|
HC SOM PARANEOPL EVAL AMPH AB
|
Facility
|
OP
|
$30.37
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
900914656
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.07 |
| Max. Negotiated Rate |
$119.10 |
| Rate for Payer: Adventist Health Commercial |
$6.07
|
| Rate for Payer: Aetna of CA HMO/PPO |
$19.92
|
| 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 |
$119.10
|
| Rate for Payer: Blue Shield of California Commercial |
$20.32
|
| Rate for Payer: Blue Shield of California EPN |
$13.42
|
| Rate for Payer: Cash Price |
$30.37
|
| Rate for Payer: Cash Price |
$30.37
|
| Rate for Payer: Cigna of CA HMO |
$19.44
|
| Rate for Payer: Cigna of CA PPO |
$22.47
|
| 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: EPIC Health Plan Commercial |
$16.27
|
| Rate for Payer: EPIC Health Plan Senior |
$12.05
|
| Rate for Payer: Galaxy Health WC |
$25.81
|
| Rate for Payer: Global Benefits Group Commercial |
$18.22
|
| Rate for Payer: Heritage Provider Network Commercial |
$19.76
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$14.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$12.05
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20.26
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$16.40
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.29
|
| 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 |
$24.30
|
| Rate for Payer: Networks By Design Commercial |
$19.74
|
| Rate for Payer: Prime Health Services Commercial |
$25.81
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$18.22
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$18.22
|
| 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 PARANEOPL EVAL ANNA1
|
Facility
|
OP
|
$30.37
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
900914649
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.07 |
| Max. Negotiated Rate |
$119.10 |
| Rate for Payer: EPIC Health Plan Senior |
$12.05
|
| Rate for Payer: Galaxy Health WC |
$25.81
|
| Rate for Payer: Adventist Health Commercial |
$6.07
|
| Rate for Payer: Aetna of CA HMO/PPO |
$19.92
|
| 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 |
$119.10
|
| Rate for Payer: Blue Shield of California Commercial |
$20.32
|
| Rate for Payer: Blue Shield of California EPN |
$13.42
|
| Rate for Payer: Cash Price |
$30.37
|
| Rate for Payer: Cash Price |
$30.37
|
| Rate for Payer: Cigna of CA HMO |
$19.44
|
| Rate for Payer: Cigna of CA PPO |
$22.47
|
| 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: EPIC Health Plan Commercial |
$16.27
|
| Rate for Payer: Global Benefits Group Commercial |
$18.22
|
| Rate for Payer: Heritage Provider Network Commercial |
$19.76
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$14.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$12.05
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20.26
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$16.40
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.29
|
| 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 |
$24.30
|
| Rate for Payer: Networks By Design Commercial |
$19.74
|
| Rate for Payer: Prime Health Services Commercial |
$25.81
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$18.22
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$18.22
|
| 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 PARANEOPL EVAL ANNA1
|
Facility
|
IP
|
$30.37
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
900914649
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.07 |
| Max. Negotiated Rate |
$25.81 |
| Rate for Payer: Adventist Health Commercial |
$6.07
|
| Rate for Payer: Cash Price |
$30.37
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.15
|
| Rate for Payer: EPIC Health Plan Senior |
$12.15
|
| Rate for Payer: Galaxy Health WC |
$25.81
|
| Rate for Payer: Global Benefits Group Commercial |
$18.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20.26
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.29
|
| Rate for Payer: Multiplan Commercial |
$24.30
|
| Rate for Payer: Networks By Design Commercial |
$19.74
|
| Rate for Payer: Prime Health Services Commercial |
$25.81
|
|
|
HC SOM PARANEOPL EVAL ANNA2
|
Facility
|
IP
|
$30.36
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
900914650
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.07 |
| Max. Negotiated Rate |
$25.81 |
| Rate for Payer: Adventist Health Commercial |
$6.07
|
| Rate for Payer: Cash Price |
$30.36
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.14
|
| Rate for Payer: EPIC Health Plan Senior |
$12.14
|
| Rate for Payer: Galaxy Health WC |
$25.81
|
| Rate for Payer: Global Benefits Group Commercial |
$18.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.29
|
| Rate for Payer: Multiplan Commercial |
$24.29
|
| Rate for Payer: Networks By Design Commercial |
$19.73
|
| Rate for Payer: Prime Health Services Commercial |
$25.81
|
|
|
HC SOM PARANEOPL EVAL ANNA2
|
Facility
|
OP
|
$30.36
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
900914650
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.07 |
| Max. Negotiated Rate |
$119.10 |
| Rate for Payer: Adventist Health Commercial |
$6.07
|
| Rate for Payer: Aetna of CA HMO/PPO |
$19.91
|
| 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 |
$119.10
|
| Rate for Payer: Blue Shield of California Commercial |
$20.31
|
| Rate for Payer: Blue Shield of California EPN |
$13.42
|
| Rate for Payer: Cash Price |
$30.36
|
| Rate for Payer: Cash Price |
$30.36
|
| Rate for Payer: Cigna of CA HMO |
$19.43
|
| Rate for Payer: Cigna of CA PPO |
$22.47
|
| 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: EPIC Health Plan Commercial |
$16.27
|
| Rate for Payer: EPIC Health Plan Senior |
$12.05
|
| Rate for Payer: Galaxy Health WC |
$25.81
|
| Rate for Payer: Global Benefits Group Commercial |
$18.22
|
| Rate for Payer: Heritage Provider Network Commercial |
$19.76
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$14.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$12.05
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$16.40
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.29
|
| 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 |
$24.29
|
| Rate for Payer: Networks By Design Commercial |
$19.73
|
| Rate for Payer: Prime Health Services Commercial |
$25.81
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$18.22
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$18.22
|
| 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 PARANEOPL EVAL ANNA3
|
Facility
|
OP
|
$30.36
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
900914651
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.07 |
| Max. Negotiated Rate |
$119.10 |
| Rate for Payer: Adventist Health Commercial |
$6.07
|
| Rate for Payer: Aetna of CA HMO/PPO |
$19.91
|
| 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 |
$119.10
|
| Rate for Payer: Blue Shield of California Commercial |
$20.31
|
| Rate for Payer: Blue Shield of California EPN |
$13.42
|
| Rate for Payer: Cash Price |
$30.36
|
| Rate for Payer: Cash Price |
$30.36
|
| Rate for Payer: Cigna of CA HMO |
$19.43
|
| Rate for Payer: Cigna of CA PPO |
$22.47
|
| 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: EPIC Health Plan Commercial |
$16.27
|
| Rate for Payer: EPIC Health Plan Senior |
$12.05
|
| Rate for Payer: Galaxy Health WC |
$25.81
|
| Rate for Payer: Global Benefits Group Commercial |
$18.22
|
| Rate for Payer: Heritage Provider Network Commercial |
$19.76
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$14.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$12.05
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$16.40
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.29
|
| 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 |
$24.29
|
| Rate for Payer: Networks By Design Commercial |
$19.73
|
| Rate for Payer: Prime Health Services Commercial |
$25.81
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$18.22
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$18.22
|
| 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 PARANEOPL EVAL ANNA3
|
Facility
|
IP
|
$30.36
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
900914651
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.07 |
| Max. Negotiated Rate |
$25.81 |
| Rate for Payer: Adventist Health Commercial |
$6.07
|
| Rate for Payer: Cash Price |
$30.36
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.14
|
| Rate for Payer: EPIC Health Plan Senior |
$12.14
|
| Rate for Payer: Galaxy Health WC |
$25.81
|
| Rate for Payer: Global Benefits Group Commercial |
$18.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.29
|
| Rate for Payer: Multiplan Commercial |
$24.29
|
| Rate for Payer: Networks By Design Commercial |
$19.73
|
| Rate for Payer: Prime Health Services Commercial |
$25.81
|
|
|
HC SOM PARANEOPL EVAL CRMP5 AB
|
Facility
|
IP
|
$30.37
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
900914657
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.07 |
| Max. Negotiated Rate |
$25.81 |
| Rate for Payer: Adventist Health Commercial |
$6.07
|
| Rate for Payer: Cash Price |
$30.37
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.15
|
| Rate for Payer: EPIC Health Plan Senior |
$12.15
|
| Rate for Payer: Galaxy Health WC |
$25.81
|
| Rate for Payer: Global Benefits Group Commercial |
$18.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20.26
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.29
|
| Rate for Payer: Multiplan Commercial |
$24.30
|
| Rate for Payer: Networks By Design Commercial |
$19.74
|
| Rate for Payer: Prime Health Services Commercial |
$25.81
|
|
|
HC SOM PARANEOPL EVAL CRMP5 AB
|
Facility
|
OP
|
$30.37
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
900914657
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.07 |
| Max. Negotiated Rate |
$119.10 |
| Rate for Payer: Adventist Health Commercial |
$6.07
|
| Rate for Payer: Aetna of CA HMO/PPO |
$19.92
|
| 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 |
$119.10
|
| Rate for Payer: Blue Shield of California Commercial |
$20.32
|
| Rate for Payer: Blue Shield of California EPN |
$13.42
|
| Rate for Payer: Cash Price |
$30.37
|
| Rate for Payer: Cash Price |
$30.37
|
| Rate for Payer: Cigna of CA HMO |
$19.44
|
| Rate for Payer: Cigna of CA PPO |
$22.47
|
| 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: EPIC Health Plan Commercial |
$16.27
|
| Rate for Payer: EPIC Health Plan Senior |
$12.05
|
| Rate for Payer: Galaxy Health WC |
$25.81
|
| Rate for Payer: Global Benefits Group Commercial |
$18.22
|
| Rate for Payer: Heritage Provider Network Commercial |
$19.76
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$14.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$12.05
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20.26
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$16.40
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.29
|
| 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 |
$24.30
|
| Rate for Payer: Networks By Design Commercial |
$19.74
|
| Rate for Payer: Prime Health Services Commercial |
$25.81
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$18.22
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$18.22
|
| 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 PARANEOPL EVAL NEU AB
|
Facility
|
OP
|
$46.36
|
|
|
Service Code
|
CPT 83519
|
| Hospital Charge Code |
900914661
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.27 |
| Max. Negotiated Rate |
$133.46 |
| Rate for Payer: EPIC Health Plan Senior |
$18.40
|
| Rate for Payer: Galaxy Health WC |
$39.41
|
| Rate for Payer: Adventist Health Commercial |
$9.27
|
| Rate for Payer: Aetna of CA HMO/PPO |
$30.41
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$27.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$20.24
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$18.40
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$133.46
|
| Rate for Payer: Blue Shield of California Commercial |
$31.01
|
| Rate for Payer: Blue Shield of California EPN |
$20.49
|
| Rate for Payer: Cash Price |
$46.36
|
| Rate for Payer: Cash Price |
$46.36
|
| Rate for Payer: Cigna of CA HMO |
$29.67
|
| Rate for Payer: Cigna of CA PPO |
$34.31
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$27.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$20.24
|
| Rate for Payer: Dignity Health Medicare Advantage |
$18.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$24.84
|
| Rate for Payer: Global Benefits Group Commercial |
$27.82
|
| Rate for Payer: Heritage Provider Network Commercial |
$30.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$20.61
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$18.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$30.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$23.31
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.13
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$23.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$24.66
|
| Rate for Payer: Multiplan Commercial |
$37.09
|
| Rate for Payer: Networks By Design Commercial |
$30.13
|
| Rate for Payer: Prime Health Services Commercial |
$39.41
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$27.82
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$27.82
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.90
|
| Rate for Payer: United Healthcare All Other HMO |
$14.90
|
| Rate for Payer: United Healthcare HMO Rider |
$14.90
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.90
|
| Rate for Payer: Upland Medical Group Pediatric |
$18.40
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$27.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$20.24
|
| Rate for Payer: Vantage Medical Group Senior |
$18.40
|
|
|
HC SOM PARANEOPL EVAL NEU AB
|
Facility
|
IP
|
$46.36
|
|
|
Service Code
|
CPT 83519
|
| Hospital Charge Code |
900914661
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.27 |
| Max. Negotiated Rate |
$39.41 |
| Rate for Payer: Adventist Health Commercial |
$9.27
|
| Rate for Payer: Cash Price |
$46.36
|
| Rate for Payer: EPIC Health Plan Commercial |
$18.54
|
| Rate for Payer: EPIC Health Plan Senior |
$18.54
|
| Rate for Payer: Galaxy Health WC |
$39.41
|
| Rate for Payer: Global Benefits Group Commercial |
$27.82
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$30.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$17.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$28.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.13
|
| Rate for Payer: Multiplan Commercial |
$37.09
|
| Rate for Payer: Networks By Design Commercial |
$30.13
|
| Rate for Payer: Prime Health Services Commercial |
$39.41
|
|
|
HC SOM PARANEOPL EVAL NTYPE AB
|
Facility
|
IP
|
$32.31
|
|
|
Service Code
|
CPT 83519
|
| Hospital Charge Code |
900914659
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.46 |
| Max. Negotiated Rate |
$27.46 |
| Rate for Payer: Adventist Health Commercial |
$6.46
|
| Rate for Payer: Cash Price |
$32.31
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.92
|
| Rate for Payer: EPIC Health Plan Senior |
$12.92
|
| Rate for Payer: Galaxy Health WC |
$27.46
|
| Rate for Payer: Global Benefits Group Commercial |
$19.39
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$21.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12.31
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$20.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.75
|
| Rate for Payer: Multiplan Commercial |
$25.85
|
| Rate for Payer: Networks By Design Commercial |
$21.00
|
| Rate for Payer: Prime Health Services Commercial |
$27.46
|
|
|
HC SOM PARANEOPL EVAL NTYPE AB
|
Facility
|
OP
|
$32.31
|
|
|
Service Code
|
CPT 83519
|
| Hospital Charge Code |
900914659
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.46 |
| Max. Negotiated Rate |
$133.46 |
| Rate for Payer: Adventist Health Commercial |
$6.46
|
| Rate for Payer: Aetna of CA HMO/PPO |
$21.19
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$27.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$20.24
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$18.40
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$133.46
|
| Rate for Payer: Blue Shield of California Commercial |
$21.62
|
| Rate for Payer: Blue Shield of California EPN |
$14.28
|
| Rate for Payer: Cash Price |
$32.31
|
| Rate for Payer: Cash Price |
$32.31
|
| Rate for Payer: Cigna of CA HMO |
$20.68
|
| Rate for Payer: Cigna of CA PPO |
$23.91
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$27.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$20.24
|
| Rate for Payer: Dignity Health Medicare Advantage |
$18.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$24.84
|
| Rate for Payer: EPIC Health Plan Senior |
$18.40
|
| Rate for Payer: Galaxy Health WC |
$27.46
|
| Rate for Payer: Global Benefits Group Commercial |
$19.39
|
| Rate for Payer: Heritage Provider Network Commercial |
$30.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$20.61
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$18.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$21.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$23.31
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$23.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$24.66
|
| Rate for Payer: Multiplan Commercial |
$25.85
|
| Rate for Payer: Networks By Design Commercial |
$21.00
|
| Rate for Payer: Prime Health Services Commercial |
$27.46
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$19.39
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$19.39
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.90
|
| Rate for Payer: United Healthcare All Other HMO |
$14.90
|
| Rate for Payer: United Healthcare HMO Rider |
$14.90
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.90
|
| Rate for Payer: Upland Medical Group Pediatric |
$18.40
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$27.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$20.24
|
| Rate for Payer: Vantage Medical Group Senior |
$18.40
|
|
|
HC SOM PARANEOPL EVAL PCA1
|
Facility
|
IP
|
$30.36
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
900914653
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.07 |
| Max. Negotiated Rate |
$25.81 |
| Rate for Payer: Adventist Health Commercial |
$6.07
|
| Rate for Payer: Cash Price |
$30.36
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.14
|
| Rate for Payer: EPIC Health Plan Senior |
$12.14
|
| Rate for Payer: Galaxy Health WC |
$25.81
|
| Rate for Payer: Global Benefits Group Commercial |
$18.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.29
|
| Rate for Payer: Multiplan Commercial |
$24.29
|
| Rate for Payer: Networks By Design Commercial |
$19.73
|
| Rate for Payer: Prime Health Services Commercial |
$25.81
|
|
|
HC SOM PARANEOPL EVAL PCA1
|
Facility
|
OP
|
$30.36
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
900914653
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.07 |
| Max. Negotiated Rate |
$119.10 |
| Rate for Payer: Adventist Health Commercial |
$6.07
|
| Rate for Payer: Aetna of CA HMO/PPO |
$19.91
|
| 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 |
$119.10
|
| Rate for Payer: Blue Shield of California Commercial |
$20.31
|
| Rate for Payer: Blue Shield of California EPN |
$13.42
|
| Rate for Payer: Cash Price |
$30.36
|
| Rate for Payer: Cash Price |
$30.36
|
| Rate for Payer: Cigna of CA HMO |
$19.43
|
| Rate for Payer: Cigna of CA PPO |
$22.47
|
| 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: EPIC Health Plan Commercial |
$16.27
|
| Rate for Payer: EPIC Health Plan Senior |
$12.05
|
| Rate for Payer: Galaxy Health WC |
$25.81
|
| Rate for Payer: Global Benefits Group Commercial |
$18.22
|
| Rate for Payer: Heritage Provider Network Commercial |
$19.76
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$14.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$12.05
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$16.40
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.29
|
| 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 |
$24.29
|
| Rate for Payer: Networks By Design Commercial |
$19.73
|
| Rate for Payer: Prime Health Services Commercial |
$25.81
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$18.22
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$18.22
|
| 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 PARANEOPL EVAL PCA2
|
Facility
|
OP
|
$30.36
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
900914654
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.07 |
| Max. Negotiated Rate |
$119.10 |
| Rate for Payer: Adventist Health Commercial |
$6.07
|
| Rate for Payer: Aetna of CA HMO/PPO |
$19.91
|
| 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 |
$119.10
|
| Rate for Payer: Blue Shield of California Commercial |
$20.31
|
| Rate for Payer: Blue Shield of California EPN |
$13.42
|
| Rate for Payer: Cash Price |
$30.36
|
| Rate for Payer: Cash Price |
$30.36
|
| Rate for Payer: Cigna of CA HMO |
$19.43
|
| Rate for Payer: Cigna of CA PPO |
$22.47
|
| 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: EPIC Health Plan Commercial |
$16.27
|
| Rate for Payer: EPIC Health Plan Senior |
$12.05
|
| Rate for Payer: Galaxy Health WC |
$25.81
|
| Rate for Payer: Global Benefits Group Commercial |
$18.22
|
| Rate for Payer: Heritage Provider Network Commercial |
$19.76
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$14.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$12.05
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$16.40
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.29
|
| 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 |
$24.29
|
| Rate for Payer: Networks By Design Commercial |
$19.73
|
| Rate for Payer: Prime Health Services Commercial |
$25.81
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$18.22
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$18.22
|
| 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 PARANEOPL EVAL PCA2
|
Facility
|
IP
|
$30.36
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
900914654
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.07 |
| Max. Negotiated Rate |
$25.81 |
| Rate for Payer: Adventist Health Commercial |
$6.07
|
| Rate for Payer: Cash Price |
$30.36
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.14
|
| Rate for Payer: EPIC Health Plan Senior |
$12.14
|
| Rate for Payer: Galaxy Health WC |
$25.81
|
| Rate for Payer: Global Benefits Group Commercial |
$18.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.29
|
| Rate for Payer: Multiplan Commercial |
$24.29
|
| Rate for Payer: Networks By Design Commercial |
$19.73
|
| Rate for Payer: Prime Health Services Commercial |
$25.81
|
|
|
HC SOM PARANEOPL EVAL PCATR
|
Facility
|
IP
|
$30.36
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
900914655
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.07 |
| Max. Negotiated Rate |
$25.81 |
| Rate for Payer: Adventist Health Commercial |
$6.07
|
| Rate for Payer: Cash Price |
$30.36
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.14
|
| Rate for Payer: EPIC Health Plan Senior |
$12.14
|
| Rate for Payer: Galaxy Health WC |
$25.81
|
| Rate for Payer: Global Benefits Group Commercial |
$18.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.29
|
| Rate for Payer: Multiplan Commercial |
$24.29
|
| Rate for Payer: Networks By Design Commercial |
$19.73
|
| Rate for Payer: Prime Health Services Commercial |
$25.81
|
|
|
HC SOM PARANEOPL EVAL PCATR
|
Facility
|
OP
|
$30.36
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
900914655
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.07 |
| Max. Negotiated Rate |
$119.10 |
| Rate for Payer: EPIC Health Plan Senior |
$12.05
|
| Rate for Payer: Galaxy Health WC |
$25.81
|
| Rate for Payer: Adventist Health Commercial |
$6.07
|
| Rate for Payer: Aetna of CA HMO/PPO |
$19.91
|
| 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 |
$119.10
|
| Rate for Payer: Blue Shield of California Commercial |
$20.31
|
| Rate for Payer: Blue Shield of California EPN |
$13.42
|
| Rate for Payer: Cash Price |
$30.36
|
| Rate for Payer: Cash Price |
$30.36
|
| Rate for Payer: Cigna of CA HMO |
$19.43
|
| Rate for Payer: Cigna of CA PPO |
$22.47
|
| 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: EPIC Health Plan Commercial |
$16.27
|
| Rate for Payer: Global Benefits Group Commercial |
$18.22
|
| Rate for Payer: Heritage Provider Network Commercial |
$19.76
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$14.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$12.05
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$16.40
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.29
|
| 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 |
$24.29
|
| Rate for Payer: Networks By Design Commercial |
$19.73
|
| Rate for Payer: Prime Health Services Commercial |
$25.81
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$18.22
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$18.22
|
| 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 PARANEOPL EVAL P/Q AB
|
Facility
|
IP
|
$30.37
|
|
|
Service Code
|
CPT 86596
|
| Hospital Charge Code |
900914658
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.07 |
| Max. Negotiated Rate |
$25.81 |
| Rate for Payer: Adventist Health Commercial |
$6.07
|
| Rate for Payer: Cash Price |
$30.37
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.15
|
| Rate for Payer: EPIC Health Plan Senior |
$12.15
|
| Rate for Payer: Galaxy Health WC |
$25.81
|
| Rate for Payer: Global Benefits Group Commercial |
$18.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20.26
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.29
|
| Rate for Payer: Multiplan Commercial |
$24.30
|
| Rate for Payer: Networks By Design Commercial |
$19.74
|
| Rate for Payer: Prime Health Services Commercial |
$25.81
|
|
|
HC SOM PARANEOPL EVAL P/Q AB
|
Facility
|
OP
|
$30.37
|
|
|
Service Code
|
CPT 86596
|
| Hospital Charge Code |
900914658
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.07 |
| Max. Negotiated Rate |
$51.14 |
| Rate for Payer: EPIC Health Plan Senior |
$12.05
|
| Rate for Payer: Galaxy Health WC |
$25.81
|
| Rate for Payer: Adventist Health Commercial |
$6.07
|
| Rate for Payer: Aetna of CA HMO/PPO |
$19.92
|
| 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 |
$51.14
|
| Rate for Payer: Blue Shield of California Commercial |
$20.32
|
| Rate for Payer: Blue Shield of California EPN |
$13.42
|
| Rate for Payer: Cash Price |
$30.37
|
| Rate for Payer: Cash Price |
$30.37
|
| Rate for Payer: Cigna of CA HMO |
$19.44
|
| Rate for Payer: Cigna of CA PPO |
$22.47
|
| 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: EPIC Health Plan Commercial |
$16.27
|
| Rate for Payer: Global Benefits Group Commercial |
$18.22
|
| Rate for Payer: Heritage Provider Network Commercial |
$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 Permanente of CA Commercial/Self Funded |
$20.26
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$22.89
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.29
|
| 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 |
$24.30
|
| Rate for Payer: Networks By Design Commercial |
$19.74
|
| Rate for Payer: Prime Health Services Commercial |
$25.81
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$18.22
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$18.22
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.90
|
| Rate for Payer: United Healthcare All Other HMO |
$14.90
|
| Rate for Payer: United Healthcare HMO Rider |
$14.90
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.90
|
| 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 PARASITIC EXAM CONC
|
Facility
|
IP
|
$28.71
|
|
|
Service Code
|
CPT 87015
|
| Hospital Charge Code |
900914691
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$5.74 |
| Max. Negotiated Rate |
$24.40 |
| Rate for Payer: Adventist Health Commercial |
$5.74
|
| Rate for Payer: Cash Price |
$28.71
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.48
|
| Rate for Payer: EPIC Health Plan Senior |
$11.48
|
| Rate for Payer: Galaxy Health WC |
$24.40
|
| Rate for Payer: Global Benefits Group Commercial |
$17.23
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$19.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$17.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.89
|
| Rate for Payer: Multiplan Commercial |
$22.97
|
| Rate for Payer: Networks By Design Commercial |
$18.66
|
| Rate for Payer: Prime Health Services Commercial |
$24.40
|
|
|
HC SOM PARASITIC EXAM CONC
|
Facility
|
OP
|
$28.71
|
|
|
Service Code
|
CPT 87015
|
| Hospital Charge Code |
900914691
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$5.41 |
| Max. Negotiated Rate |
$65.97 |
| Rate for Payer: Adventist Health Commercial |
$5.74
|
| Rate for Payer: Aetna of CA HMO/PPO |
$18.83
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10.02
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6.68
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$65.97
|
| Rate for Payer: Blue Shield of California Commercial |
$19.21
|
| Rate for Payer: Blue Shield of California EPN |
$12.69
|
| Rate for Payer: Cash Price |
$28.71
|
| Rate for Payer: Cash Price |
$28.71
|
| Rate for Payer: Cigna of CA HMO |
$18.37
|
| Rate for Payer: Cigna of CA PPO |
$21.25
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.02
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.02
|
| Rate for Payer: EPIC Health Plan Senior |
$6.68
|
| Rate for Payer: Galaxy Health WC |
$24.40
|
| Rate for Payer: Global Benefits Group Commercial |
$17.23
|
| Rate for Payer: Heritage Provider Network Commercial |
$10.96
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$9.76
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6.68
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$19.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.04
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.89
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8.42
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8.95
|
| Rate for Payer: Multiplan Commercial |
$22.97
|
| Rate for Payer: Networks By Design Commercial |
$18.66
|
| Rate for Payer: Prime Health Services Commercial |
$24.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$17.23
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$17.23
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.41
|
| Rate for Payer: United Healthcare All Other HMO |
$5.41
|
| Rate for Payer: United Healthcare HMO Rider |
$5.41
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.41
|
| Rate for Payer: Upland Medical Group Pediatric |
$6.68
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10.02
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.35
|
| Rate for Payer: Vantage Medical Group Senior |
$6.68
|
|
|
HC SOM PARASITIC EXAM STAIN
|
Facility
|
OP
|
$77.27
|
|
|
Service Code
|
CPT 87209
|
| Hospital Charge Code |
900914692
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$14.56 |
| Max. Negotiated Rate |
$173.62 |
| Rate for Payer: EPIC Health Plan Senior |
$17.98
|
| Rate for Payer: Galaxy Health WC |
$65.68
|
| Rate for Payer: Adventist Health Commercial |
$15.45
|
| Rate for Payer: Aetna of CA HMO/PPO |
$50.68
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$26.97
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19.78
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$17.98
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$173.62
|
| Rate for Payer: Blue Shield of California Commercial |
$51.69
|
| Rate for Payer: Blue Shield of California EPN |
$34.15
|
| Rate for Payer: Cash Price |
$77.27
|
| Rate for Payer: Cash Price |
$77.27
|
| Rate for Payer: Cigna of CA HMO |
$49.45
|
| Rate for Payer: Cigna of CA PPO |
$57.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$26.97
|
| Rate for Payer: Dignity Health Medi-Cal |
$19.78
|
| Rate for Payer: Dignity Health Medicare Advantage |
$17.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$24.27
|
| Rate for Payer: Global Benefits Group Commercial |
$46.36
|
| Rate for Payer: Heritage Provider Network Commercial |
$29.49
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$26.85
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$17.98
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$51.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$30.36
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$17.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18.54
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$22.65
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$24.09
|
| Rate for Payer: Multiplan Commercial |
$61.82
|
| Rate for Payer: Networks By Design Commercial |
$50.23
|
| Rate for Payer: Prime Health Services Commercial |
$65.68
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$46.36
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$46.36
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.56
|
| Rate for Payer: United Healthcare All Other HMO |
$14.56
|
| Rate for Payer: United Healthcare HMO Rider |
$14.56
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.56
|
| Rate for Payer: Upland Medical Group Pediatric |
$17.98
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$26.97
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.78
|
| Rate for Payer: Vantage Medical Group Senior |
$17.98
|
|
|
HC SOM PARASITIC EXAM STAIN
|
Facility
|
IP
|
$77.27
|
|
|
Service Code
|
CPT 87209
|
| Hospital Charge Code |
900914692
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$15.45 |
| Max. Negotiated Rate |
$65.68 |
| Rate for Payer: Adventist Health Commercial |
$15.45
|
| Rate for Payer: Cash Price |
$77.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$30.91
|
| Rate for Payer: EPIC Health Plan Senior |
$30.91
|
| Rate for Payer: Galaxy Health WC |
$65.68
|
| Rate for Payer: Global Benefits Group Commercial |
$46.36
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$51.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$29.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$47.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18.54
|
| Rate for Payer: Multiplan Commercial |
$61.82
|
| Rate for Payer: Networks By Design Commercial |
$50.23
|
| Rate for Payer: Prime Health Services Commercial |
$65.68
|
|
