge Code |
900914749
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.18 |
| Max. Negotiated Rate |
$13.16 |
| Rate for Payer: Adventist Health Commercial |
$3.51
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$12.06
|
| Rate for Payer: Cash Price |
$7.90
|
| Rate for Payer: Heritage Provider Network Commercial |
$11.88
|
| Rate for Payer: Heritage Provider Network Senior |
$11.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.39
|
| Rate for Payer: Multiplan Commercial |
$13.16
|
|
|
HC SOM SAL 86671B
|
Facility
OP
|
$17.56
|
|
|
Service Code
|
CPT 86671
|
| Hospital Charge Code |
900914750
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.18 |
| Max. Negotiated Rate |
$107.86 |
| Rate for Payer: Adventist Health Commercial |
$3.51
|
| Rate for Payer: Aetna of CA Gatekeeper |
$35.66
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$12.06
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$18.38
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$13.48
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$12.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$107.86
|
| Rate for Payer: Blue Shield of California Commercial |
$95.76
|
| Rate for Payer: Blue Shield of California EPN |
$74.86
|
| Rate for Payer: Cash Price |
$7.90
|
| Rate for Payer: Cash Price |
$7.90
|
| Rate for Payer: Cigna of CA HMO/PPO |
$11.41
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$18.38
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.48
|
| Rate for Payer: Dignity Health Senior |
$12.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.41
|
| Rate for Payer: EPIC Health Plan Medicare |
$12.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$10.87
|
| Rate for Payer: Heritage Provider Network Senior |
$10.87
|
| Rate for Payer: Humana Medicare |
$12.25
|
| Rate for Payer: IEHP Medi-Cal |
$16.99
|
| Rate for Payer: IEHP Medicare Advantage |
$12.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$23.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.18
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.39
|
| 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 |
$13.17
|
| 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 |
$13.48
|
| Rate for Payer: Vantage Medical Group Senior |
$12.25
|
|
|
HC SOM SAL 86671B
|
Facility
IP
|
$17.56
|
|
|
Service Code
|
CPT 86671
|
| Hospital Charge Code |
900914750
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.18 |
| Max. Negotiated Rate |
$13.17 |
| Rate for Payer: Adventist Health Commercial |
$3.51
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$12.06
|
| Rate for Payer: Cash Price |
$7.90
|
| Rate for Payer: Heritage Provider Network Commercial |
$11.89
|
| Rate for Payer: Heritage Provider Network Senior |
$11.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.39
|
| Rate for Payer: Multiplan Commercial |
$13.17
|
|
|
HC SOM SARS-COV-2 IGG
|
Facility
IP
|
$43.00
|
|
|
Service Code
|
CPT 86769
|
| Hospital Charge Code |
900915349
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.78 |
| Max. Negotiated Rate |
$32.25 |
| Rate for Payer: Adventist Health Commercial |
$8.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$29.54
|
| Rate for Payer: Cash Price |
$19.35
|
| Rate for Payer: Heritage Provider Network Commercial |
$29.11
|
| Rate for Payer: Heritage Provider Network Senior |
$29.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.75
|
| Rate for Payer: Multiplan Commercial |
$32.25
|
|
|
HC SOM SARS-COV-2 IGG
|
Facility
OP
|
$43.00
|
|
|
Service Code
|
CPT 86769
|
| Hospital Charge Code |
900915349
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.78 |
| Max. Negotiated Rate |
$247.94 |
| Rate for Payer: Adventist Health Commercial |
$8.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$102.47
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$29.54
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$63.20
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$46.34
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$42.13
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$247.94
|
| Rate for Payer: Blue Shield of California Commercial |
$26.70
|
| Rate for Payer: Blue Shield of California EPN |
$25.24
|
| Rate for Payer: Cash Price |
$19.35
|
| Rate for Payer: Cash Price |
$19.35
|
| Rate for Payer: Cigna of CA HMO/PPO |
$27.95
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$63.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$46.34
|
| Rate for Payer: Dignity Health Senior |
$42.13
|
| Rate for Payer: EPIC Health Plan Commercial |
$27.95
|
| Rate for Payer: EPIC Health Plan Medicare |
$42.13
|
| Rate for Payer: Heritage Provider Network Commercial |
$26.62
|
| Rate for Payer: Heritage Provider Network Senior |
$26.62
|
| Rate for Payer: Humana Medicare |
$42.13
|
| Rate for Payer: IEHP Medi-Cal |
$65.72
|
| Rate for Payer: IEHP Medicare Advantage |
$42.13
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$80.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$49.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$53.08
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$53.08
|
| Rate for Payer: Multiplan Commercial |
$32.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$42.13
|
| Rate for Payer: TriValley Medical Group Senior |
$42.13
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$45.50
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$45.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$63.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$46.34
|
| Rate for Payer: Vantage Medical Group Senior |
$42.13
|
|
|
HC SOM SCHISTOSOMIASIS AB IGG
|
Facility
IP
|
$88.49
|
|
|
Service Code
|
CPT 86682
|
| Hospital Charge Code |
900911335
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.02 |
| Max. Negotiated Rate |
$66.37 |
| Rate for Payer: Adventist Health Commercial |
$17.70
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$60.79
|
| Rate for Payer: Cash Price |
$39.82
|
| Rate for Payer: Heritage Provider Network Commercial |
$59.91
|
| Rate for Payer: Heritage Provider Network Senior |
$59.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$16.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.12
|
| Rate for Payer: Multiplan Commercial |
$66.37
|
|
|
HC SOM SCHISTOSOMIASIS AB IGG
|
Facility
OP
|
$88.49
|
|
|
Service Code
|
CPT 86682
|
| Hospital Charge Code |
900911335
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.01 |
| Max. Negotiated Rate |
$109.88 |
| Rate for Payer: Adventist Health Commercial |
$17.70
|
| Rate for Payer: Aetna of CA Gatekeeper |
$37.85
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$60.79
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$19.52
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$14.31
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$13.01
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$109.88
|
| Rate for Payer: Blue Shield of California Commercial |
$101.57
|
| Rate for Payer: Blue Shield of California EPN |
$79.40
|
| Rate for Payer: Cash Price |
$39.82
|
| Rate for Payer: Cash Price |
$39.82
|
| Rate for Payer: Cigna of CA HMO/PPO |
$57.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.52
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.31
|
| Rate for Payer: Dignity Health Senior |
$13.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$57.52
|
| Rate for Payer: EPIC Health Plan Medicare |
$13.01
|
| Rate for Payer: Heritage Provider Network Commercial |
$54.78
|
| Rate for Payer: Heritage Provider Network Senior |
$54.78
|
| Rate for Payer: Humana Medicare |
$13.01
|
| Rate for Payer: IEHP Medi-Cal |
$18.03
|
| Rate for Payer: IEHP Medicare Advantage |
$13.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$24.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$16.02
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16.39
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16.39
|
| Rate for Payer: Multiplan Commercial |
$66.37
|
| Rate for Payer: TriValley Medical Group Commercial |
$13.01
|
| Rate for Payer: TriValley Medical Group Senior |
$13.01
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$14.05
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$14.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.31
|
| Rate for Payer: Vantage Medical Group Senior |
$13.01
|
|
|
HC SOM SECOBARBITAL
|
Facility
OP
|
$228.60
|
|
|
Service Code
|
CPT 80345
|
| Hospital Charge Code |
900910552
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$0.02 |
| Max. Negotiated Rate |
$194.31 |
| Rate for Payer: Adventist Health Commercial |
$45.72
|
| Rate for Payer: Aetna of CA Gatekeeper |
$0.02
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$157.05
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$194.31
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$125.73
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$171.45
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$91.96
|
| Rate for Payer: Cash Price |
$102.87
|
| Rate for Payer: Cash Price |
$102.87
|
| Rate for Payer: Cigna of CA HMO/PPO |
$148.59
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$194.31
|
| Rate for Payer: Dignity Health Medi-Cal |
$194.31
|
| Rate for Payer: Dignity Health Senior |
$194.31
|
| Rate for Payer: EPIC Health Plan Commercial |
$148.59
|
| Rate for Payer: Heritage Provider Network Commercial |
$141.50
|
| Rate for Payer: Heritage Provider Network Senior |
$141.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$110.19
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$41.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$57.15
|
| Rate for Payer: Multiplan Commercial |
$171.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$194.31
|
| Rate for Payer: Vantage Medical Group Senior |
$194.31
|
|
|
HC SOM SECOBARBITAL
|
Facility
IP
|
$228.60
|
|
|
Service Code
|
CPT 80345
|
| Hospital Charge Code |
900910552
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$41.38 |
| Max. Negotiated Rate |
$171.45 |
| Rate for Payer: Adventist Health Commercial |
$45.72
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$157.05
|
| Rate for Payer: Cash Price |
$102.87
|
| Rate for Payer: Heritage Provider Network Commercial |
$154.76
|
| Rate for Payer: Heritage Provider Network Senior |
$154.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$41.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$57.15
|
| Rate for Payer: Multiplan Commercial |
$171.45
|
|
|
HC SOM SELENIUM URINE
|
Facility
OP
|
$25.62
|
|
|
Service Code
|
CPT 84255
|
| Hospital Charge Code |
900911019
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.64 |
| Max. Negotiated Rate |
$213.74 |
| Rate for Payer: Adventist Health Commercial |
$5.12
|
| Rate for Payer: Aetna of CA Gatekeeper |
$74.28
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$17.60
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$38.30
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$28.08
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$25.53
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$213.74
|
| Rate for Payer: Blue Shield of California Commercial |
$199.40
|
| Rate for Payer: Blue Shield of California EPN |
$155.88
|
| Rate for Payer: Cash Price |
$11.53
|
| Rate for Payer: Cash Price |
$11.53
|
| Rate for Payer: Cigna of CA HMO/PPO |
$16.65
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$38.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$28.08
|
| Rate for Payer: Dignity Health Senior |
$25.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.65
|
| Rate for Payer: EPIC Health Plan Medicare |
$25.53
|
| Rate for Payer: Heritage Provider Network Commercial |
$15.86
|
| Rate for Payer: Heritage Provider Network Senior |
$15.86
|
| Rate for Payer: Humana Medicare |
$25.53
|
| Rate for Payer: IEHP Medi-Cal |
$35.40
|
| Rate for Payer: IEHP Medicare Advantage |
$25.53
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$48.51
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.64
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$30.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$32.17
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$32.17
|
| Rate for Payer: Multiplan Commercial |
$19.22
|
| Rate for Payer: TriValley Medical Group Commercial |
$25.53
|
| Rate for Payer: TriValley Medical Group Senior |
$25.53
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$27.58
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$27.58
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$38.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$28.08
|
| Rate for Payer: Vantage Medical Group Senior |
$25.53
|
|
|
HC SOM SELENIUM URINE
|
Facility
IP
|
$25.62
|
|
|
Service Code
|
CPT 84255
|
| Hospital Charge Code |
900911019
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.64 |
| Max. Negotiated Rate |
$19.22 |
| Rate for Payer: Adventist Health Commercial |
$5.12
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$17.60
|
| Rate for Payer: Cash Price |
$11.53
|
| Rate for Payer: Heritage Provider Network Commercial |
$17.34
|
| Rate for Payer: Heritage Provider Network Senior |
$17.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.40
|
| Rate for Payer: Multiplan Commercial |
$19.22
|
|
|
HC SOM SEROTONIN BLOOD
|
Facility
IP
|
$30.00
|
|
|
Service Code
|
CPT 84260
|
| Hospital Charge Code |
900911033
|
|
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: 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 SEROTONIN BLOOD
|
Facility
OP
|
$30.00
|
|
|
Service Code
|
CPT 84260
|
| Hospital Charge Code |
900911033
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.43 |
| Max. Negotiated Rate |
$259.27 |
| Rate for Payer: Adventist Health Commercial |
$6.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$90.12
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$20.61
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$46.47
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$34.08
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$30.98
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$259.27
|
| Rate for Payer: Blue Shield of California Commercial |
$241.94
|
| Rate for Payer: Blue Shield of California EPN |
$189.13
|
| 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 |
$46.47
|
| Rate for Payer: Dignity Health Medi-Cal |
$34.08
|
| Rate for Payer: Dignity Health Senior |
$30.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.50
|
| Rate for Payer: EPIC Health Plan Medicare |
$30.98
|
| Rate for Payer: Heritage Provider Network Commercial |
$18.57
|
| Rate for Payer: Heritage Provider Network Senior |
$18.57
|
| Rate for Payer: Humana Medicare |
$30.98
|
| Rate for Payer: IEHP Medi-Cal |
$42.96
|
| Rate for Payer: IEHP Medicare Advantage |
$30.98
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$58.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.43
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$36.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$39.03
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$39.03
|
| Rate for Payer: Multiplan Commercial |
$22.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$30.98
|
| Rate for Payer: TriValley Medical Group Senior |
$30.98
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$33.46
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$33.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$46.47
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$34.08
|
| Rate for Payer: Vantage Medical Group Senior |
$30.98
|
|
|
HC SOM SEX HORMN BINDNG GLOBU SER
|
Facility
OP
|
$13.00
|
|
|
Service Code
|
CPT 84270
|
| Hospital Charge Code |
900913804
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.35 |
| Max. Negotiated Rate |
$181.79 |
| Rate for Payer: Adventist Health Commercial |
$2.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$63.22
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$8.93
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$32.60
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$23.90
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$21.73
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$181.79
|
| Rate for Payer: Blue Shield of California Commercial |
$169.71
|
| Rate for Payer: Blue Shield of California EPN |
$132.67
|
| Rate for Payer: Cash Price |
$5.85
|
| Rate for Payer: Cash Price |
$5.85
|
| Rate for Payer: Cigna of CA HMO/PPO |
$8.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$32.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$23.90
|
| Rate for Payer: Dignity Health Senior |
$21.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.45
|
| Rate for Payer: EPIC Health Plan Medicare |
$21.73
|
| Rate for Payer: Heritage Provider Network Commercial |
$8.05
|
| Rate for Payer: Heritage Provider Network Senior |
$8.05
|
| Rate for Payer: Humana Medicare |
$21.73
|
| Rate for Payer: IEHP Medi-Cal |
$29.20
|
| Rate for Payer: IEHP Medicare Advantage |
$21.73
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$41.29
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$27.38
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$27.38
|
| Rate for Payer: Multiplan Commercial |
$9.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$21.73
|
| Rate for Payer: TriValley Medical Group Senior |
$21.73
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$23.47
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$23.47
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$32.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$23.90
|
| Rate for Payer: Vantage Medical Group Senior |
$21.73
|
|
