|
HC SOM ANTI-GBM TITER AB
|
Facility
|
IP
|
$30.55
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
900911188
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.11 |
| Max. Negotiated Rate |
$25.97 |
| Rate for Payer: Adventist Health Commercial |
$6.11
|
| Rate for Payer: Cash Price |
$30.55
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$21.39
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.22
|
| Rate for Payer: EPIC Health Plan Senior |
$12.22
|
| Rate for Payer: Galaxy Health WC |
$25.97
|
| Rate for Payer: Global Benefits Group Commercial |
$18.33
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$19.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$18.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.33
|
| Rate for Payer: Multiplan Commercial |
$24.44
|
| Rate for Payer: Networks By Design Commercial |
$19.86
|
| Rate for Payer: Prime Health Services Commercial |
$25.97
|
|
|
HC SOM ANTI-LIVERKIDNEY MICROSOMAL AB
|
Facility
|
OP
|
$13.50
|
|
|
Service Code
|
CPT 86376
|
| Hospital Charge Code |
900911453
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.70 |
| Max. Negotiated Rate |
$151.14 |
| Rate for Payer: Adventist Health Commercial |
$2.70
|
| Rate for Payer: Aetna of CA HMO/PPO |
$121.04
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$16.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$151.14
|
| Rate for Payer: Blue Shield of California Commercial |
$6.22
|
| Rate for Payer: Blue Shield of California Commercial |
$9.41
|
| Rate for Payer: Cash Price |
$13.50
|
| Rate for Payer: Cash Price |
$13.50
|
| Rate for Payer: Cigna of CA HMO |
$8.64
|
| Rate for Payer: Cigna of CA PPO |
$9.99
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$16.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$14.55
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$24.01
|
| Rate for Payer: EPIC Health Plan Senior |
$16.00
|
| Rate for Payer: Galaxy Health WC |
$11.47
|
| Rate for Payer: Global Benefits Group Commercial |
$8.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$23.86
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$21.72
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$14.55
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8.57
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$24.57
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$20.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18.33
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$19.50
|
| Rate for Payer: Multiplan Commercial |
$10.80
|
| Rate for Payer: Networks By Design Commercial |
$8.78
|
| Rate for Payer: Prime Health Services Commercial |
$11.47
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8.10
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$8.10
|
| Rate for Payer: United Healthcare All Other Commercial |
$11.79
|
| Rate for Payer: United Healthcare All Other HMO |
$11.79
|
| Rate for Payer: United Healthcare HMO Rider |
$11.79
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.79
|
| Rate for Payer: Upland Medical Group Pediatric |
$14.55
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$16.00
|
| Rate for Payer: Vantage Medical Group Senior |
$14.55
|
|
|
HC SOM ANTI-LIVERKIDNEY MICROSOMAL AB
|
Facility
|
IP
|
$13.50
|
|
|
Service Code
|
CPT 86376
|
| Hospital Charge Code |
900911453
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.70 |
| Max. Negotiated Rate |
$11.47 |
| Rate for Payer: Adventist Health Commercial |
$2.70
|
| Rate for Payer: Cash Price |
$13.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.40
|
| Rate for Payer: EPIC Health Plan Senior |
$5.40
|
| Rate for Payer: Galaxy Health WC |
$11.47
|
| Rate for Payer: Global Benefits Group Commercial |
$8.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8.57
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.24
|
| Rate for Payer: Multiplan Commercial |
$10.80
|
| Rate for Payer: Networks By Design Commercial |
$8.78
|
| Rate for Payer: Prime Health Services Commercial |
$11.47
|
|
|
HC SOM ANTIMULLERIAN HORMONE, S
|
Facility
|
IP
|
$55.00
|
|
|
Service Code
|
CPT 82166
|
| Hospital Charge Code |
900912908
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.00 |
| Max. Negotiated Rate |
$46.75 |
| Rate for Payer: Adventist Health Commercial |
$11.00
|
| Rate for Payer: Cash Price |
$55.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$38.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$22.00
|
| Rate for Payer: EPIC Health Plan Senior |
$22.00
|
| Rate for Payer: Galaxy Health WC |
$46.75
|
| Rate for Payer: Global Benefits Group Commercial |
$33.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$34.92
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$32.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.20
|
| Rate for Payer: Multiplan Commercial |
$44.00
|
| Rate for Payer: Networks By Design Commercial |
$35.75
|
| Rate for Payer: Prime Health Services Commercial |
$46.75
|
|
|
HC SOM ANTIMULLERIAN HORMONE, S
|
Facility
|
OP
|
$55.00
|
|
|
Service Code
|
CPT 82166
|
| Hospital Charge Code |
900912908
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.00 |
| Max. Negotiated Rate |
$228.24 |
| Rate for Payer: Adventist Health Commercial |
$11.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$228.24
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$57.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$42.48
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$38.62
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$112.16
|
| Rate for Payer: Blue Shield of California Commercial |
$38.34
|
| Rate for Payer: Blue Shield of California Commercial |
$25.36
|
| Rate for Payer: Cash Price |
$55.00
|
| Rate for Payer: Cash Price |
$55.00
|
| Rate for Payer: Cigna of CA HMO |
$35.20
|
| Rate for Payer: Cigna of CA PPO |
$40.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$57.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$42.48
|
| Rate for Payer: Dignity Health Medicare Advantage |
$38.62
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$38.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$63.72
|
| Rate for Payer: EPIC Health Plan Senior |
$42.48
|
| Rate for Payer: Galaxy Health WC |
$46.75
|
| Rate for Payer: Global Benefits Group Commercial |
$33.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$63.34
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$64.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$38.62
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$34.92
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$73.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$54.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$48.66
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$51.75
|
| Rate for Payer: Multiplan Commercial |
$44.00
|
| Rate for Payer: Networks By Design Commercial |
$35.75
|
| Rate for Payer: Prime Health Services Commercial |
$46.75
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$33.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$33.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$27.50
|
| Rate for Payer: United Healthcare All Other HMO |
$27.50
|
| Rate for Payer: United Healthcare HMO Rider |
$27.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$27.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$38.62
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$57.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$42.48
|
| Rate for Payer: Vantage Medical Group Senior |
$38.62
|
|
|
HC SOM ANTI-NEUTROPHIL AB
|
Facility
|
IP
|
$72.00
|
|
|
Service Code
|
CPT 86021
|
| Hospital Charge Code |
900911211
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$14.40 |
| Max. Negotiated Rate |
$61.20 |
| Rate for Payer: Adventist Health Commercial |
$14.40
|
| Rate for Payer: Cash Price |
$72.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$50.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$28.80
|
| Rate for Payer: EPIC Health Plan Senior |
$28.80
|
| Rate for Payer: Galaxy Health WC |
$61.20
|
| Rate for Payer: Global Benefits Group Commercial |
$43.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$45.72
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$42.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$17.28
|
| Rate for Payer: Multiplan Commercial |
$57.60
|
| Rate for Payer: Networks By Design Commercial |
$46.80
|
| Rate for Payer: Prime Health Services Commercial |
$61.20
|
|
|
HC SOM ANTI-NEUTROPHIL AB
|
Facility
|
OP
|
$72.00
|
|
|
Service Code
|
CPT 86021
|
| Hospital Charge Code |
900911211
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.20 |
| Max. Negotiated Rate |
$155.38 |
| Rate for Payer: Adventist Health Commercial |
$14.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$113.67
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$22.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$16.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$15.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$155.38
|
| Rate for Payer: Blue Shield of California Commercial |
$33.19
|
| Rate for Payer: Blue Shield of California Commercial |
$50.18
|
| Rate for Payer: Cash Price |
$72.00
|
| Rate for Payer: Cash Price |
$72.00
|
| Rate for Payer: Cigna of CA HMO |
$46.08
|
| Rate for Payer: Cigna of CA PPO |
$53.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$22.57
|
| Rate for Payer: Dignity Health Medi-Cal |
$16.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$15.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$50.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$24.83
|
| Rate for Payer: EPIC Health Plan Senior |
$16.55
|
| Rate for Payer: Galaxy Health WC |
$61.20
|
| Rate for Payer: Global Benefits Group Commercial |
$43.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$24.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$22.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$15.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$45.72
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$25.42
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$21.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$17.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18.96
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$20.17
|
| Rate for Payer: Multiplan Commercial |
$57.60
|
| Rate for Payer: Networks By Design Commercial |
$46.80
|
| Rate for Payer: Prime Health Services Commercial |
$61.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$43.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$43.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$12.20
|
| Rate for Payer: United Healthcare All Other HMO |
$12.20
|
| Rate for Payer: United Healthcare HMO Rider |
$12.20
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$12.20
|
| Rate for Payer: Upland Medical Group Pediatric |
$15.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$22.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$16.55
|
| Rate for Payer: Vantage Medical Group Senior |
$15.05
|
|
|
HC SOM ANTI-NEUTROPHIL CYTOPLASM ANTI
|
Facility
|
IP
|
$23.15
|
|
|
Service Code
|
CPT 86036
|
| Hospital Charge Code |
900910287
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.63 |
| Max. Negotiated Rate |
$19.68 |
| Rate for Payer: Adventist Health Commercial |
$4.63
|
| Rate for Payer: Cash Price |
$23.15
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$16.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.26
|
| Rate for Payer: EPIC Health Plan Senior |
$9.26
|
| Rate for Payer: Galaxy Health WC |
$19.68
|
| Rate for Payer: Global Benefits Group Commercial |
$13.89
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$14.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$13.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.56
|
| Rate for Payer: Multiplan Commercial |
$18.52
|
| Rate for Payer: Networks By Design Commercial |
$15.05
|
| Rate for Payer: Prime Health Services Commercial |
$19.68
|
|
|
HC SOM ANTI-NEUTROPHIL CYTOPLASM ANTI
|
Facility
|
OP
|
$23.15
|
|
|
Service Code
|
CPT 86036
|
| Hospital Charge Code |
900910287
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.63 |
| Max. Negotiated Rate |
$71.19 |
| Rate for Payer: Adventist Health Commercial |
$4.63
|
| Rate for Payer: Aetna of CA HMO/PPO |
$71.19
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$18.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$35.02
|
| Rate for Payer: Blue Shield of California Commercial |
$10.67
|
| Rate for Payer: Blue Shield of California Commercial |
$16.14
|
| Rate for Payer: Cash Price |
$23.15
|
| Rate for Payer: Cash Price |
$23.15
|
| Rate for Payer: Cigna of CA HMO |
$14.82
|
| Rate for Payer: Cigna of CA PPO |
$17.13
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$18.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.26
|
| Rate for Payer: Dignity Health Medicare Advantage |
$12.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$16.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.88
|
| Rate for Payer: EPIC Health Plan Senior |
$13.26
|
| Rate for Payer: Galaxy Health WC |
$19.68
|
| Rate for Payer: Global Benefits Group Commercial |
$13.89
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$19.76
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$20.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$12.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$14.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$22.89
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$16.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.56
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$15.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16.15
|
| Rate for Payer: Multiplan Commercial |
$18.52
|
| Rate for Payer: Networks By Design Commercial |
$15.05
|
| Rate for Payer: Prime Health Services Commercial |
$19.68
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$13.89
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$13.89
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.77
|
| Rate for Payer: United Healthcare All Other HMO |
$9.77
|
| Rate for Payer: United Healthcare HMO Rider |
$9.77
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.77
|
| Rate for Payer: Upland Medical Group Pediatric |
$12.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$18.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.26
|
| Rate for Payer: Vantage Medical Group Senior |
$12.05
|
|
|
HC SOM ANTINUCLEAR AB,HEP-2 SUB,S
|
Facility
|
IP
|
$8.50
|
|
|
Service Code
|
CPT 86039
|
| Hospital Charge Code |
900912903
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$1.70 |
| Max. Negotiated Rate |
$7.22 |
| Rate for Payer: Adventist Health Commercial |
$1.70
|
| Rate for Payer: Cash Price |
$8.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.40
|
| Rate for Payer: EPIC Health Plan Senior |
$3.40
|
| Rate for Payer: Galaxy Health WC |
$7.22
|
| Rate for Payer: Global Benefits Group Commercial |
$5.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.04
|
| Rate for Payer: Multiplan Commercial |
$6.80
|
| Rate for Payer: Networks By Design Commercial |
$5.53
|
| Rate for Payer: Prime Health Services Commercial |
$7.22
|
|
|
HC SOM ANTINUCLEAR AB,HEP-2 SUB,S
|
Facility
|
OP
|
$8.50
|
|
|
Service Code
|
CPT 86039
|
| Hospital Charge Code |
900912903
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$1.70 |
| Max. Negotiated Rate |
$115.07 |
| Rate for Payer: Adventist Health Commercial |
$1.70
|
| Rate for Payer: Aetna of CA HMO/PPO |
$92.81
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$16.74
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$12.28
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11.16
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$115.07
|
| Rate for Payer: Blue Shield of California Commercial |
$3.92
|
| Rate for Payer: Blue Shield of California Commercial |
$5.92
|
| Rate for Payer: Cash Price |
$8.50
|
| Rate for Payer: Cash Price |
$8.50
|
| Rate for Payer: Cigna of CA HMO |
$5.44
|
| Rate for Payer: Cigna of CA PPO |
$6.29
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$16.74
|
| Rate for Payer: Dignity Health Medi-Cal |
$12.28
|
| Rate for Payer: Dignity Health Medicare Advantage |
$11.16
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$18.41
|
| Rate for Payer: EPIC Health Plan Senior |
$12.28
|
| Rate for Payer: Galaxy Health WC |
$7.22
|
| Rate for Payer: Global Benefits Group Commercial |
$5.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$18.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$16.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$11.16
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$18.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$15.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.04
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$14.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14.95
|
| Rate for Payer: Multiplan Commercial |
$6.80
|
| Rate for Payer: Networks By Design Commercial |
$5.53
|
| Rate for Payer: Prime Health Services Commercial |
$7.22
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5.10
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5.10
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.04
|
| Rate for Payer: United Healthcare All Other HMO |
$9.04
|
| Rate for Payer: United Healthcare HMO Rider |
$9.04
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.04
|
| Rate for Payer: Upland Medical Group Pediatric |
$11.16
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$16.74
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$12.28
|
| Rate for Payer: Vantage Medical Group Senior |
$11.16
|
|
|
HC SOM ANTINUCLEAR ANTIBODY(MULTI
|
Facility
|
OP
|
$16.00
|
|
|
Service Code
|
CPT 86039
|
| Hospital Charge Code |
900912906
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.20 |
| Max. Negotiated Rate |
$115.07 |
| Rate for Payer: Adventist Health Commercial |
$3.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$92.81
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$16.74
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$12.28
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11.16
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$115.07
|
| Rate for Payer: Blue Shield of California Commercial |
$11.15
|
| Rate for Payer: Blue Shield of California Commercial |
$7.38
|
| Rate for Payer: Cash Price |
$16.00
|
| Rate for Payer: Cash Price |
$16.00
|
| Rate for Payer: Cigna of CA HMO |
$10.24
|
| Rate for Payer: Cigna of CA PPO |
$11.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$16.74
|
| Rate for Payer: Dignity Health Medi-Cal |
$12.28
|
| Rate for Payer: Dignity Health Medicare Advantage |
$11.16
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$11.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$18.41
|
| Rate for Payer: EPIC Health Plan Senior |
$12.28
|
| Rate for Payer: Galaxy Health WC |
$13.60
|
| Rate for Payer: Global Benefits Group Commercial |
$9.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$18.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$16.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$11.16
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$10.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$18.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$15.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.84
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$14.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14.95
|
| Rate for Payer: Multiplan Commercial |
$12.80
|
| Rate for Payer: Networks By Design Commercial |
$10.40
|
| Rate for Payer: Prime Health Services Commercial |
$13.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.04
|
| Rate for Payer: United Healthcare All Other HMO |
$9.04
|
| Rate for Payer: United Healthcare HMO Rider |
$9.04
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.04
|
| Rate for Payer: Upland Medical Group Pediatric |
$11.16
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$16.74
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$12.28
|
| Rate for Payer: Vantage Medical Group Senior |
$11.16
|
|
|
HC SOM ANTINUCLEAR ANTIBODY(MULTI
|
Facility
|
IP
|
$16.00
|
|
|
Service Code
|
CPT 86039
|
| Hospital Charge Code |
900912906
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.20 |
| Max. Negotiated Rate |
$13.60 |
| Rate for Payer: Adventist Health Commercial |
$3.20
|
| Rate for Payer: Cash Price |
$16.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$11.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.40
|
| Rate for Payer: EPIC Health Plan Senior |
$6.40
|
| Rate for Payer: Galaxy Health WC |
$13.60
|
| Rate for Payer: Global Benefits Group Commercial |
$9.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$10.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.84
|
| Rate for Payer: Multiplan Commercial |
$12.80
|
| Rate for Payer: Networks By Design Commercial |
$10.40
|
| Rate for Payer: Prime Health Services Commercial |
$13.60
|
|
|
HC SOM ANTI-SMOOTH MUSCLE
|
Facility
|
IP
|
$11.50
|
|
|
Service Code
|
CPT 86015
|
| Hospital Charge Code |
900911176
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.30 |
| Max. Negotiated Rate |
$9.78 |
| Rate for Payer: Adventist Health Commercial |
$2.30
|
| Rate for Payer: Cash Price |
$11.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.60
|
| Rate for Payer: EPIC Health Plan Senior |
$4.60
|
| Rate for Payer: Galaxy Health WC |
$9.78
|
| Rate for Payer: Global Benefits Group Commercial |
$6.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.76
|
| Rate for Payer: Multiplan Commercial |
$9.20
|
| Rate for Payer: Networks By Design Commercial |
$7.47
|
| Rate for Payer: Prime Health Services Commercial |
$9.78
|
|
|
HC SOM ANTI-SMOOTH MUSCLE
|
Facility
|
OP
|
$11.50
|
|
|
Service Code
|
CPT 86015
|
| Hospital Charge Code |
900911176
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.30 |
| Max. Negotiated Rate |
$68.13 |
| Rate for Payer: Adventist Health Commercial |
$2.30
|
| Rate for Payer: Aetna of CA HMO/PPO |
$68.13
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$18.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$33.42
|
| Rate for Payer: Blue Shield of California Commercial |
$5.30
|
| Rate for Payer: Blue Shield of California Commercial |
$8.02
|
| Rate for Payer: Cash Price |
$11.50
|
| Rate for Payer: Cash Price |
$11.50
|
| Rate for Payer: Cigna of CA HMO |
$7.36
|
| Rate for Payer: Cigna of CA PPO |
$8.51
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$18.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.26
|
| Rate for Payer: Dignity Health Medicare Advantage |
$12.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.88
|
| Rate for Payer: EPIC Health Plan Senior |
$13.26
|
| Rate for Payer: Galaxy Health WC |
$9.78
|
| Rate for Payer: Global Benefits Group Commercial |
$6.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$19.76
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$19.37
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$12.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$21.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$16.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.76
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$15.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16.15
|
| Rate for Payer: Multiplan Commercial |
$9.20
|
| Rate for Payer: Networks By Design Commercial |
$7.47
|
| Rate for Payer: Prime Health Services Commercial |
$9.78
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6.90
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6.90
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.34
|
| Rate for Payer: United Healthcare All Other HMO |
$9.34
|
| Rate for Payer: United Healthcare HMO Rider |
$9.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.34
|
| Rate for Payer: Upland Medical Group Pediatric |
$12.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$18.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.26
|
| Rate for Payer: Vantage Medical Group Senior |
$12.05
|
|
|
HC SOM ANTI-STRIATED MUSCLE AB
|
Facility
|
IP
|
$24.00
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
900911368
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.80 |
| Max. Negotiated Rate |
$20.40 |
| Rate for Payer: Adventist Health Commercial |
$4.80
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$16.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.60
|
| Rate for Payer: EPIC Health Plan Senior |
$9.60
|
| Rate for Payer: Galaxy Health WC |
$20.40
|
| Rate for Payer: Global Benefits Group Commercial |
$14.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$15.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$14.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.76
|
| Rate for Payer: Multiplan Commercial |
$19.20
|
| Rate for Payer: Networks By Design Commercial |
$15.60
|
| Rate for Payer: Prime Health Services Commercial |
$20.40
|
|
|
HC SOM ANTI-STRIATED MUSCLE AB
|
Facility
|
OP
|
$24.00
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
900911368
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.80 |
| Max. Negotiated Rate |
$133.63 |
| Rate for Payer: Adventist Health Commercial |
$4.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$107.69
|
| 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 |
$133.63
|
| Rate for Payer: Blue Shield of California Commercial |
$11.06
|
| Rate for Payer: Blue Shield of California Commercial |
$16.73
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cigna of CA HMO |
$15.36
|
| Rate for Payer: Cigna of CA PPO |
$17.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$25.91
|
| Rate for Payer: Dignity Health Medi-Cal |
$19.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$17.27
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$16.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$28.50
|
| Rate for Payer: EPIC Health Plan Senior |
$19.00
|
| Rate for Payer: Galaxy Health WC |
$20.40
|
| Rate for Payer: Global Benefits Group Commercial |
$14.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$28.32
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$17.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$17.27
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$15.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$19.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$24.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.76
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$21.76
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$23.14
|
| Rate for Payer: Multiplan Commercial |
$19.20
|
| Rate for Payer: Networks By Design Commercial |
$15.60
|
| Rate for Payer: Prime Health Services Commercial |
$20.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$14.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$14.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$13.99
|
| Rate for Payer: United Healthcare All Other HMO |
$13.99
|
| Rate for Payer: United Healthcare HMO Rider |
$13.99
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$13.99
|
| Rate for Payer: Upland Medical Group Pediatric |
$17.27
|
| 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 SOM APOLIPOPROTEIN A-1
|
Facility
|
IP
|
$23.38
|
|
|
Service Code
|
CPT 82172
|
| Hospital Charge Code |
900910800
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.68 |
| Max. Negotiated Rate |
$19.87 |
| Rate for Payer: Adventist Health Commercial |
$4.68
|
| Rate for Payer: Cash Price |
$23.38
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$16.37
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.35
|
| Rate for Payer: EPIC Health Plan Senior |
$9.35
|
| Rate for Payer: Galaxy Health WC |
$19.87
|
| Rate for Payer: Global Benefits Group Commercial |
$14.03
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$14.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$13.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.61
|
| Rate for Payer: Multiplan Commercial |
$18.70
|
| Rate for Payer: Networks By Design Commercial |
$15.20
|
| Rate for Payer: Prime Health Services Commercial |
$19.87
|
|
|
HC SOM APOLIPOPROTEIN A-1
|
Facility
|
OP
|
$23.38
|
|
|
Service Code
|
CPT 82172
|
| Hospital Charge Code |
900910800
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.68 |
| Max. Negotiated Rate |
$121.12 |
| Rate for Payer: Adventist Health Commercial |
$4.68
|
| Rate for Payer: Aetna of CA HMO/PPO |
$117.21
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$31.64
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$23.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$21.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$121.12
|
| Rate for Payer: Blue Shield of California Commercial |
$10.78
|
| Rate for Payer: Blue Shield of California Commercial |
$16.30
|
| Rate for Payer: Cash Price |
$23.38
|
| Rate for Payer: Cash Price |
$23.38
|
| Rate for Payer: Cigna of CA HMO |
$14.96
|
| Rate for Payer: Cigna of CA PPO |
$17.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$31.64
|
| Rate for Payer: Dignity Health Medi-Cal |
$23.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$21.09
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$16.37
|
| Rate for Payer: EPIC Health Plan Commercial |
$34.80
|
| Rate for Payer: EPIC Health Plan Senior |
$23.20
|
| Rate for Payer: Galaxy Health WC |
$19.87
|
| Rate for Payer: Global Benefits Group Commercial |
$14.03
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$34.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$22.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$21.09
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$14.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$24.98
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$29.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.61
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$26.57
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$28.26
|
| Rate for Payer: Multiplan Commercial |
$18.70
|
| Rate for Payer: Networks By Design Commercial |
$15.20
|
| Rate for Payer: Prime Health Services Commercial |
$19.87
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$14.03
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$14.03
|
| Rate for Payer: United Healthcare All Other Commercial |
$17.08
|
| Rate for Payer: United Healthcare All Other HMO |
$17.08
|
| Rate for Payer: United Healthcare HMO Rider |
$17.08
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$17.08
|
| Rate for Payer: Upland Medical Group Pediatric |
$21.09
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$31.64
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$23.20
|
| Rate for Payer: Vantage Medical Group Senior |
$21.09
|
|
|
HC SOM APOLIPOPROTEIN B
|
Facility
|
OP
|
$15.00
|
|
|
Service Code
|
CPT 82172
|
| Hospital Charge Code |
900910801
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.00 |
| Max. Negotiated Rate |
$121.12 |
| Rate for Payer: Adventist Health Commercial |
$3.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$117.21
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$31.64
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$23.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$21.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$121.12
|
| Rate for Payer: Blue Shield of California Commercial |
$10.46
|
| Rate for Payer: Blue Shield of California Commercial |
$6.92
|
| Rate for Payer: Cash Price |
$15.00
|
| Rate for Payer: Cash Price |
$15.00
|
| Rate for Payer: Cigna of CA HMO |
$9.60
|
| Rate for Payer: Cigna of CA PPO |
$11.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$31.64
|
| Rate for Payer: Dignity Health Medi-Cal |
$23.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$21.09
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$10.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$34.80
|
| Rate for Payer: EPIC Health Plan Senior |
$23.20
|
| Rate for Payer: Galaxy Health WC |
$12.75
|
| Rate for Payer: Global Benefits Group Commercial |
$9.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$34.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$22.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$21.09
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$9.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$24.98
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$29.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$26.57
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$28.26
|
| Rate for Payer: Multiplan Commercial |
$12.00
|
| Rate for Payer: Networks By Design Commercial |
$9.75
|
| Rate for Payer: Prime Health Services Commercial |
$12.75
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$17.08
|
| Rate for Payer: United Healthcare All Other HMO |
$17.08
|
| Rate for Payer: United Healthcare HMO Rider |
$17.08
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$17.08
|
| Rate for Payer: Upland Medical Group Pediatric |
$21.09
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$31.64
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$23.20
|
| Rate for Payer: Vantage Medical Group Senior |
$21.09
|
|
|
HC SOM APOLIPOPROTEIN B
|
Facility
|
IP
|
$15.00
|
|
|
Service Code
|
CPT 82172
|
| Hospital Charge Code |
900910801
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.00 |
| Max. Negotiated Rate |
$12.75 |
| Rate for Payer: Adventist Health Commercial |
$3.00
|
| Rate for Payer: Cash Price |
$15.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$10.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.00
|
| Rate for Payer: EPIC Health Plan Senior |
$6.00
|
| Rate for Payer: Galaxy Health WC |
$12.75
|
| Rate for Payer: Global Benefits Group Commercial |
$9.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$9.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.60
|
| Rate for Payer: Multiplan Commercial |
$12.00
|
| Rate for Payer: Networks By Design Commercial |
$9.75
|
| Rate for Payer: Prime Health Services Commercial |
$12.75
|
|
|
HC SOM APOLIPOPROTEIN E GENOTYPING
|
Facility
|
OP
|
$225.00
|
|
|
Service Code
|
CPT 81401
|
| Hospital Charge Code |
900914646
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$45.00 |
| Max. Negotiated Rate |
$326.60 |
| Rate for Payer: Adventist Health Commercial |
$45.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$271.14
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$205.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$150.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$137.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$326.60
|
| Rate for Payer: Blue Shield of California Commercial |
$103.72
|
| Rate for Payer: Blue Shield of California Commercial |
$156.82
|
| Rate for Payer: Cash Price |
$225.00
|
| Rate for Payer: Cash Price |
$225.00
|
| Rate for Payer: Cigna of CA HMO |
$144.00
|
| Rate for Payer: Cigna of CA PPO |
$166.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$205.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$150.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$137.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$157.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$226.05
|
| Rate for Payer: EPIC Health Plan Senior |
$150.70
|
| Rate for Payer: Galaxy Health WC |
$191.25
|
| Rate for Payer: Global Benefits Group Commercial |
$135.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$224.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$230.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$137.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$142.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$260.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$191.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$54.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$172.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$183.58
|
| Rate for Payer: Multiplan Commercial |
$180.00
|
| Rate for Payer: Networks By Design Commercial |
$146.25
|
| Rate for Payer: Prime Health Services Commercial |
$191.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$135.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$135.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$110.97
|
| Rate for Payer: United Healthcare All Other HMO |
$110.97
|
| Rate for Payer: United Healthcare HMO Rider |
$110.97
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$110.97
|
| Rate for Payer: Upland Medical Group Pediatric |
$137.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$205.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$150.70
|
| Rate for Payer: Vantage Medical Group Senior |
$137.00
|
|
|
HC SOM APOLIPOPROTEIN E GENOTYPING
|
Facility
|
IP
|
$225.00
|
|
|
Service Code
|
CPT 81401
|
| Hospital Charge Code |
900914646
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$45.00 |
| Max. Negotiated Rate |
$191.25 |
| Rate for Payer: Adventist Health Commercial |
$45.00
|
| Rate for Payer: Cash Price |
$225.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$157.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$90.00
|
| Rate for Payer: EPIC Health Plan Senior |
$90.00
|
| Rate for Payer: Galaxy Health WC |
$191.25
|
| Rate for Payer: Global Benefits Group Commercial |
$135.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$142.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$132.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$54.00
|
| Rate for Payer: Multiplan Commercial |
$180.00
|
| Rate for Payer: Networks By Design Commercial |
$146.25
|
| Rate for Payer: Prime Health Services Commercial |
$191.25
|
|
|
HC SOM ARSENIC BLOOD
|
Facility
|
OP
|
$29.50
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
900910563
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.90 |
| Max. Negotiated Rate |
$195.82 |
| Rate for Payer: Cigna of CA PPO |
$21.83
|
| Rate for Payer: Adventist Health Commercial |
$5.90
|
| Rate for Payer: Aetna of CA HMO/PPO |
$157.81
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$28.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$20.87
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$18.97
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$195.82
|
| Rate for Payer: Blue Shield of California Commercial |
$13.60
|
| Rate for Payer: Blue Shield of California Commercial |
$20.56
|
| Rate for Payer: Cash Price |
$29.50
|
| Rate for Payer: Cash Price |
$29.50
|
| Rate for Payer: Cigna of CA HMO |
$18.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$28.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$20.87
|
| Rate for Payer: Dignity Health Medicare Advantage |
$18.97
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$20.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$31.30
|
| Rate for Payer: EPIC Health Plan Senior |
$20.87
|
| Rate for Payer: Galaxy Health WC |
$25.07
|
| Rate for Payer: Global Benefits Group Commercial |
$17.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$31.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$28.32
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$18.97
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$18.73
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$32.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$26.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.08
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$23.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$25.42
|
| Rate for Payer: Multiplan Commercial |
$23.60
|
| Rate for Payer: Networks By Design Commercial |
$19.18
|
| Rate for Payer: Prime Health Services Commercial |
$25.07
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$17.70
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$17.70
|
| Rate for Payer: United Healthcare All Other Commercial |
$15.36
|
| Rate for Payer: United Healthcare All Other HMO |
$15.36
|
| Rate for Payer: United Healthcare HMO Rider |
$15.36
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15.36
|
| Rate for Payer: Upland Medical Group Pediatric |
$18.97
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$28.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$20.87
|
| Rate for Payer: Vantage Medical Group Senior |
$18.97
|
|
|
HC SOM ARSENIC BLOOD
|
Facility
|
IP
|
$29.50
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
900910563
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.90 |
| Max. Negotiated Rate |
$25.07 |
| Rate for Payer: Adventist Health Commercial |
$5.90
|
| Rate for Payer: Cash Price |
$29.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$20.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.80
|
| Rate for Payer: EPIC Health Plan Senior |
$11.80
|
| Rate for Payer: Galaxy Health WC |
$25.07
|
| Rate for Payer: Global Benefits Group Commercial |
$17.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$18.73
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$17.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.08
|
| Rate for Payer: Multiplan Commercial |
$23.60
|
| Rate for Payer: Networks By Design Commercial |
$19.18
|
| Rate for Payer: Prime Health Services Commercial |
$25.07
|
|
