|
HC SOM CAH 17-OH PREGNENOLONE
|
Facility
|
IP
|
$59.95
|
|
|
Service Code
|
CPT 84143
|
| Hospital Charge Code |
900912776
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.99 |
| Max. Negotiated Rate |
$50.96 |
| Rate for Payer: Adventist Health Commercial |
$11.99
|
| Rate for Payer: Cash Price |
$59.95
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$41.97
|
| Rate for Payer: EPIC Health Plan Commercial |
$23.98
|
| Rate for Payer: EPIC Health Plan Senior |
$23.98
|
| Rate for Payer: Galaxy Health WC |
$50.96
|
| Rate for Payer: Global Benefits Group Commercial |
$35.97
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$38.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$35.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.39
|
| Rate for Payer: Multiplan Commercial |
$47.96
|
| Rate for Payer: Networks By Design Commercial |
$38.97
|
| Rate for Payer: Prime Health Services Commercial |
$50.96
|
|
|
HC SOM CAH 17-OH PREGNENOLONE
|
Facility
|
OP
|
$59.95
|
|
|
Service Code
|
CPT 84143
|
| Hospital Charge Code |
900912776
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.99 |
| Max. Negotiated Rate |
$235.57 |
| Rate for Payer: Adventist Health Commercial |
$11.99
|
| Rate for Payer: Aetna of CA HMO/PPO |
$189.80
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$34.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$25.09
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$22.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$235.57
|
| Rate for Payer: Blue Shield of California Commercial |
$27.64
|
| Rate for Payer: Blue Shield of California Commercial |
$41.79
|
| Rate for Payer: Cash Price |
$59.95
|
| Rate for Payer: Cash Price |
$59.95
|
| Rate for Payer: Cigna of CA HMO |
$38.37
|
| Rate for Payer: Cigna of CA PPO |
$44.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$34.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$25.09
|
| Rate for Payer: Dignity Health Medicare Advantage |
$22.81
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$41.97
|
| Rate for Payer: EPIC Health Plan Commercial |
$37.64
|
| Rate for Payer: EPIC Health Plan Senior |
$25.09
|
| Rate for Payer: Galaxy Health WC |
$50.96
|
| Rate for Payer: Global Benefits Group Commercial |
$35.97
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$37.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$34.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$22.81
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$38.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$38.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$31.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.39
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$28.74
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$30.57
|
| Rate for Payer: Multiplan Commercial |
$47.96
|
| Rate for Payer: Networks By Design Commercial |
$38.97
|
| Rate for Payer: Prime Health Services Commercial |
$50.96
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$35.97
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$35.97
|
| Rate for Payer: United Healthcare All Other Commercial |
$18.48
|
| Rate for Payer: United Healthcare All Other HMO |
$18.48
|
| Rate for Payer: United Healthcare HMO Rider |
$18.48
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$18.48
|
| Rate for Payer: Upland Medical Group Pediatric |
$22.81
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$34.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25.09
|
| Rate for Payer: Vantage Medical Group Senior |
$22.81
|
|
|
HC SOM CAH ANDROSTENEDIONE
|
Facility
|
IP
|
$76.95
|
|
|
Service Code
|
CPT 82157
|
| Hospital Charge Code |
900912771
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.39 |
| Max. Negotiated Rate |
$65.41 |
| Rate for Payer: Adventist Health Commercial |
$15.39
|
| Rate for Payer: Cash Price |
$76.95
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$53.87
|
| Rate for Payer: EPIC Health Plan Commercial |
$30.78
|
| Rate for Payer: EPIC Health Plan Senior |
$30.78
|
| Rate for Payer: Galaxy Health WC |
$65.41
|
| Rate for Payer: Global Benefits Group Commercial |
$46.17
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$48.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$45.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18.47
|
| Rate for Payer: Multiplan Commercial |
$61.56
|
| Rate for Payer: Networks By Design Commercial |
$50.02
|
| Rate for Payer: Prime Health Services Commercial |
$65.41
|
|
|
HC SOM CAH ANDROSTENEDIONE
|
Facility
|
OP
|
$76.95
|
|
|
Service Code
|
CPT 82157
|
| Hospital Charge Code |
900912771
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.39 |
| Max. Negotiated Rate |
$302.07 |
| Rate for Payer: Adventist Health Commercial |
$15.39
|
| Rate for Payer: Aetna of CA HMO/PPO |
$243.47
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$43.92
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$32.21
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$29.28
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$302.07
|
| Rate for Payer: Blue Shield of California Commercial |
$35.47
|
| Rate for Payer: Blue Shield of California Commercial |
$53.63
|
| Rate for Payer: Cash Price |
$76.95
|
| Rate for Payer: Cash Price |
$76.95
|
| Rate for Payer: Cigna of CA HMO |
$49.25
|
| Rate for Payer: Cigna of CA PPO |
$56.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$43.92
|
| Rate for Payer: Dignity Health Medi-Cal |
$32.21
|
| Rate for Payer: Dignity Health Medicare Advantage |
$29.28
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$53.87
|
| Rate for Payer: EPIC Health Plan Commercial |
$48.31
|
| Rate for Payer: EPIC Health Plan Senior |
$32.21
|
| Rate for Payer: Galaxy Health WC |
$65.41
|
| Rate for Payer: Global Benefits Group Commercial |
$46.17
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$48.02
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$43.71
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$29.28
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$48.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$49.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$40.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18.47
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$36.89
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$39.24
|
| Rate for Payer: Multiplan Commercial |
$61.56
|
| Rate for Payer: Networks By Design Commercial |
$50.02
|
| Rate for Payer: Prime Health Services Commercial |
$65.41
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$46.17
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$46.17
|
| Rate for Payer: United Healthcare All Other Commercial |
$23.71
|
| Rate for Payer: United Healthcare All Other HMO |
$23.71
|
| Rate for Payer: United Healthcare HMO Rider |
$23.71
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$23.71
|
| Rate for Payer: Upland Medical Group Pediatric |
$29.28
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$43.92
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$32.21
|
| Rate for Payer: Vantage Medical Group Senior |
$29.28
|
|
|
HC SOM CAH CORTISOL
|
Facility
|
OP
|
$42.84
|
|
|
Service Code
|
CPT 82533
|
| Hospital Charge Code |
900912772
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.57 |
| Max. Negotiated Rate |
$168.44 |
| Rate for Payer: Adventist Health Commercial |
$8.57
|
| Rate for Payer: Aetna of CA HMO/PPO |
$135.64
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$24.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$17.93
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$16.30
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$168.44
|
| Rate for Payer: Blue Shield of California Commercial |
$19.75
|
| Rate for Payer: Blue Shield of California Commercial |
$29.86
|
| Rate for Payer: Cash Price |
$42.84
|
| Rate for Payer: Cash Price |
$42.84
|
| Rate for Payer: Cigna of CA HMO |
$27.42
|
| Rate for Payer: Cigna of CA PPO |
$31.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$24.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$17.93
|
| Rate for Payer: Dignity Health Medicare Advantage |
$16.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$29.99
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.89
|
| Rate for Payer: EPIC Health Plan Senior |
$17.93
|
| Rate for Payer: Galaxy Health WC |
$36.41
|
| Rate for Payer: Global Benefits Group Commercial |
$25.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$26.73
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$24.34
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$16.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$27.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$27.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$22.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$20.54
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$21.84
|
| Rate for Payer: Multiplan Commercial |
$34.27
|
| Rate for Payer: Networks By Design Commercial |
$27.85
|
| Rate for Payer: Prime Health Services Commercial |
$36.41
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$25.70
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$25.70
|
| Rate for Payer: United Healthcare All Other Commercial |
$13.20
|
| Rate for Payer: United Healthcare All Other HMO |
$13.20
|
| Rate for Payer: United Healthcare HMO Rider |
$13.20
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$13.20
|
| Rate for Payer: Upland Medical Group Pediatric |
$16.30
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$24.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$17.93
|
| Rate for Payer: Vantage Medical Group Senior |
$16.30
|
|
|
HC SOM CAH CORTISOL
|
Facility
|
IP
|
$42.84
|
|
|
Service Code
|
CPT 82533
|
| Hospital Charge Code |
900912772
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.57 |
| Max. Negotiated Rate |
$36.41 |
| Rate for Payer: Adventist Health Commercial |
$8.57
|
| Rate for Payer: Cash Price |
$42.84
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$29.99
|
| Rate for Payer: EPIC Health Plan Commercial |
$17.14
|
| Rate for Payer: EPIC Health Plan Senior |
$17.14
|
| Rate for Payer: Galaxy Health WC |
$36.41
|
| Rate for Payer: Global Benefits Group Commercial |
$25.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$27.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$25.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.28
|
| Rate for Payer: Multiplan Commercial |
$34.27
|
| Rate for Payer: Networks By Design Commercial |
$27.85
|
| Rate for Payer: Prime Health Services Commercial |
$36.41
|
|
|
HC SOM CAH DEHYDROEPIANDROSTERONE
|
Facility
|
IP
|
$66.41
|
|
|
Service Code
|
CPT 82626
|
| Hospital Charge Code |
900912774
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.28 |
| Max. Negotiated Rate |
$56.45 |
| Rate for Payer: Adventist Health Commercial |
$13.28
|
| Rate for Payer: Cash Price |
$66.41
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$46.49
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.56
|
| Rate for Payer: EPIC Health Plan Senior |
$26.56
|
| Rate for Payer: Galaxy Health WC |
$56.45
|
| Rate for Payer: Global Benefits Group Commercial |
$39.85
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$42.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$39.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.94
|
| Rate for Payer: Multiplan Commercial |
$53.13
|
| Rate for Payer: Networks By Design Commercial |
$43.17
|
| Rate for Payer: Prime Health Services Commercial |
$56.45
|
|
|
HC SOM CAH DEHYDROEPIANDROSTERONE
|
Facility
|
OP
|
$66.41
|
|
|
Service Code
|
CPT 82626
|
| Hospital Charge Code |
900912774
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.28 |
| Max. Negotiated Rate |
$260.86 |
| Rate for Payer: Adventist Health Commercial |
$13.28
|
| Rate for Payer: Aetna of CA HMO/PPO |
$210.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$37.91
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$27.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$25.27
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$260.86
|
| Rate for Payer: Blue Shield of California Commercial |
$30.62
|
| Rate for Payer: Blue Shield of California Commercial |
$46.29
|
| Rate for Payer: Cash Price |
$66.41
|
| Rate for Payer: Cash Price |
$66.41
|
| Rate for Payer: Cigna of CA HMO |
$42.50
|
| Rate for Payer: Cigna of CA PPO |
$49.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$37.91
|
| Rate for Payer: Dignity Health Medi-Cal |
$27.80
|
| Rate for Payer: Dignity Health Medicare Advantage |
$25.27
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$46.49
|
| Rate for Payer: EPIC Health Plan Commercial |
$41.70
|
| Rate for Payer: EPIC Health Plan Senior |
$27.80
|
| Rate for Payer: Galaxy Health WC |
$56.45
|
| Rate for Payer: Global Benefits Group Commercial |
$39.85
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$41.44
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$37.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$25.27
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$42.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$42.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$35.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.94
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$31.84
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$33.86
|
| Rate for Payer: Multiplan Commercial |
$53.13
|
| Rate for Payer: Networks By Design Commercial |
$43.17
|
| Rate for Payer: Prime Health Services Commercial |
$56.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$39.85
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$39.85
|
| Rate for Payer: United Healthcare All Other Commercial |
$20.47
|
| Rate for Payer: United Healthcare All Other HMO |
$20.47
|
| Rate for Payer: United Healthcare HMO Rider |
$20.47
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$20.47
|
| Rate for Payer: Upland Medical Group Pediatric |
$25.27
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$37.91
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$27.80
|
| Rate for Payer: Vantage Medical Group Senior |
$25.27
|
|
|
HC SOM CAH DEOXYCORTICOSTERONE
|
Facility
|
IP
|
$81.42
|
|
|
Service Code
|
CPT 82633
|
| Hospital Charge Code |
900912773
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$16.28 |
| Max. Negotiated Rate |
$69.21 |
| Rate for Payer: Adventist Health Commercial |
$16.28
|
| Rate for Payer: Cash Price |
$81.42
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$56.99
|
| Rate for Payer: EPIC Health Plan Commercial |
$32.57
|
| Rate for Payer: EPIC Health Plan Senior |
$32.57
|
| Rate for Payer: Galaxy Health WC |
$69.21
|
| Rate for Payer: Global Benefits Group Commercial |
$48.85
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$51.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$48.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.54
|
| Rate for Payer: Multiplan Commercial |
$65.14
|
| Rate for Payer: Networks By Design Commercial |
$52.92
|
| Rate for Payer: Prime Health Services Commercial |
$69.21
|
|
|
HC SOM CAH DEOXYCORTICOSTERONE
|
Facility
|
OP
|
$81.42
|
|
|
Service Code
|
CPT 82633
|
| Hospital Charge Code |
900912773
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$16.28 |
| Max. Negotiated Rate |
$309.37 |
| Rate for Payer: Adventist Health Commercial |
$16.28
|
| Rate for Payer: Aetna of CA HMO/PPO |
$257.58
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$46.47
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$34.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$30.98
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$309.37
|
| Rate for Payer: Blue Shield of California Commercial |
$37.53
|
| Rate for Payer: Blue Shield of California Commercial |
$56.75
|
| Rate for Payer: Cash Price |
$81.42
|
| Rate for Payer: Cash Price |
$81.42
|
| Rate for Payer: Cigna of CA HMO |
$52.11
|
| Rate for Payer: Cigna of CA PPO |
$60.25
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$46.47
|
| Rate for Payer: Dignity Health Medi-Cal |
$34.08
|
| Rate for Payer: Dignity Health Medicare Advantage |
$30.98
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$56.99
|
| Rate for Payer: EPIC Health Plan Commercial |
$51.12
|
| Rate for Payer: EPIC Health Plan Senior |
$34.08
|
| Rate for Payer: Galaxy Health WC |
$69.21
|
| Rate for Payer: Global Benefits Group Commercial |
$48.85
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$50.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$46.27
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$30.98
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$51.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$52.33
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$43.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.54
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$39.03
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$41.51
|
| Rate for Payer: Multiplan Commercial |
$65.14
|
| Rate for Payer: Networks By Design Commercial |
$52.92
|
| Rate for Payer: Prime Health Services Commercial |
$69.21
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$48.85
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$48.85
|
| Rate for Payer: United Healthcare All Other Commercial |
$25.09
|
| Rate for Payer: United Healthcare All Other HMO |
$25.09
|
| Rate for Payer: United Healthcare HMO Rider |
$25.09
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$25.09
|
| Rate for Payer: Upland Medical Group Pediatric |
$30.98
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$46.47
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$34.08
|
| Rate for Payer: Vantage Medical Group Senior |
$30.98
|
|
|
HC SOM CAH PROGESTERONE
|
Facility
|
IP
|
$54.83
|
|
|
Service Code
|
CPT 84144
|
| Hospital Charge Code |
900912777
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.97 |
| Max. Negotiated Rate |
$46.61 |
| Rate for Payer: Adventist Health Commercial |
$10.97
|
| Rate for Payer: Cash Price |
$54.83
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$38.38
|
| Rate for Payer: EPIC Health Plan Commercial |
$21.93
|
| Rate for Payer: EPIC Health Plan Senior |
$21.93
|
| Rate for Payer: Galaxy Health WC |
$46.61
|
| Rate for Payer: Global Benefits Group Commercial |
$32.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$34.82
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$32.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.16
|
| Rate for Payer: Multiplan Commercial |
$43.86
|
| Rate for Payer: Networks By Design Commercial |
$35.64
|
| Rate for Payer: Prime Health Services Commercial |
$46.61
|
|
|
HC SOM CAH PROGESTERONE
|
Facility
|
OP
|
$54.83
|
|
|
Service Code
|
CPT 84144
|
| Hospital Charge Code |
900912777
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.97 |
| Max. Negotiated Rate |
$215.35 |
| Rate for Payer: United Healthcare HMO Rider |
$16.89
|
| Rate for Payer: Adventist Health Commercial |
$10.97
|
| Rate for Payer: Aetna of CA HMO/PPO |
$173.53
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$31.29
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$22.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$20.86
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$215.35
|
| Rate for Payer: Blue Shield of California Commercial |
$25.28
|
| Rate for Payer: Blue Shield of California Commercial |
$38.22
|
| Rate for Payer: Cash Price |
$54.83
|
| Rate for Payer: Cash Price |
$54.83
|
| Rate for Payer: Cigna of CA HMO |
$35.09
|
| Rate for Payer: Cigna of CA PPO |
$40.57
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$31.29
|
| Rate for Payer: Dignity Health Medi-Cal |
$22.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$20.86
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$38.38
|
| Rate for Payer: EPIC Health Plan Commercial |
$34.42
|
| Rate for Payer: EPIC Health Plan Senior |
$22.95
|
| Rate for Payer: Galaxy Health WC |
$46.61
|
| Rate for Payer: Global Benefits Group Commercial |
$32.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$34.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$30.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$20.86
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$34.82
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$34.77
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$29.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$26.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$27.95
|
| Rate for Payer: Multiplan Commercial |
$43.86
|
| Rate for Payer: Networks By Design Commercial |
$35.64
|
| Rate for Payer: Prime Health Services Commercial |
$46.61
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$32.90
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$32.90
|
| Rate for Payer: United Healthcare All Other Commercial |
$16.89
|
| Rate for Payer: United Healthcare All Other HMO |
$16.89
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16.89
|
| Rate for Payer: Upland Medical Group Pediatric |
$20.86
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$31.29
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$22.95
|
| Rate for Payer: Vantage Medical Group Senior |
$20.86
|
|
|
HC SOM CAH TESTOSTERONE
|
Facility
|
OP
|
$67.83
|
|
|
Service Code
|
CPT 84403
|
| Hospital Charge Code |
900912779
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.57 |
| Max. Negotiated Rate |
$266.42 |
| Rate for Payer: Adventist Health Commercial |
$13.57
|
| Rate for Payer: Aetna of CA HMO/PPO |
$214.68
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$38.72
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$28.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$25.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$266.42
|
| Rate for Payer: Blue Shield of California Commercial |
$31.27
|
| Rate for Payer: Blue Shield of California Commercial |
$47.28
|
| Rate for Payer: Cash Price |
$67.83
|
| Rate for Payer: Cash Price |
$67.83
|
| Rate for Payer: Cigna of CA HMO |
$43.41
|
| Rate for Payer: Cigna of CA PPO |
$50.19
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$38.72
|
| Rate for Payer: Dignity Health Medi-Cal |
$28.39
|
| Rate for Payer: Dignity Health Medicare Advantage |
$25.81
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$47.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$42.59
|
| Rate for Payer: EPIC Health Plan Senior |
$28.39
|
| Rate for Payer: Galaxy Health WC |
$57.66
|
| Rate for Payer: Global Benefits Group Commercial |
$40.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$42.33
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$38.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$25.81
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$43.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$43.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$36.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$32.52
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$34.59
|
| Rate for Payer: Multiplan Commercial |
$54.26
|
| Rate for Payer: Networks By Design Commercial |
$44.09
|
| Rate for Payer: Prime Health Services Commercial |
$57.66
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$40.70
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$40.70
|
| Rate for Payer: United Healthcare All Other Commercial |
$20.91
|
| Rate for Payer: United Healthcare All Other HMO |
$20.91
|
| Rate for Payer: United Healthcare HMO Rider |
$20.91
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$20.91
|
| Rate for Payer: Upland Medical Group Pediatric |
$25.81
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$38.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$28.39
|
| Rate for Payer: Vantage Medical Group Senior |
$25.81
|
|
|
HC SOM CAH TESTOSTERONE
|
Facility
|
IP
|
$67.83
|
|
|
Service Code
|
CPT 84403
|
| Hospital Charge Code |
900912779
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.57 |
| Max. Negotiated Rate |
$57.66 |
| Rate for Payer: Adventist Health Commercial |
$13.57
|
| Rate for Payer: Cash Price |
$67.83
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$47.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$27.13
|
| Rate for Payer: EPIC Health Plan Senior |
$27.13
|
| Rate for Payer: Galaxy Health WC |
$57.66
|
| Rate for Payer: Global Benefits Group Commercial |
$40.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$43.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$40.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.28
|
| Rate for Payer: Multiplan Commercial |
$54.26
|
| Rate for Payer: Networks By Design Commercial |
$44.09
|
| Rate for Payer: Prime Health Services Commercial |
$57.66
|
|
|
HC SOM CALCITONIN
|
Facility
|
IP
|
$22.00
|
|
|
Service Code
|
CPT 82308
|
| Hospital Charge Code |
900911003
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.40 |
| Max. Negotiated Rate |
$18.70 |
| Rate for Payer: Adventist Health Commercial |
$4.40
|
| Rate for Payer: Cash Price |
$22.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$15.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.80
|
| Rate for Payer: EPIC Health Plan Senior |
$8.80
|
| Rate for Payer: Galaxy Health WC |
$18.70
|
| Rate for Payer: Global Benefits Group Commercial |
$13.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$13.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$12.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.28
|
| Rate for Payer: Multiplan Commercial |
$17.60
|
| Rate for Payer: Networks By Design Commercial |
$14.30
|
| Rate for Payer: Prime Health Services Commercial |
$18.70
|
|
|
HC SOM CALCITONIN
|
Facility
|
OP
|
$22.00
|
|
|
Service Code
|
CPT 82308
|
| Hospital Charge Code |
900911003
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.40 |
| Max. Negotiated Rate |
$276.43 |
| Rate for Payer: Adventist Health Commercial |
$4.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$222.75
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$40.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$29.47
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$26.79
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$276.43
|
| Rate for Payer: Blue Shield of California Commercial |
$10.14
|
| Rate for Payer: Blue Shield of California Commercial |
$15.33
|
| Rate for Payer: Cash Price |
$22.00
|
| Rate for Payer: Cash Price |
$22.00
|
| Rate for Payer: Cigna of CA HMO |
$14.08
|
| Rate for Payer: Cigna of CA PPO |
$16.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$40.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$29.47
|
| Rate for Payer: Dignity Health Medicare Advantage |
$26.79
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$15.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$44.20
|
| Rate for Payer: EPIC Health Plan Senior |
$29.47
|
| Rate for Payer: Galaxy Health WC |
$18.70
|
| Rate for Payer: Global Benefits Group Commercial |
$13.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$43.94
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$40.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$26.79
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$13.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$45.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$37.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$33.76
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$35.90
|
| Rate for Payer: Multiplan Commercial |
$17.60
|
| Rate for Payer: Networks By Design Commercial |
$14.30
|
| Rate for Payer: Prime Health Services Commercial |
$18.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$13.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$13.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$21.70
|
| Rate for Payer: United Healthcare All Other HMO |
$21.70
|
| Rate for Payer: United Healthcare HMO Rider |
$21.70
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$21.70
|
| Rate for Payer: Upland Medical Group Pediatric |
$26.79
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$40.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$29.47
|
| Rate for Payer: Vantage Medical Group Senior |
$26.79
|
|
|
HC SOM CALPROTECTIN
|
Facility
|
IP
|
$60.00
|
|
|
Service Code
|
CPT 83993
|
| Hospital Charge Code |
900912938
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.00 |
| Max. Negotiated Rate |
$51.00 |
| Rate for Payer: Adventist Health Commercial |
$12.00
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$42.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$24.00
|
| Rate for Payer: EPIC Health Plan Senior |
$24.00
|
| Rate for Payer: Galaxy Health WC |
$51.00
|
| Rate for Payer: Global Benefits Group Commercial |
$36.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$38.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$35.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.40
|
| Rate for Payer: Multiplan Commercial |
$48.00
|
| Rate for Payer: Networks By Design Commercial |
$39.00
|
| Rate for Payer: Prime Health Services Commercial |
$51.00
|
|
|
HC SOM CALPROTECTIN
|
Facility
|
OP
|
$60.00
|
|
|
Service Code
|
CPT 83993
|
| Hospital Charge Code |
900912938
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.00 |
| Max. Negotiated Rate |
$202.56 |
| Rate for Payer: Adventist Health Commercial |
$12.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$163.24
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$29.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$21.59
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$19.63
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$202.56
|
| Rate for Payer: Blue Shield of California Commercial |
$27.66
|
| Rate for Payer: Blue Shield of California Commercial |
$41.82
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cigna of CA HMO |
$38.40
|
| Rate for Payer: Cigna of CA PPO |
$44.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$29.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$21.59
|
| Rate for Payer: Dignity Health Medicare Advantage |
$19.63
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$42.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$32.39
|
| Rate for Payer: EPIC Health Plan Senior |
$21.59
|
| Rate for Payer: Galaxy Health WC |
$51.00
|
| Rate for Payer: Global Benefits Group Commercial |
$36.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$32.19
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$29.32
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$19.63
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$38.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$33.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$27.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$24.73
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$26.30
|
| Rate for Payer: Multiplan Commercial |
$48.00
|
| Rate for Payer: Networks By Design Commercial |
$39.00
|
| Rate for Payer: Prime Health Services Commercial |
$51.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$36.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$36.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$15.90
|
| Rate for Payer: United Healthcare All Other HMO |
$15.90
|
| Rate for Payer: United Healthcare HMO Rider |
$15.90
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15.90
|
| Rate for Payer: Upland Medical Group Pediatric |
$19.63
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$29.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$21.59
|
| Rate for Payer: Vantage Medical Group Senior |
$19.63
|
|
|
HC SOM CANDIDA AURIS SURV PCR
|
Facility
|
IP
|
$200.39
|
|
|
Service Code
|
CPT 87481
|
| Hospital Charge Code |
900915483
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$40.08 |
| Max. Negotiated Rate |
$170.33 |
| Rate for Payer: Adventist Health Commercial |
$40.08
|
| Rate for Payer: Cash Price |
$200.39
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$140.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$80.16
|
| Rate for Payer: EPIC Health Plan Senior |
$80.16
|
| Rate for Payer: Galaxy Health WC |
$170.33
|
| Rate for Payer: Global Benefits Group Commercial |
$120.23
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$127.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$118.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$48.09
|
| Rate for Payer: Multiplan Commercial |
$160.31
|
| Rate for Payer: Networks By Design Commercial |
$130.25
|
| Rate for Payer: Prime Health Services Commercial |
$170.33
|
|
|
HC SOM CANDIDA AURIS SURV PCR
|
Facility
|
OP
|
$200.39
|
|
|
Service Code
|
CPT 87481
|
| Hospital Charge Code |
900915483
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$28.42 |
| Max. Negotiated Rate |
$350.50 |
| Rate for Payer: Adventist Health Commercial |
$40.08
|
| Rate for Payer: Aetna of CA HMO/PPO |
$291.85
|
| 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 |
$350.50
|
| Rate for Payer: Blue Shield of California Commercial |
$139.67
|
| Rate for Payer: Blue Shield of California Commercial |
$92.38
|
| Rate for Payer: Cash Price |
$200.39
|
| Rate for Payer: Cash Price |
$200.39
|
| Rate for Payer: Cigna of CA HMO |
$128.25
|
| Rate for Payer: Cigna of CA PPO |
$148.29
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$52.63
|
| Rate for Payer: Dignity Health Medi-Cal |
$38.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$35.09
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$140.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$57.90
|
| Rate for Payer: EPIC Health Plan Senior |
$38.60
|
| Rate for Payer: Galaxy Health WC |
$170.33
|
| Rate for Payer: Global Benefits Group Commercial |
$120.23
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$57.55
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$52.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$35.09
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$127.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$59.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$49.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$48.09
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$44.21
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$47.02
|
| Rate for Payer: Multiplan Commercial |
$160.31
|
| Rate for Payer: Networks By Design Commercial |
$130.25
|
| Rate for Payer: Prime Health Services Commercial |
$170.33
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$120.23
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$120.23
|
| Rate for Payer: United Healthcare All Other Commercial |
$28.42
|
| Rate for Payer: United Healthcare All Other HMO |
$28.42
|
| Rate for Payer: United Healthcare HMO Rider |
$28.42
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$28.42
|
| Rate for Payer: Upland Medical Group Pediatric |
$35.09
|
| 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 SOM CARBAPEN MOD HODGE TEST
|
Facility
|
OP
|
$164.70
|
|
|
Service Code
|
CPT 87185
|
| Hospital Charge Code |
900914208
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$2.03 |
| Max. Negotiated Rate |
$140.00 |
| Rate for Payer: Adventist Health Commercial |
$32.94
|
| Rate for Payer: Aetna of CA HMO/PPO |
$13.56
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.12
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.22
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$29.74
|
| Rate for Payer: Blue Shield of California Commercial |
$114.80
|
| Rate for Payer: Blue Shield of California Commercial |
$75.93
|
| Rate for Payer: Cash Price |
$164.70
|
| Rate for Payer: Cash Price |
$164.70
|
| Rate for Payer: Cigna of CA HMO |
$105.41
|
| Rate for Payer: Cigna of CA PPO |
$121.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.22
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4.75
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$115.29
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.84
|
| Rate for Payer: EPIC Health Plan Senior |
$5.22
|
| Rate for Payer: Galaxy Health WC |
$140.00
|
| Rate for Payer: Global Benefits Group Commercial |
$98.82
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7.79
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$2.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4.75
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$104.58
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$39.53
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5.99
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.37
|
| Rate for Payer: Multiplan Commercial |
$131.76
|
| Rate for Payer: Networks By Design Commercial |
$107.06
|
| Rate for Payer: Prime Health Services Commercial |
$140.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$98.82
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$98.82
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.85
|
| Rate for Payer: United Healthcare All Other HMO |
$3.85
|
| Rate for Payer: United Healthcare HMO Rider |
$3.85
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.85
|
| Rate for Payer: Upland Medical Group Pediatric |
$4.75
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.22
|
| Rate for Payer: Vantage Medical Group Senior |
$4.75
|
|
|
HC SOM CARBAPEN MOD HODGE TEST
|
Facility
|
IP
|
$164.70
|
|
|
Service Code
|
CPT 87185
|
| Hospital Charge Code |
900914208
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$32.94 |
| Max. Negotiated Rate |
$140.00 |
| Rate for Payer: Adventist Health Commercial |
$32.94
|
| Rate for Payer: Cash Price |
$164.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$115.29
|
| Rate for Payer: EPIC Health Plan Commercial |
$65.88
|
| Rate for Payer: EPIC Health Plan Senior |
$65.88
|
| Rate for Payer: Galaxy Health WC |
$140.00
|
| Rate for Payer: Global Benefits Group Commercial |
$98.82
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$104.58
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$97.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$39.53
|
| Rate for Payer: Multiplan Commercial |
$131.76
|
| Rate for Payer: Networks By Design Commercial |
$107.06
|
| Rate for Payer: Prime Health Services Commercial |
$140.00
|
|
|
HC SOM CARB DEF TRANS CONGENITAL
|
Facility
|
OP
|
$49.93
|
|
|
Service Code
|
CPT 82373
|
| Hospital Charge Code |
900912514
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.99 |
| Max. Negotiated Rate |
$150.17 |
| Rate for Payer: Adventist Health Commercial |
$9.99
|
| Rate for Payer: Aetna of CA HMO/PPO |
$150.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$27.09
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19.87
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$18.06
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$74.28
|
| Rate for Payer: Blue Shield of California Commercial |
$23.02
|
| Rate for Payer: Blue Shield of California Commercial |
$34.80
|
| Rate for Payer: Cash Price |
$49.93
|
| Rate for Payer: Cash Price |
$49.93
|
| Rate for Payer: Cigna of CA HMO |
$31.96
|
| Rate for Payer: Cigna of CA PPO |
$36.95
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$27.09
|
| Rate for Payer: Dignity Health Medi-Cal |
$19.87
|
| Rate for Payer: Dignity Health Medicare Advantage |
$18.06
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$34.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$29.80
|
| Rate for Payer: EPIC Health Plan Senior |
$19.87
|
| Rate for Payer: Galaxy Health WC |
$42.44
|
| Rate for Payer: Global Benefits Group Commercial |
$29.96
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$29.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$15.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$18.06
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$31.71
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$17.71
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$25.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.98
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$22.76
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$24.20
|
| Rate for Payer: Multiplan Commercial |
$39.94
|
| Rate for Payer: Networks By Design Commercial |
$32.45
|
| Rate for Payer: Prime Health Services Commercial |
$42.44
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$29.96
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$29.96
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.62
|
| Rate for Payer: United Healthcare All Other HMO |
$14.62
|
| Rate for Payer: United Healthcare HMO Rider |
$14.62
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.62
|
| Rate for Payer: Upland Medical Group Pediatric |
$18.06
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$27.09
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.87
|
| Rate for Payer: Vantage Medical Group Senior |
$18.06
|
|
|
HC SOM CARB DEF TRANS CONGENITAL
|
Facility
|
IP
|
$49.93
|
|
|
Service Code
|
CPT 82373
|
| Hospital Charge Code |
900912514
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.99 |
| Max. Negotiated Rate |
$42.44 |
| Rate for Payer: Adventist Health Commercial |
$9.99
|
| Rate for Payer: Cash Price |
$49.93
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$34.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.97
|
| Rate for Payer: EPIC Health Plan Senior |
$19.97
|
| Rate for Payer: Galaxy Health WC |
$42.44
|
| Rate for Payer: Global Benefits Group Commercial |
$29.96
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$31.71
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$29.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.98
|
| Rate for Payer: Multiplan Commercial |
$39.94
|
| Rate for Payer: Networks By Design Commercial |
$32.45
|
| Rate for Payer: Prime Health Services Commercial |
$42.44
|
|
|
HC SOM CARB DEF TRANSFERRIN ADULT
|
Facility
|
IP
|
$49.93
|
|
|
Service Code
|
CPT 82373
|
| Hospital Charge Code |
900912717
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.99 |
| Max. Negotiated Rate |
$42.44 |
| Rate for Payer: Adventist Health Commercial |
$9.99
|
| Rate for Payer: Cash Price |
$49.93
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$34.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.97
|
| Rate for Payer: EPIC Health Plan Senior |
$19.97
|
| Rate for Payer: Galaxy Health WC |
$42.44
|
| Rate for Payer: Global Benefits Group Commercial |
$29.96
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$31.71
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$29.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.98
|
| Rate for Payer: Multiplan Commercial |
$39.94
|
| Rate for Payer: Networks By Design Commercial |
$32.45
|
| Rate for Payer: Prime Health Services Commercial |
$42.44
|
|
