Loma Linda University Behavioral Medicine Center (BMC)

All Charges

Charge

Type

Setting

Price

HC CULTURE QUANT ANAEROBIC

Facility

$429.00

Service Code	CPT 87073
Hospital Charge Code	900912434
Hospital Revenue Code	306
Min. Negotiated Rate	$235.95
Max. Negotiated Rate	$343.20
Rate for Payer: Cash Price	$193.05
Rate for Payer: Evernorth Behavioral Health (Cigna Behavioral Health) - HMO HMO/PPO	$343.20
Rate for Payer: Health Smart Auto/Commercial	$257.40
Rate for Payer: LLUH Dept of Risk Management WC	$235.95
Rate for Payer: Multiplan Commercial	$321.75

HC CULTURE QUANTITATIVE

Facility

$73.00

Service Code	CPT 87071
Hospital Charge Code	900912409
Hospital Revenue Code	306
Min. Negotiated Rate	$9.89
Max. Negotiated Rate	$58.40
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$43.80
Rate for Payer: Aetna of CA Government/Medicare	$43.80
Rate for Payer: Cash Price	$32.85
Rate for Payer: Cash Price	$32.85
Rate for Payer: Evernorth Behavioral Health (Cigna Behavioral Health) - HMO HMO/PPO	$58.40
Rate for Payer: Health Smart Auto/Commercial	$43.80
Rate for Payer: Intervalley Health Plan Commercial	$9.89
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$43.80
Rate for Payer: LLUH Dept of Risk Management WC	$40.15
Rate for Payer: Multiplan Commercial	$54.75

HC CULTURE QUANTITATIVE

Facility

$390.00

Service Code	CPT 87071
Hospital Charge Code	900912409
Hospital Revenue Code	306
Min. Negotiated Rate	$214.50
Max. Negotiated Rate	$312.00
Rate for Payer: Cash Price	$175.50
Rate for Payer: Evernorth Behavioral Health (Cigna Behavioral Health) - HMO HMO/PPO	$312.00
Rate for Payer: Health Smart Auto/Commercial	$234.00
Rate for Payer: LLUH Dept of Risk Management WC	$214.50
Rate for Payer: Multiplan Commercial	$292.50

HC CULTURE RAPID NEG ID3

Facility

$200.00

Service Code	CPT 87077
Hospital Charge Code	900912415
Hospital Revenue Code	306
Min. Negotiated Rate	$110.00
Max. Negotiated Rate	$160.00
Rate for Payer: Cash Price	$90.00
Rate for Payer: Evernorth Behavioral Health (Cigna Behavioral Health) - HMO HMO/PPO	$160.00
Rate for Payer: Health Smart Auto/Commercial	$120.00
Rate for Payer: LLUH Dept of Risk Management WC	$110.00
Rate for Payer: Multiplan Commercial	$150.00

HC CULTURE RAPID NEG ID3

Facility

$72.00

Service Code	CPT 87077
Hospital Charge Code	900912415
Hospital Revenue Code	306
Min. Negotiated Rate	$8.08
Max. Negotiated Rate	$57.60
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$43.20
Rate for Payer: Aetna of CA Government/Medicare	$43.20
Rate for Payer: Cash Price	$32.40
Rate for Payer: Cash Price	$32.40
Rate for Payer: Evernorth Behavioral Health (Cigna Behavioral Health) - HMO HMO/PPO	$57.60
Rate for Payer: Health Smart Auto/Commercial	$43.20
Rate for Payer: Intervalley Health Plan Commercial	$8.08
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$43.20
Rate for Payer: LLUH Dept of Risk Management WC	$39.60
Rate for Payer: Multiplan Commercial	$54.00

HC CULTURE RESPIRATORY

Facility

$92.00

Service Code	CPT 87070
Hospital Charge Code	900912435
Hospital Revenue Code	306
Min. Negotiated Rate	$8.62
Max. Negotiated Rate	$73.60
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$55.20
Rate for Payer: Aetna of CA Government/Medicare	$55.20
Rate for Payer: Cash Price	$41.40
Rate for Payer: Cash Price	$41.40
Rate for Payer: Evernorth Behavioral Health (Cigna Behavioral Health) - HMO HMO/PPO	$73.60
Rate for Payer: Health Smart Auto/Commercial	$55.20
Rate for Payer: Intervalley Health Plan Commercial	$8.62
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$55.20
Rate for Payer: LLUH Dept of Risk Management WC	$50.60
Rate for Payer: Multiplan Commercial	$69.00

HC CULTURE RESPIRATORY

Facility

$390.00

Service Code	CPT 87070
Hospital Charge Code	900912435
Hospital Revenue Code	306
Min. Negotiated Rate	$214.50
Max. Negotiated Rate	$312.00
Rate for Payer: Cash Price	$175.50
Rate for Payer: Evernorth Behavioral Health (Cigna Behavioral Health) - HMO HMO/PPO	$312.00
Rate for Payer: Health Smart Auto/Commercial	$234.00
Rate for Payer: LLUH Dept of Risk Management WC	$214.50
Rate for Payer: Multiplan Commercial	$292.50

HC CULTURE SPUTUM

Facility

$84.00

Service Code	CPT 87070
Hospital Charge Code	900911513
Hospital Revenue Code	306
Min. Negotiated Rate	$8.62
Max. Negotiated Rate	$67.20
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$50.40
Rate for Payer: Aetna of CA Government/Medicare	$50.40
Rate for Payer: Cash Price	$37.80
Rate for Payer: Cash Price	$37.80
Rate for Payer: Evernorth Behavioral Health (Cigna Behavioral Health) - HMO HMO/PPO	$67.20
Rate for Payer: Health Smart Auto/Commercial	$50.40
Rate for Payer: Intervalley Health Plan Commercial	$8.62
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$50.40
Rate for Payer: LLUH Dept of Risk Management WC	$46.20
Rate for Payer: Multiplan Commercial	$63.00

HC CULTURE SPUTUM

Facility

$390.00

Service Code	CPT 87070
Hospital Charge Code	900911513
Hospital Revenue Code	306
Min. Negotiated Rate	$214.50
Max. Negotiated Rate	$312.00
Rate for Payer: Cash Price	$175.50
Rate for Payer: Evernorth Behavioral Health (Cigna Behavioral Health) - HMO HMO/PPO	$312.00
Rate for Payer: Health Smart Auto/Commercial	$234.00
Rate for Payer: LLUH Dept of Risk Management WC	$214.50
Rate for Payer: Multiplan Commercial	$292.50

HC CULTURE STAPHAUREX

Facility

$77.00

Service Code	CPT 87147
Hospital Charge Code	900912421
Hospital Revenue Code	306
Min. Negotiated Rate	$42.35
Max. Negotiated Rate	$61.60
Rate for Payer: Cash Price	$34.65
Rate for Payer: Evernorth Behavioral Health (Cigna Behavioral Health) - HMO HMO/PPO	$61.60
Rate for Payer: Health Smart Auto/Commercial	$46.20
Rate for Payer: LLUH Dept of Risk Management WC	$42.35
Rate for Payer: Multiplan Commercial	$57.75

HC CULTURE STAPHAUREX

Facility

$46.00

Service Code	CPT 87147
Hospital Charge Code	900912421
Hospital Revenue Code	306
Min. Negotiated Rate	$5.18
Max. Negotiated Rate	$36.80
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$27.60
Rate for Payer: Aetna of CA Government/Medicare	$27.60
Rate for Payer: Cash Price	$20.70
Rate for Payer: Cash Price	$20.70
Rate for Payer: Evernorth Behavioral Health (Cigna Behavioral Health) - HMO HMO/PPO	$36.80
Rate for Payer: Health Smart Auto/Commercial	$27.60
Rate for Payer: Intervalley Health Plan Commercial	$5.18
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$27.60
Rate for Payer: LLUH Dept of Risk Management WC	$25.30
Rate for Payer: Multiplan Commercial	$34.50

HC CULTURE STOOL

Facility

$390.00

Service Code	CPT 87045
Hospital Charge Code	900911514
Hospital Revenue Code	306
Min. Negotiated Rate	$214.50
Max. Negotiated Rate	$312.00
Rate for Payer: Cash Price	$175.50
Rate for Payer: Evernorth Behavioral Health (Cigna Behavioral Health) - HMO HMO/PPO	$312.00
Rate for Payer: Health Smart Auto/Commercial	$234.00
Rate for Payer: LLUH Dept of Risk Management WC	$214.50
Rate for Payer: Multiplan Commercial	$292.50

HC CULTURE STOOL

Facility

$76.00

Service Code	CPT 87045
Hospital Charge Code	900911514
Hospital Revenue Code	306
Min. Negotiated Rate	$9.44
Max. Negotiated Rate	$60.80
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$45.60
Rate for Payer: Aetna of CA Government/Medicare	$45.60
Rate for Payer: Cash Price	$34.20
Rate for Payer: Cash Price	$34.20
Rate for Payer: Evernorth Behavioral Health (Cigna Behavioral Health) - HMO HMO/PPO	$60.80
Rate for Payer: Health Smart Auto/Commercial	$45.60
Rate for Payer: Intervalley Health Plan Commercial	$9.44
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$45.60
Rate for Payer: LLUH Dept of Risk Management WC	$41.80
Rate for Payer: Multiplan Commercial	$57.00

HC CULTURE STREPTOCARD

Facility

$103.00

Service Code	CPT 87147
Hospital Charge Code	900912420
Hospital Revenue Code	306
Min. Negotiated Rate	$56.65
Max. Negotiated Rate	$82.40
Rate for Payer: Cash Price	$46.35
Rate for Payer: Evernorth Behavioral Health (Cigna Behavioral Health) - HMO HMO/PPO	$82.40
Rate for Payer: Health Smart Auto/Commercial	$61.80
Rate for Payer: LLUH Dept of Risk Management WC	$56.65
Rate for Payer: Multiplan Commercial	$77.25

HC CULTURE STREPTOCARD

Facility

$46.00

Service Code	CPT 87147
Hospital Charge Code	900912420
Hospital Revenue Code	306
Min. Negotiated Rate	$5.18
Max. Negotiated Rate	$36.80
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$27.60
Rate for Payer: Aetna of CA Government/Medicare	$27.60
Rate for Payer: Cash Price	$20.70
Rate for Payer: Cash Price	$20.70
Rate for Payer: Evernorth Behavioral Health (Cigna Behavioral Health) - HMO HMO/PPO	$36.80
Rate for Payer: Health Smart Auto/Commercial	$27.60
Rate for Payer: Intervalley Health Plan Commercial	$5.18
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$27.60
Rate for Payer: LLUH Dept of Risk Management WC	$25.30
Rate for Payer: Multiplan Commercial	$34.50

HC CULTURE SURGICAL WOUND

Facility

$92.00

Service Code	CPT 87070
Hospital Charge Code	900912436
Hospital Revenue Code	306
Min. Negotiated Rate	$8.62
Max. Negotiated Rate	$73.60
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$55.20
Rate for Payer: Aetna of CA Government/Medicare	$55.20
Rate for Payer: Cash Price	$41.40
Rate for Payer: Cash Price	$41.40
Rate for Payer: Evernorth Behavioral Health (Cigna Behavioral Health) - HMO HMO/PPO	$73.60
Rate for Payer: Health Smart Auto/Commercial	$55.20
Rate for Payer: Intervalley Health Plan Commercial	$8.62
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$55.20
Rate for Payer: LLUH Dept of Risk Management WC	$50.60
Rate for Payer: Multiplan Commercial	$69.00

HC CULTURE SURGICAL WOUND

Facility

$390.00

Service Code	CPT 87070
Hospital Charge Code	900912436
Hospital Revenue Code	306
Min. Negotiated Rate	$214.50
Max. Negotiated Rate	$312.00
Rate for Payer: Cash Price	$175.50
Rate for Payer: Evernorth Behavioral Health (Cigna Behavioral Health) - HMO HMO/PPO	$312.00
Rate for Payer: Health Smart Auto/Commercial	$234.00
Rate for Payer: LLUH Dept of Risk Management WC	$214.50
Rate for Payer: Multiplan Commercial	$292.50

HC CULTURE THROAT

Facility

$76.00

Service Code	CPT 87070
Hospital Charge Code	900911515
Hospital Revenue Code	306
Min. Negotiated Rate	$8.62
Max. Negotiated Rate	$60.80
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$45.60
Rate for Payer: Aetna of CA Government/Medicare	$45.60
Rate for Payer: Cash Price	$34.20
Rate for Payer: Cash Price	$34.20
Rate for Payer: Evernorth Behavioral Health (Cigna Behavioral Health) - HMO HMO/PPO	$60.80
Rate for Payer: Health Smart Auto/Commercial	$45.60
Rate for Payer: Intervalley Health Plan Commercial	$8.62
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$45.60
Rate for Payer: LLUH Dept of Risk Management WC	$41.80
Rate for Payer: Multiplan Commercial	$57.00

HC CULTURE THROAT

Facility

$232.00

Service Code	CPT 87070
Hospital Charge Code	900911515
Hospital Revenue Code	306
Min. Negotiated Rate	$127.60
Max. Negotiated Rate	$185.60
Rate for Payer: Cash Price	$104.40
Rate for Payer: Evernorth Behavioral Health (Cigna Behavioral Health) - HMO HMO/PPO	$185.60
Rate for Payer: Health Smart Auto/Commercial	$139.20
Rate for Payer: LLUH Dept of Risk Management WC	$127.60
Rate for Payer: Multiplan Commercial	$174.00

HC CULTURE TISSUE

Facility

$84.00

Service Code	CPT 87070
Hospital Charge Code	900911516
Hospital Revenue Code	306
Min. Negotiated Rate	$8.62
Max. Negotiated Rate	$67.20
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$50.40
Rate for Payer: Aetna of CA Government/Medicare	$50.40
Rate for Payer: Cash Price	$37.80
Rate for Payer: Cash Price	$37.80
Rate for Payer: Evernorth Behavioral Health (Cigna Behavioral Health) - HMO HMO/PPO	$67.20
Rate for Payer: Health Smart Auto/Commercial	$50.40
Rate for Payer: Intervalley Health Plan Commercial	$8.62
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$50.40
Rate for Payer: LLUH Dept of Risk Management WC	$46.20
Rate for Payer: Multiplan Commercial	$63.00

HC CULTURE TISSUE

Facility

$390.00

Service Code	CPT 87070
Hospital Charge Code	900911516
Hospital Revenue Code	306
Min. Negotiated Rate	$214.50
Max. Negotiated Rate	$312.00
Rate for Payer: Cash Price	$175.50
Rate for Payer: Evernorth Behavioral Health (Cigna Behavioral Health) - HMO HMO/PPO	$312.00
Rate for Payer: Health Smart Auto/Commercial	$234.00
Rate for Payer: LLUH Dept of Risk Management WC	$214.50
Rate for Payer: Multiplan Commercial	$292.50

HC CULTURE TRACHEAL ASPIRATE

Facility

$84.00

Service Code	CPT 87070
Hospital Charge Code	900911517
Hospital Revenue Code	306
Min. Negotiated Rate	$8.62
Max. Negotiated Rate	$67.20
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$50.40
Rate for Payer: Aetna of CA Government/Medicare	$50.40
Rate for Payer: Cash Price	$37.80
Rate for Payer: Cash Price	$37.80
Rate for Payer: Evernorth Behavioral Health (Cigna Behavioral Health) - HMO HMO/PPO	$67.20
Rate for Payer: Health Smart Auto/Commercial	$50.40
Rate for Payer: Intervalley Health Plan Commercial	$8.62
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$50.40
Rate for Payer: LLUH Dept of Risk Management WC	$46.20
Rate for Payer: Multiplan Commercial	$63.00

HC CULTURE TRACHEAL ASPIRATE

Facility

$390.00

Service Code	CPT 87070
Hospital Charge Code	900911517
Hospital Revenue Code	306
Min. Negotiated Rate	$214.50
Max. Negotiated Rate	$312.00
Rate for Payer: Cash Price	$175.50
Rate for Payer: Evernorth Behavioral Health (Cigna Behavioral Health) - HMO HMO/PPO	$312.00
Rate for Payer: Health Smart Auto/Commercial	$234.00
Rate for Payer: LLUH Dept of Risk Management WC	$214.50
Rate for Payer: Multiplan Commercial	$292.50

HC CULTURE URINE

Facility

$35.88

Service Code	CPT 87088
Hospital Charge Code	900911530
Hospital Revenue Code	300
Min. Negotiated Rate	$8.09
Max. Negotiated Rate	$28.70
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$21.53
Rate for Payer: Aetna of CA Government/Medicare	$21.53
Rate for Payer: Cash Price	$16.15
Rate for Payer: Cash Price	$16.15
Rate for Payer: Evernorth Behavioral Health (Cigna Behavioral Health) - HMO HMO/PPO	$28.70
Rate for Payer: Health Smart Auto/Commercial	$21.53
Rate for Payer: Intervalley Health Plan Commercial	$8.09
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$21.53
Rate for Payer: LLUH Dept of Risk Management WC	$19.73
Rate for Payer: Multiplan Commercial	$26.91

HC CULTURE URINE

Facility

$459.00

Service Code	CPT 87088
Hospital Charge Code	900911530
Hospital Revenue Code	300
Min. Negotiated Rate	$252.45
Max. Negotiated Rate	$367.20
Rate for Payer: Cash Price	$206.55
Rate for Payer: Evernorth Behavioral Health (Cigna Behavioral Health) - HMO HMO/PPO	$367.20
Rate for Payer: Health Smart Auto/Commercial	$275.40
Rate for Payer: LLUH Dept of Risk Management WC	$252.45
Rate for Payer: Multiplan Commercial	$344.25

Know your out-of-pocket cost for care.

All Charges