|
HC SOM Y ENTEROCOL AB A G M
|
Facility
|
IP
|
$224.65
|
|
|
Service Code
|
CPT 86793
|
| Hospital Charge Code |
900914716
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$40.66 |
| Max. Negotiated Rate |
$168.49 |
| Rate for Payer: Adventist Health Commercial |
$44.93
|
| Rate for Payer: Cash Price |
$224.65
|
| Rate for Payer: Heritage Provider Network Commercial |
$152.09
|
| Rate for Payer: Heritage Provider Network Senior |
$152.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$40.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$56.16
|
| Rate for Payer: Multiplan Commercial |
$168.49
|
|
|
HC SOM Y ENTEROCOL AB A G M
|
Facility
|
OP
|
$224.65
|
|
|
Service Code
|
CPT 86793
|
| Hospital Charge Code |
900914716
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.19 |
| Max. Negotiated Rate |
$168.49 |
| Rate for Payer: Adventist Health Commercial |
$44.93
|
| Rate for Payer: Aetna of CA Gatekeeper |
$120.08
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$154.33
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19.79
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.51
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13.19
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$120.41
|
| Rate for Payer: Blue Shield of California Commercial |
$106.16
|
| Rate for Payer: Blue Shield of California EPN |
$85.15
|
| Rate for Payer: Cash Price |
$224.65
|
| Rate for Payer: Cash Price |
$224.65
|
| Rate for Payer: Cigna of CA HMO/PPO |
$146.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.79
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.51
|
| Rate for Payer: Dignity Health Senior |
$13.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$146.02
|
| Rate for Payer: EPIC Health Plan Medicare |
$13.19
|
| Rate for Payer: Heritage Provider Network Commercial |
$139.06
|
| Rate for Payer: Heritage Provider Network Senior |
$139.06
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$18.99
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13.19
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$107.16
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$40.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$56.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16.62
|
| Rate for Payer: Multiplan Commercial |
$168.49
|
| Rate for Payer: TriValley Medical Group Commercial |
$13.19
|
| Rate for Payer: TriValley Medical Group Senior |
$13.19
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$14.24
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$14.24
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.79
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.51
|
| Rate for Payer: Vantage Medical Group Senior |
$13.19
|
|
|
HC SOM ZINC
|
Facility
|
OP
|
$12.17
|
|
|
Service Code
|
CPT 84630
|
| Hospital Charge Code |
900911152
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.20 |
| Max. Negotiated Rate |
$104.00 |
| Rate for Payer: Adventist Health Commercial |
$2.43
|
| Rate for Payer: Aetna of CA Gatekeeper |
$6.50
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$8.36
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$17.09
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$12.53
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11.39
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$104.00
|
| Rate for Payer: Blue Shield of California Commercial |
$91.64
|
| Rate for Payer: Blue Shield of California EPN |
$73.50
|
| Rate for Payer: Cash Price |
$12.17
|
| Rate for Payer: Cash Price |
$12.17
|
| Rate for Payer: Cigna of CA HMO/PPO |
$7.91
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$17.09
|
| Rate for Payer: Dignity Health Medi-Cal |
$12.53
|
| Rate for Payer: Dignity Health Senior |
$11.39
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.91
|
| Rate for Payer: EPIC Health Plan Medicare |
$11.39
|
| Rate for Payer: Heritage Provider Network Commercial |
$7.53
|
| Rate for Payer: Heritage Provider Network Senior |
$7.53
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$16.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$11.39
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$5.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.20
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.04
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$14.35
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14.35
|
| Rate for Payer: Multiplan Commercial |
$9.13
|
| Rate for Payer: TriValley Medical Group Commercial |
$11.39
|
| Rate for Payer: TriValley Medical Group Senior |
$11.39
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$12.30
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$12.30
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$17.09
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$12.53
|
| Rate for Payer: Vantage Medical Group Senior |
$11.39
|
|
|
HC SOM ZINC
|
Facility
|
IP
|
$12.17
|
|
|
Service Code
|
CPT 84630
|
| Hospital Charge Code |
900911152
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.20 |
| Max. Negotiated Rate |
$9.13 |
| Rate for Payer: Adventist Health Commercial |
$2.43
|
| Rate for Payer: Cash Price |
$12.17
|
| Rate for Payer: Heritage Provider Network Commercial |
$8.24
|
| Rate for Payer: Heritage Provider Network Senior |
$8.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.04
|
| Rate for Payer: Multiplan Commercial |
$9.13
|
|
|
HC SOM ZINC TRANSPORTER 8 AUTOAB
|
Facility
|
OP
|
$150.00
|
|
|
Service Code
|
CPT 86341
|
| Hospital Charge Code |
900915260
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$23.57 |
| Max. Negotiated Rate |
$140.38 |
| Rate for Payer: Adventist Health Commercial |
$30.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$80.17
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$103.05
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$35.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$25.93
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$23.57
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$140.38
|
| Rate for Payer: Blue Shield of California Commercial |
$133.75
|
| Rate for Payer: Blue Shield of California EPN |
$107.28
|
| Rate for Payer: Cash Price |
$150.00
|
| Rate for Payer: Cash Price |
$150.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$97.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$35.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$25.93
|
| Rate for Payer: Dignity Health Senior |
$23.57
|
| Rate for Payer: EPIC Health Plan Commercial |
$97.50
|
| Rate for Payer: EPIC Health Plan Medicare |
$23.57
|
| Rate for Payer: Heritage Provider Network Commercial |
$92.85
|
| Rate for Payer: Heritage Provider Network Senior |
$92.85
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$29.31
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$23.57
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$71.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$27.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$27.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$37.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$29.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$29.70
|
| Rate for Payer: Multiplan Commercial |
$112.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$23.57
|
| Rate for Payer: TriValley Medical Group Senior |
$23.57
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$25.45
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$25.45
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$35.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25.93
|
| Rate for Payer: Vantage Medical Group Senior |
$23.57
|
|
|
HC SOM ZINC TRANSPORTER 8 AUTOAB
|
Facility
|
IP
|
$150.00
|
|
|
Service Code
|
CPT 86341
|
| Hospital Charge Code |
900915260
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$27.15 |
| Max. Negotiated Rate |
$112.50 |
| Rate for Payer: Adventist Health Commercial |
$30.00
|
| Rate for Payer: Cash Price |
$150.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$101.55
|
| Rate for Payer: Heritage Provider Network Senior |
$101.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$27.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$37.50
|
| Rate for Payer: Multiplan Commercial |
$112.50
|
|
|
HC SOM ZINC URINE
|
Facility
|
IP
|
$185.52
|
|
|
Service Code
|
CPT 84630
|
| Hospital Charge Code |
900911153
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$33.58 |
| Max. Negotiated Rate |
$139.14 |
| Rate for Payer: Adventist Health Commercial |
$37.10
|
| Rate for Payer: Cash Price |
$185.52
|
| Rate for Payer: Heritage Provider Network Commercial |
$125.60
|
| Rate for Payer: Heritage Provider Network Senior |
$125.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$33.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$46.38
|
| Rate for Payer: Multiplan Commercial |
$139.14
|
|
|
HC SOM ZINC URINE
|
Facility
|
OP
|
$185.52
|
|
|
Service Code
|
CPT 84630
|
| Hospital Charge Code |
900911153
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.39 |
| Max. Negotiated Rate |
$139.14 |
| Rate for Payer: Adventist Health Commercial |
$37.10
|
| Rate for Payer: Aetna of CA Gatekeeper |
$99.16
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$127.45
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$17.09
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$12.53
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11.39
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$104.00
|
| Rate for Payer: Blue Shield of California Commercial |
$91.64
|
| Rate for Payer: Blue Shield of California EPN |
$73.50
|
| Rate for Payer: Cash Price |
$185.52
|
| Rate for Payer: Cash Price |
$185.52
|
| Rate for Payer: Cigna of CA HMO/PPO |
$120.59
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$17.09
|
| Rate for Payer: Dignity Health Medi-Cal |
$12.53
|
| Rate for Payer: Dignity Health Senior |
$11.39
|
| Rate for Payer: EPIC Health Plan Commercial |
$120.59
|
| Rate for Payer: EPIC Health Plan Medicare |
$11.39
|
| Rate for Payer: Heritage Provider Network Commercial |
$114.84
|
| Rate for Payer: Heritage Provider Network Senior |
$114.84
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$16.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$11.39
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$88.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$33.58
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$46.38
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$14.35
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14.35
|
| Rate for Payer: Multiplan Commercial |
$139.14
|
| Rate for Payer: TriValley Medical Group Commercial |
$11.39
|
| Rate for Payer: TriValley Medical Group Senior |
$11.39
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$12.30
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$12.30
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$17.09
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$12.53
|
| Rate for Payer: Vantage Medical Group Senior |
$11.39
|
|
|
HC SOM ZONISAMIDE LEVEL
|
Facility
|
OP
|
$39.85
|
|
|
Service Code
|
CPT 80203
|
| Hospital Charge Code |
900912714
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.21 |
| Max. Negotiated Rate |
$104.20 |
| Rate for Payer: Adventist Health Commercial |
$7.97
|
| Rate for Payer: Aetna of CA Gatekeeper |
$21.30
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$27.38
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.57
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$72.77
|
| Rate for Payer: Blue Shield of California Commercial |
$104.20
|
| Rate for Payer: Blue Shield of California EPN |
$83.58
|
| Rate for Payer: Cash Price |
$39.85
|
| Rate for Payer: Cash Price |
$39.85
|
| Rate for Payer: Cigna of CA HMO/PPO |
$25.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.88
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.57
|
| Rate for Payer: Dignity Health Senior |
$13.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$25.90
|
| Rate for Payer: EPIC Health Plan Medicare |
$13.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$24.67
|
| Rate for Payer: Heritage Provider Network Senior |
$24.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$19.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$19.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.96
|
| 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 |
$29.89
|
| 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 |
$14.57
|
| Rate for Payer: Vantage Medical Group Senior |
$13.25
|
|
|
HC SOM ZONISAMIDE LEVEL
|
Facility
|
IP
|
$39.85
|
|
|
Service Code
|
CPT 80203
|
| Hospital Charge Code |
900912714
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.21 |
| Max. Negotiated Rate |
$29.89 |
| Rate for Payer: Adventist Health Commercial |
$7.97
|
| Rate for Payer: Cash Price |
$39.85
|
| Rate for Payer: Heritage Provider Network Commercial |
$26.98
|
| Rate for Payer: Heritage Provider Network Senior |
$26.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.96
|
| Rate for Payer: Multiplan Commercial |
$29.89
|
|
|
HC SONGI 14011200 HCV PCR QL
|
Facility
|
OP
|
$235.00
|
|
|
Service Code
|
CPT 87521
|
| Hospital Charge Code |
900914766
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$35.09 |
| Max. Negotiated Rate |
$310.02 |
| Rate for Payer: Adventist Health Commercial |
$47.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$125.61
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$161.44
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$52.63
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$38.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$35.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$310.02
|
| Rate for Payer: Blue Shield of California Commercial |
$282.47
|
| Rate for Payer: Blue Shield of California EPN |
$226.56
|
| Rate for Payer: Cash Price |
$129.25
|
| Rate for Payer: Cash Price |
$129.25
|
| Rate for Payer: Cigna of CA HMO/PPO |
$152.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$52.63
|
| Rate for Payer: Dignity Health Medi-Cal |
$38.60
|
| Rate for Payer: Dignity Health Senior |
$35.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$152.75
|
| Rate for Payer: EPIC Health Plan Medicare |
$35.09
|
| Rate for Payer: Heritage Provider Network Commercial |
$145.47
|
| Rate for Payer: Heritage Provider Network Senior |
$145.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$50.53
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$35.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$112.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$42.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$40.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$58.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$44.21
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$44.21
|
| Rate for Payer: Multiplan Commercial |
$176.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$35.09
|
| Rate for Payer: TriValley Medical Group Senior |
$35.09
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$37.90
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$37.90
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$52.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$38.60
|
| Rate for Payer: Vantage Medical Group Senior |
$35.09
|
|
|
HC SONGI 14011200 HCV PCR QL
|
Facility
|
IP
|
$235.00
|
|
|
Service Code
|
CPT 87521
|
| Hospital Charge Code |
900914766
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$42.53 |
| Max. Negotiated Rate |
$176.25 |
| Rate for Payer: Adventist Health Commercial |
$47.00
|
| Rate for Payer: Cash Price |
$129.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$159.09
|
| Rate for Payer: Heritage Provider Network Senior |
$159.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$42.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$58.75
|
| Rate for Payer: Multiplan Commercial |
$176.25
|
|
|
HC SONOHYSTEROGRAPHY W COLOR DOPP
|
Facility
|
OP
|
$995.00
|
|
|
Service Code
|
CPT 76831
|
| Hospital Charge Code |
950402003
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$122.34 |
| Max. Negotiated Rate |
$746.25 |
| Rate for Payer: Adventist Health Commercial |
$199.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$531.83
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$683.57
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$460.69
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$337.84
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$307.13
|
| Rate for Payer: Blue Shield of California Commercial |
$321.50
|
| Rate for Payer: Blue Shield of California EPN |
$258.54
|
| Rate for Payer: Cash Price |
$547.25
|
| Rate for Payer: Cash Price |
$547.25
|
| Rate for Payer: Cigna of CA HMO/PPO |
$646.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$460.69
|
| Rate for Payer: Dignity Health Medi-Cal |
$337.84
|
| Rate for Payer: Dignity Health Senior |
$307.13
|
| Rate for Payer: EPIC Health Plan Commercial |
$646.75
|
| Rate for Payer: EPIC Health Plan Medicare |
$307.13
|
| Rate for Payer: Heritage Provider Network Commercial |
$615.90
|
| Rate for Payer: Heritage Provider Network Senior |
$615.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$122.34
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$307.13
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$474.62
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$180.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$353.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$248.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$386.98
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$386.98
|
| Rate for Payer: Multiplan Commercial |
$746.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$307.13
|
| Rate for Payer: TriValley Medical Group Senior |
$307.13
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$243.41
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$243.41
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$460.69
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$337.84
|
| Rate for Payer: Vantage Medical Group Senior |
$307.13
|
|
|
HC SONOHYSTEROGRAPHY W COLOR DOPP
|
Facility
|
IP
|
$995.00
|
|
|
Service Code
|
CPT 76831
|
| Hospital Charge Code |
950402003
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$180.09 |
| Max. Negotiated Rate |
$746.25 |
| Rate for Payer: Adventist Health Commercial |
$199.00
|
| Rate for Payer: Cash Price |
$547.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$673.62
|
| Rate for Payer: Heritage Provider Network Senior |
$673.62
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$180.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$248.75
|
| Rate for Payer: Multiplan Commercial |
$746.25
|
|
|
HC SOP CELIAC PLUS
|
Facility
|
IP
|
$127.50
|
|
|
Service Code
|
CPT 88346
|
| Hospital Charge Code |
900914910
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$23.08 |
| Max. Negotiated Rate |
$95.62 |
| Rate for Payer: Adventist Health Commercial |
$25.50
|
| Rate for Payer: Cash Price |
$70.12
|
| Rate for Payer: Heritage Provider Network Commercial |
$86.32
|
| Rate for Payer: Heritage Provider Network Senior |
$86.32
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$23.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$31.88
|
| Rate for Payer: Multiplan Commercial |
$95.62
|
|
|
HC SOP CELIAC PLUS
|
Facility
|
OP
|
$127.50
|
|
|
Service Code
|
CPT 88346
|
| Hospital Charge Code |
900914910
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$23.08 |
| Max. Negotiated Rate |
$326.60 |
| Rate for Payer: Adventist Health Commercial |
$25.50
|
| Rate for Payer: Aetna of CA Gatekeeper |
$68.15
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$87.59
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$326.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$239.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$217.73
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$68.90
|
| Rate for Payer: Blue Shield of California Commercial |
$219.02
|
| Rate for Payer: Blue Shield of California EPN |
$176.13
|
| Rate for Payer: Cash Price |
$70.12
|
| Rate for Payer: Cash Price |
$70.12
|
| Rate for Payer: Cigna of CA HMO/PPO |
$82.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$326.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$239.50
|
| Rate for Payer: Dignity Health Senior |
$217.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$82.88
|
| Rate for Payer: EPIC Health Plan Medicare |
$217.73
|
| Rate for Payer: Heritage Provider Network Commercial |
$78.92
|
| Rate for Payer: Heritage Provider Network Senior |
$78.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$90.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$217.73
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$60.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$23.08
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$250.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$31.88
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$274.34
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$274.34
|
| Rate for Payer: Multiplan Commercial |
$95.62
|
| Rate for Payer: TriValley Medical Group Commercial |
$217.73
|
| Rate for Payer: TriValley Medical Group Senior |
$217.73
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$321.25
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$321.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$326.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$239.50
|
| Rate for Payer: Vantage Medical Group Senior |
$217.73
|
|
|
HC SOP CELIAC PLUS 81382
|
Facility
|
IP
|
$276.25
|
|
|
Service Code
|
CPT 81382
|
| Hospital Charge Code |
900914907
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$50.00 |
| Max. Negotiated Rate |
$207.19 |
| Rate for Payer: Adventist Health Commercial |
$55.25
|
| Rate for Payer: Cash Price |
$151.94
|
| Rate for Payer: Heritage Provider Network Commercial |
$187.02
|
| Rate for Payer: Heritage Provider Network Senior |
$187.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$50.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$69.06
|
| Rate for Payer: Multiplan Commercial |
$207.19
|
|
|
HC SOP CELIAC PLUS 81382
|
Facility
|
OP
|
$276.25
|
|
|
Service Code
|
CPT 81382
|
| Hospital Charge Code |
900914907
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$50.00 |
| Max. Negotiated Rate |
$768.90 |
| Rate for Payer: Adventist Health Commercial |
$55.25
|
| Rate for Payer: Aetna of CA Gatekeeper |
$147.66
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$189.78
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$185.52
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$136.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$123.68
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$768.90
|
| Rate for Payer: Blue Shield of California Commercial |
$168.51
|
| Rate for Payer: Blue Shield of California EPN |
$134.81
|
| Rate for Payer: Cash Price |
$151.94
|
| Rate for Payer: Cash Price |
$151.94
|
| Rate for Payer: Cigna of CA HMO/PPO |
$179.56
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$185.52
|
| Rate for Payer: Dignity Health Medi-Cal |
$136.05
|
| Rate for Payer: Dignity Health Senior |
$123.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$179.56
|
| Rate for Payer: EPIC Health Plan Medicare |
$123.68
|
| Rate for Payer: Heritage Provider Network Commercial |
$171.00
|
| Rate for Payer: Heritage Provider Network Senior |
$171.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$178.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$123.68
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$131.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$50.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$142.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$69.06
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$155.84
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$155.84
|
| Rate for Payer: Multiplan Commercial |
$207.19
|
| Rate for Payer: TriValley Medical Group Commercial |
$123.68
|
| Rate for Payer: TriValley Medical Group Senior |
$123.68
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$133.57
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$133.57
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$185.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$136.05
|
| Rate for Payer: Vantage Medical Group Senior |
$123.68
|
|
|
HC SOP CELIAC PLUS 82784
|
Facility
|
OP
|
$21.26
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
900914909
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$3.85 |
| Max. Negotiated Rate |
$74.82 |
| Rate for Payer: Adventist Health Commercial |
$4.25
|
| Rate for Payer: Aetna of CA Gatekeeper |
$11.36
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$14.61
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9.30
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$70.74
|
| Rate for Payer: Blue Shield of California Commercial |
$74.82
|
| Rate for Payer: Blue Shield of California EPN |
$60.01
|
| Rate for Payer: Cash Price |
$11.69
|
| Rate for Payer: Cash Price |
$11.69
|
| Rate for Payer: Cigna of CA HMO/PPO |
$13.82
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$10.23
|
| Rate for Payer: Dignity Health Senior |
$9.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.82
|
| Rate for Payer: EPIC Health Plan Medicare |
$9.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$13.16
|
| Rate for Payer: Heritage Provider Network Senior |
$13.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$9.85
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$9.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$10.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.85
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11.72
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11.72
|
| Rate for Payer: Multiplan Commercial |
$15.95
|
| Rate for Payer: TriValley Medical Group Commercial |
$9.30
|
| Rate for Payer: TriValley Medical Group Senior |
$9.30
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$10.04
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$10.04
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.23
|
| Rate for Payer: Vantage Medical Group Senior |
$9.30
|
|
|
HC SOP CELIAC PLUS 82784
|
Facility
|
IP
|
$21.26
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
900914909
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$3.85 |
| Max. Negotiated Rate |
$15.95 |
| Rate for Payer: Adventist Health Commercial |
$4.25
|
| Rate for Payer: Cash Price |
$11.69
|
| Rate for Payer: Heritage Provider Network Commercial |
$14.39
|
| Rate for Payer: Heritage Provider Network Senior |
$14.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.32
|
| Rate for Payer: Multiplan Commercial |
$15.95
|
|
|
HC SOP CELIAC PLUS 83520
|
Facility
|
OP
|
$32.58
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
900914908
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$5.90 |
| Max. Negotiated Rate |
$118.19 |
| Rate for Payer: Adventist Health Commercial |
$6.52
|
| Rate for Payer: Aetna of CA Gatekeeper |
$17.41
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$22.38
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$25.91
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$17.27
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$118.19
|
| Rate for Payer: Blue Shield of California Commercial |
$104.20
|
| Rate for Payer: Blue Shield of California EPN |
$83.58
|
| Rate for Payer: Cash Price |
$17.92
|
| Rate for Payer: Cash Price |
$17.92
|
| Rate for Payer: Cigna of CA HMO/PPO |
$21.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$25.91
|
| Rate for Payer: Dignity Health Medi-Cal |
$19.00
|
| Rate for Payer: Dignity Health Senior |
$17.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$21.18
|
| Rate for Payer: EPIC Health Plan Medicare |
$17.27
|
| Rate for Payer: Heritage Provider Network Commercial |
$20.17
|
| Rate for Payer: Heritage Provider Network Senior |
$20.17
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$16.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$17.27
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$15.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$19.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.14
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$21.76
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$21.76
|
| Rate for Payer: Multiplan Commercial |
$24.43
|
| Rate for Payer: TriValley Medical Group Commercial |
$17.27
|
| Rate for Payer: TriValley Medical Group Senior |
$17.27
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$18.65
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$18.65
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$25.91
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.00
|
| Rate for Payer: Vantage Medical Group Senior |
$17.27
|
|
|
HC SOP CELIAC PLUS 83520
|
Facility
|
IP
|
$32.58
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
900914908
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$5.90 |
| Max. Negotiated Rate |
$24.43 |
| Rate for Payer: Adventist Health Commercial |
$6.52
|
| Rate for Payer: Cash Price |
$17.92
|
| Rate for Payer: Heritage Provider Network Commercial |
$22.06
|
| Rate for Payer: Heritage Provider Network Senior |
$22.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.14
|
| Rate for Payer: Multiplan Commercial |
$24.43
|
|
|
HC SOP CELIAC SEROLOGY
|
Facility
|
IP
|
$127.50
|
|
|
Service Code
|
CPT 88346
|
| Hospital Charge Code |
900914914
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$23.08 |
| Max. Negotiated Rate |
$95.62 |
| Rate for Payer: Adventist Health Commercial |
$25.50
|
| Rate for Payer: Cash Price |
$70.12
|
| Rate for Payer: Heritage Provider Network Commercial |
$86.32
|
| Rate for Payer: Heritage Provider Network Senior |
$86.32
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$23.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$31.88
|
| Rate for Payer: Multiplan Commercial |
$95.62
|
|
|
HC SOP CELIAC SEROLOGY
|
Facility
|
OP
|
$127.50
|
|
|
Service Code
|
CPT 88346
|
| Hospital Charge Code |
900914914
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$23.08 |
| Max. Negotiated Rate |
$326.60 |
| Rate for Payer: Adventist Health Commercial |
$25.50
|
| Rate for Payer: Aetna of CA Gatekeeper |
$68.15
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$87.59
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$326.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$239.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$217.73
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$68.90
|
| Rate for Payer: Blue Shield of California Commercial |
$219.02
|
| Rate for Payer: Blue Shield of California EPN |
$176.13
|
| Rate for Payer: Cash Price |
$70.12
|
| Rate for Payer: Cash Price |
$70.12
|
| Rate for Payer: Cigna of CA HMO/PPO |
$82.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$326.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$239.50
|
| Rate for Payer: Dignity Health Senior |
$217.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$82.88
|
| Rate for Payer: EPIC Health Plan Medicare |
$217.73
|
| Rate for Payer: Heritage Provider Network Commercial |
$78.92
|
| Rate for Payer: Heritage Provider Network Senior |
$78.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$90.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$217.73
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$60.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$23.08
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$250.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$31.88
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$274.34
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$274.34
|
| Rate for Payer: Multiplan Commercial |
$95.62
|
| Rate for Payer: TriValley Medical Group Commercial |
$217.73
|
| Rate for Payer: TriValley Medical Group Senior |
$217.73
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$321.25
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$321.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$326.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$239.50
|
| Rate for Payer: Vantage Medical Group Senior |
$217.73
|
|
|
HC SOP TPMT ENZYME
|
Facility
|
OP
|
$93.50
|
|
|
Service Code
|
CPT 82542
|
| Hospital Charge Code |
900914906
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$16.92 |
| Max. Negotiated Rate |
$164.17 |
| Rate for Payer: Adventist Health Commercial |
$18.70
|
| Rate for Payer: Aetna of CA Gatekeeper |
$49.98
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$64.23
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$36.13
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$26.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$24.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$164.17
|
| Rate for Payer: Blue Shield of California Commercial |
$145.32
|
| Rate for Payer: Blue Shield of California EPN |
$116.56
|
| Rate for Payer: Cash Price |
$51.43
|
| Rate for Payer: Cash Price |
$51.43
|
| Rate for Payer: Cigna of CA HMO/PPO |
$60.77
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$36.13
|
| Rate for Payer: Dignity Health Medi-Cal |
$26.50
|
| Rate for Payer: Dignity Health Senior |
$24.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$60.77
|
| Rate for Payer: EPIC Health Plan Medicare |
$24.09
|
| Rate for Payer: Heritage Provider Network Commercial |
$57.88
|
| Rate for Payer: Heritage Provider Network Senior |
$57.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$24.87
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$24.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$44.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$16.92
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$27.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23.38
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$30.35
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$30.35
|
| Rate for Payer: Multiplan Commercial |
$70.12
|
| Rate for Payer: TriValley Medical Group Commercial |
$24.09
|
| Rate for Payer: TriValley Medical Group Senior |
$24.09
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$26.02
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$26.02
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$36.13
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$26.50
|
| Rate for Payer: Vantage Medical Group Senior |
$24.09
|
|
