Loma Linda University Behavioral Medicine Center (BMC)

All Charges

Charge

Type

Setting

Price

HC CULTURE,INVASIVE LOWER RESP

Facility

$32.00

Service Code	CPT 87070
Hospital Charge Code	900912408
Hospital Revenue Code	306
Min. Negotiated Rate	$17.60
Max. Negotiated Rate	$24.00
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$19.20
Rate for Payer: Aetna of CA Government/Medicare	$19.20
Rate for Payer: Cash Price	$14.40
Rate for Payer: Health Smart Auto/Commercial	$19.20
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$19.20
Rate for Payer: LLUH Dept of Risk Management WC	$17.60
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$24.00

HC CULTURE JEJUNUM AEROBIC

Facility

$399.00

Service Code	CPT 87071
Hospital Charge Code	900911507
Hospital Revenue Code	306
Min. Negotiated Rate	$219.45
Max. Negotiated Rate	$319.20
Rate for Payer: Cash Price	$179.55
Rate for Payer: Cigna of CA HMO/PPO	$319.20
Rate for Payer: Health Smart Auto/Commercial	$239.40
Rate for Payer: LLUH Dept of Risk Management WC	$219.45
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$299.25

HC CULTURE JEJUNUM AEROBIC

Facility

$36.00

Service Code	CPT 87071
Hospital Charge Code	900911507
Hospital Revenue Code	306
Min. Negotiated Rate	$19.80
Max. Negotiated Rate	$27.00
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$21.60
Rate for Payer: Aetna of CA Government/Medicare	$21.60
Rate for Payer: Cash Price	$16.20
Rate for Payer: Health Smart Auto/Commercial	$21.60
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$21.60
Rate for Payer: LLUH Dept of Risk Management WC	$19.80
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$27.00

HC CULTURE JEJUNUM ANAEROBIC

Facility

$439.00

Service Code	CPT 87073
Hospital Charge Code	900911508
Hospital Revenue Code	306
Min. Negotiated Rate	$241.45
Max. Negotiated Rate	$351.20
Rate for Payer: Cash Price	$197.55
Rate for Payer: Cigna of CA HMO/PPO	$351.20
Rate for Payer: Health Smart Auto/Commercial	$263.40
Rate for Payer: LLUH Dept of Risk Management WC	$241.45
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$329.25

HC CULTURE JEJUNUM ANAEROBIC

Facility

$36.00

Service Code	CPT 87073
Hospital Charge Code	900911508
Hospital Revenue Code	306
Min. Negotiated Rate	$19.80
Max. Negotiated Rate	$27.00
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$21.60
Rate for Payer: Aetna of CA Government/Medicare	$21.60
Rate for Payer: Cash Price	$16.20
Rate for Payer: Health Smart Auto/Commercial	$21.60
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$21.60
Rate for Payer: LLUH Dept of Risk Management WC	$19.80
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$27.00

HC CULTURE LEGIONELLA

Facility

$399.00

Service Code	CPT 87070
Hospital Charge Code	900911524
Hospital Revenue Code	306
Min. Negotiated Rate	$219.45
Max. Negotiated Rate	$319.20
Rate for Payer: Cash Price	$179.55
Rate for Payer: Cigna of CA HMO/PPO	$319.20
Rate for Payer: Health Smart Auto/Commercial	$239.40
Rate for Payer: LLUH Dept of Risk Management WC	$219.45
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$299.25

HC CULTURE LEGIONELLA

Facility

$32.00

Service Code	CPT 87070
Hospital Charge Code	900911524
Hospital Revenue Code	306
Min. Negotiated Rate	$17.60
Max. Negotiated Rate	$24.00
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$19.20
Rate for Payer: Aetna of CA Government/Medicare	$19.20
Rate for Payer: Cash Price	$14.40
Rate for Payer: Health Smart Auto/Commercial	$19.20
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$19.20
Rate for Payer: LLUH Dept of Risk Management WC	$17.60
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$24.00

HC CULTURE MISCELLANEOUS

Facility

$399.00

Service Code	CPT 87070
Hospital Charge Code	900911509
Hospital Revenue Code	306
Min. Negotiated Rate	$219.45
Max. Negotiated Rate	$319.20
Rate for Payer: Cash Price	$179.55
Rate for Payer: Cigna of CA HMO/PPO	$319.20
Rate for Payer: Health Smart Auto/Commercial	$239.40
Rate for Payer: LLUH Dept of Risk Management WC	$219.45
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$299.25

HC CULTURE MISCELLANEOUS

Facility

$32.00

Service Code	CPT 87070
Hospital Charge Code	900911509
Hospital Revenue Code	306
Min. Negotiated Rate	$17.60
Max. Negotiated Rate	$24.00
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$19.20
Rate for Payer: Aetna of CA Government/Medicare	$19.20
Rate for Payer: Cash Price	$14.40
Rate for Payer: Health Smart Auto/Commercial	$19.20
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$19.20
Rate for Payer: LLUH Dept of Risk Management WC	$17.60
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$24.00

HC CULTURE MOLD ID

Facility

$288.00

Service Code	CPT 87107
Hospital Charge Code	900911560
Hospital Revenue Code	306
Min. Negotiated Rate	$158.40
Max. Negotiated Rate	$230.40
Rate for Payer: Cash Price	$129.60
Rate for Payer: Cigna of CA HMO/PPO	$230.40
Rate for Payer: Health Smart Auto/Commercial	$172.80
Rate for Payer: LLUH Dept of Risk Management WC	$158.40
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$216.00

HC CULTURE MOLD ID

Facility

$39.00

Service Code	CPT 87107
Hospital Charge Code	900911560
Hospital Revenue Code	306
Min. Negotiated Rate	$21.45
Max. Negotiated Rate	$29.25
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$23.40
Rate for Payer: Aetna of CA Government/Medicare	$23.40
Rate for Payer: Cash Price	$17.55
Rate for Payer: Health Smart Auto/Commercial	$23.40
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$23.40
Rate for Payer: LLUH Dept of Risk Management WC	$21.45
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$29.25

HC CULTURE MRSA SURVELLIANCE

Facility

$339.00

Service Code	CPT 87070
Hospital Charge Code	900912438
Hospital Revenue Code	306
Min. Negotiated Rate	$186.45
Max. Negotiated Rate	$271.20
Rate for Payer: Cash Price	$152.55
Rate for Payer: Cigna of CA HMO/PPO	$271.20
Rate for Payer: Health Smart Auto/Commercial	$203.40
Rate for Payer: LLUH Dept of Risk Management WC	$186.45
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$254.25

HC CULTURE MRSA SURVELLIANCE

Facility

$32.00

Service Code	CPT 87070
Hospital Charge Code	900912438
Hospital Revenue Code	306
Min. Negotiated Rate	$17.60
Max. Negotiated Rate	$24.00
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$19.20
Rate for Payer: Aetna of CA Government/Medicare	$19.20
Rate for Payer: Cash Price	$14.40
Rate for Payer: Health Smart Auto/Commercial	$19.20
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$19.20
Rate for Payer: LLUH Dept of Risk Management WC	$17.60
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$24.00

HC CULTURE NEISS/HAEM RAPID ID

Facility

$31.00

Service Code	CPT 87077
Hospital Charge Code	900912428
Hospital Revenue Code	306
Min. Negotiated Rate	$17.05
Max. Negotiated Rate	$23.25
Rate for Payer: Health Smart Auto/Commercial	$18.60
Rate for Payer: Cash Price	$13.95
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$18.60
Rate for Payer: Aetna of CA Government/Medicare	$18.60
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$18.60
Rate for Payer: LLUH Dept of Risk Management WC	$17.05
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$23.25

HC CULTURE NEISS/HAEM RAPID ID

Facility

$204.00

Service Code	CPT 87077
Hospital Charge Code	900912428
Hospital Revenue Code	306
Min. Negotiated Rate	$112.20
Max. Negotiated Rate	$163.20
Rate for Payer: Cash Price	$91.80
Rate for Payer: Cigna of CA HMO/PPO	$163.20
Rate for Payer: Health Smart Auto/Commercial	$122.40
Rate for Payer: LLUH Dept of Risk Management WC	$112.20
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$153.00

HC CULTURE NON-FERMENT ID

Facility

$31.00

Service Code	CPT 87077
Hospital Charge Code	900912426
Hospital Revenue Code	306
Min. Negotiated Rate	$17.05
Max. Negotiated Rate	$23.25
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$18.60
Rate for Payer: Aetna of CA Government/Medicare	$18.60
Rate for Payer: Cash Price	$13.95
Rate for Payer: Health Smart Auto/Commercial	$18.60
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$18.60
Rate for Payer: LLUH Dept of Risk Management WC	$17.05
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$23.25

HC CULTURE NON-FERMENT ID

Facility

$204.00

Service Code	CPT 87077
Hospital Charge Code	900912426
Hospital Revenue Code	306
Min. Negotiated Rate	$112.20
Max. Negotiated Rate	$163.20
Rate for Payer: Cash Price	$91.80
Rate for Payer: Cigna of CA HMO/PPO	$163.20
Rate for Payer: Health Smart Auto/Commercial	$122.40
Rate for Payer: LLUH Dept of Risk Management WC	$112.20
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$153.00

HC CULTURE OPTIC

Facility

$32.00

Service Code	CPT 87077
Hospital Charge Code	900911510
Hospital Revenue Code	306
Min. Negotiated Rate	$17.60
Max. Negotiated Rate	$24.00
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$19.20
Rate for Payer: Aetna of CA Government/Medicare	$19.20
Rate for Payer: Cash Price	$14.40
Rate for Payer: Health Smart Auto/Commercial	$19.20
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$19.20
Rate for Payer: LLUH Dept of Risk Management WC	$17.60
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$24.00

HC CULTURE OPTIC

Facility

$399.00

Service Code	CPT 87077
Hospital Charge Code	900911510
Hospital Revenue Code	306
Min. Negotiated Rate	$219.45
Max. Negotiated Rate	$319.20
Rate for Payer: Cash Price	$179.55
Rate for Payer: Cigna of CA HMO/PPO	$319.20
Rate for Payer: Health Smart Auto/Commercial	$239.40
Rate for Payer: LLUH Dept of Risk Management WC	$219.45
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$299.25

HC CULTURE OTIC

Facility

$32.00

Service Code	CPT 87070
Hospital Charge Code	900911512
Hospital Revenue Code	306
Min. Negotiated Rate	$17.60
Max. Negotiated Rate	$24.00
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$19.20
Rate for Payer: Aetna of CA Government/Medicare	$19.20
Rate for Payer: Cash Price	$14.40
Rate for Payer: Health Smart Auto/Commercial	$19.20
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$19.20
Rate for Payer: LLUH Dept of Risk Management WC	$17.60
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$24.00

HC CULTURE OTIC

Facility

$399.00

Service Code	CPT 87070
Hospital Charge Code	900911512
Hospital Revenue Code	306
Min. Negotiated Rate	$219.45
Max. Negotiated Rate	$319.20
Rate for Payer: Cash Price	$179.55
Rate for Payer: Cigna of CA HMO/PPO	$319.20
Rate for Payer: Health Smart Auto/Commercial	$239.40
Rate for Payer: LLUH Dept of Risk Management WC	$219.45
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$299.25

HC CULTURE PBP2 LATEX AGGLUTINATION

Facility

$136.00

Service Code	CPT 87147
Hospital Charge Code	900912417
Hospital Revenue Code	306
Min. Negotiated Rate	$74.80
Max. Negotiated Rate	$108.80
Rate for Payer: Cash Price	$61.20
Rate for Payer: Cigna of CA HMO/PPO	$108.80
Rate for Payer: Health Smart Auto/Commercial	$81.60
Rate for Payer: LLUH Dept of Risk Management WC	$74.80
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$102.00

HC CULTURE PBP2 LATEX AGGLUTINATION

Facility

$44.00

Service Code	CPT 87147
Hospital Charge Code	900912417
Hospital Revenue Code	306
Min. Negotiated Rate	$24.20
Max. Negotiated Rate	$33.00
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$26.40
Rate for Payer: Aetna of CA Government/Medicare	$26.40
Rate for Payer: Cash Price	$19.80
Rate for Payer: Health Smart Auto/Commercial	$26.40
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$26.40
Rate for Payer: LLUH Dept of Risk Management WC	$24.20
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$33.00

HC CULTURE QUANT AEROBIC

Facility

$75.00

Service Code	CPT 87071
Hospital Charge Code	900912433
Hospital Revenue Code	306
Min. Negotiated Rate	$41.25
Max. Negotiated Rate	$56.25
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$45.00
Rate for Payer: Aetna of CA Government/Medicare	$45.00
Rate for Payer: Cash Price	$33.75
Rate for Payer: Health Smart Auto/Commercial	$45.00
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$45.00
Rate for Payer: LLUH Dept of Risk Management WC	$41.25
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$56.25

HC CULTURE QUANT AEROBIC

Facility

$399.00

Service Code	CPT 87071
Hospital Charge Code	900912433
Hospital Revenue Code	306
Min. Negotiated Rate	$219.45
Max. Negotiated Rate	$319.20
Rate for Payer: Cash Price	$179.55
Rate for Payer: Cigna of CA HMO/PPO	$319.20
Rate for Payer: Health Smart Auto/Commercial	$239.40
Rate for Payer: LLUH Dept of Risk Management WC	$219.45
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$299.25

Know your out-of-pocket cost for care.

All Charges