|
HC SOM PANCREATIC POLYPEPTIDE
|
Facility
|
IP
|
$96.30
|
|
|
Service Code
|
CPT 83519
|
| Hospital Charge Code |
900911326
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$19.26 |
| Max. Negotiated Rate |
$81.86 |
| Rate for Payer: Adventist Health Commercial |
$19.26
|
| Rate for Payer: Cash Price |
$96.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$67.41
|
| Rate for Payer: EPIC Health Plan Commercial |
$38.52
|
| Rate for Payer: EPIC Health Plan Senior |
$38.52
|
| Rate for Payer: Galaxy Health WC |
$81.86
|
| Rate for Payer: Global Benefits Group Commercial |
$57.78
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$61.15
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$56.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23.11
|
| Rate for Payer: Multiplan Commercial |
$77.04
|
| Rate for Payer: Networks By Design Commercial |
$62.59
|
| Rate for Payer: Prime Health Services Commercial |
$81.86
|
|
|
HC SOM PARANEOPL EVAL ACHR AB
|
Facility
|
IP
|
$39.35
|
|
|
Service Code
|
CPT 83519
|
| Hospital Charge Code |
900914660
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.87 |
| Max. Negotiated Rate |
$33.45 |
| Rate for Payer: Adventist Health Commercial |
$7.87
|
| Rate for Payer: Cash Price |
$39.35
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$27.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.74
|
| Rate for Payer: EPIC Health Plan Senior |
$15.74
|
| Rate for Payer: Galaxy Health WC |
$33.45
|
| Rate for Payer: Global Benefits Group Commercial |
$23.61
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$24.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$23.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.44
|
| Rate for Payer: Multiplan Commercial |
$31.48
|
| Rate for Payer: Networks By Design Commercial |
$25.58
|
| Rate for Payer: Prime Health Services Commercial |
$33.45
|
|
|
HC SOM PARANEOPL EVAL ACHR AB
|
Facility
|
OP
|
$39.35
|
|
|
Service Code
|
CPT 83519
|
| Hospital Charge Code |
900914660
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.87 |
| Max. Negotiated Rate |
$139.46 |
| Rate for Payer: Adventist Health Commercial |
$7.87
|
| Rate for Payer: Aetna of CA HMO/PPO |
$112.35
|
| 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 |
$139.46
|
| Rate for Payer: Blue Shield of California Commercial |
$18.14
|
| Rate for Payer: Blue Shield of California Commercial |
$27.43
|
| Rate for Payer: Cash Price |
$39.35
|
| Rate for Payer: Cash Price |
$39.35
|
| Rate for Payer: Cigna of CA HMO |
$25.18
|
| Rate for Payer: Cigna of CA PPO |
$29.12
|
| 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: Emerging Therapy Solutions (LifeTrac) Transplant |
$27.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$30.36
|
| Rate for Payer: EPIC Health Plan Senior |
$20.24
|
| Rate for Payer: Galaxy Health WC |
$33.45
|
| Rate for Payer: Global Benefits Group Commercial |
$23.61
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$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 Foundation Hospitals Commercial/Self Funded |
$24.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$23.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$25.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.44
|
| 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 |
$31.48
|
| Rate for Payer: Networks By Design Commercial |
$25.58
|
| Rate for Payer: Prime Health Services Commercial |
$33.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$23.61
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$23.61
|
| 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 AGNA1
|
Facility
|
IP
|
$61.11
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
900914652
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.22 |
| Max. Negotiated Rate |
$51.94 |
| Rate for Payer: Adventist Health Commercial |
$12.22
|
| Rate for Payer: Cash Price |
$61.11
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$42.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$24.44
|
| Rate for Payer: EPIC Health Plan Senior |
$24.44
|
| Rate for Payer: Galaxy Health WC |
$51.94
|
| Rate for Payer: Global Benefits Group Commercial |
$36.67
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$38.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$36.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.67
|
| Rate for Payer: Multiplan Commercial |
$48.89
|
| Rate for Payer: Networks By Design Commercial |
$39.72
|
| Rate for Payer: Prime Health Services Commercial |
$51.94
|
|
|
HC SOM PARANEOPL EVAL AGNA1
|
Facility
|
OP
|
$61.11
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
900914652
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.77 |
| Max. Negotiated Rate |
$124.45 |
| Rate for Payer: Adventist Health Commercial |
$12.22
|
| Rate for Payer: Aetna of CA HMO/PPO |
$100.25
|
| 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 |
$124.45
|
| Rate for Payer: Blue Shield of California Commercial |
$28.17
|
| Rate for Payer: Blue Shield of California Commercial |
$42.59
|
| Rate for Payer: Cash Price |
$61.11
|
| Rate for Payer: Cash Price |
$61.11
|
| Rate for Payer: Cigna of CA HMO |
$39.11
|
| Rate for Payer: Cigna of CA PPO |
$45.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$18.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.26
|
| Rate for Payer: Dignity Health Medicare Advantage |
$12.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$42.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.88
|
| Rate for Payer: EPIC Health Plan Senior |
$13.26
|
| Rate for Payer: Galaxy Health WC |
$51.94
|
| Rate for Payer: Global Benefits Group Commercial |
$36.67
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$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 Foundation Hospitals Commercial/Self Funded |
$38.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$16.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$16.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.67
|
| 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 |
$48.89
|
| Rate for Payer: Networks By Design Commercial |
$39.72
|
| Rate for Payer: Prime Health Services Commercial |
$51.94
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$36.67
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$36.67
|
| 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 AMPH AB
|
Facility
|
OP
|
$61.11
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
900914656
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.77 |
| Max. Negotiated Rate |
$124.45 |
| Rate for Payer: Adventist Health Commercial |
$12.22
|
| Rate for Payer: Aetna of CA HMO/PPO |
$100.25
|
| 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 |
$124.45
|
| Rate for Payer: Blue Shield of California Commercial |
$28.17
|
| Rate for Payer: Blue Shield of California Commercial |
$42.59
|
| Rate for Payer: Cash Price |
$61.11
|
| Rate for Payer: Cash Price |
$61.11
|
| Rate for Payer: Cigna of CA HMO |
$39.11
|
| Rate for Payer: Cigna of CA PPO |
$45.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$18.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.26
|
| Rate for Payer: Dignity Health Medicare Advantage |
$12.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$42.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.88
|
| Rate for Payer: EPIC Health Plan Senior |
$13.26
|
| Rate for Payer: Galaxy Health WC |
$51.94
|
| Rate for Payer: Global Benefits Group Commercial |
$36.67
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$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 Foundation Hospitals Commercial/Self Funded |
$38.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$16.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$16.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.67
|
| 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 |
$48.89
|
| Rate for Payer: Networks By Design Commercial |
$39.72
|
| Rate for Payer: Prime Health Services Commercial |
$51.94
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$36.67
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$36.67
|
| 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 AMPH AB
|
Facility
|
IP
|
$61.11
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
900914656
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.22 |
| Max. Negotiated Rate |
$51.94 |
| Rate for Payer: Adventist Health Commercial |
$12.22
|
| Rate for Payer: Cash Price |
$61.11
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$42.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$24.44
|
| Rate for Payer: EPIC Health Plan Senior |
$24.44
|
| Rate for Payer: Galaxy Health WC |
$51.94
|
| Rate for Payer: Global Benefits Group Commercial |
$36.67
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$38.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$36.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.67
|
| Rate for Payer: Multiplan Commercial |
$48.89
|
| Rate for Payer: Networks By Design Commercial |
$39.72
|
| Rate for Payer: Prime Health Services Commercial |
$51.94
|
|
|
HC SOM PARANEOPL EVAL ANNA1
|
Facility
|
OP
|
$61.11
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
900914649
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.77 |
| Max. Negotiated Rate |
$124.45 |
| Rate for Payer: Adventist Health Commercial |
$12.22
|
| Rate for Payer: Aetna of CA HMO/PPO |
$100.25
|
| 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 |
$124.45
|
| Rate for Payer: Blue Shield of California Commercial |
$28.17
|
| Rate for Payer: Blue Shield of California Commercial |
$42.59
|
| Rate for Payer: Cash Price |
$61.11
|
| Rate for Payer: Cash Price |
$61.11
|
| Rate for Payer: Cigna of CA HMO |
$39.11
|
| Rate for Payer: Cigna of CA PPO |
$45.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$18.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.26
|
| Rate for Payer: Dignity Health Medicare Advantage |
$12.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$42.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.88
|
| Rate for Payer: EPIC Health Plan Senior |
$13.26
|
| Rate for Payer: Galaxy Health WC |
$51.94
|
| Rate for Payer: Global Benefits Group Commercial |
$36.67
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$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 Foundation Hospitals Commercial/Self Funded |
$38.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$16.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$16.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.67
|
| 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 |
$48.89
|
| Rate for Payer: Networks By Design Commercial |
$39.72
|
| Rate for Payer: Prime Health Services Commercial |
$51.94
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$36.67
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$36.67
|
| 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
|
$61.11
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
900914649
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.22 |
| Max. Negotiated Rate |
$51.94 |
| Rate for Payer: Adventist Health Commercial |
$12.22
|
| Rate for Payer: Cash Price |
$61.11
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$42.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$24.44
|
| Rate for Payer: EPIC Health Plan Senior |
$24.44
|
| Rate for Payer: Galaxy Health WC |
$51.94
|
| Rate for Payer: Global Benefits Group Commercial |
$36.67
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$38.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$36.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.67
|
| Rate for Payer: Multiplan Commercial |
$48.89
|
| Rate for Payer: Networks By Design Commercial |
$39.72
|
| Rate for Payer: Prime Health Services Commercial |
$51.94
|
|
|
HC SOM PARANEOPL EVAL ANNA2
|
Facility
|
IP
|
$61.11
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
900914650
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.22 |
| Max. Negotiated Rate |
$51.94 |
| Rate for Payer: Adventist Health Commercial |
$12.22
|
| Rate for Payer: Cash Price |
$61.11
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$42.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$24.44
|
| Rate for Payer: EPIC Health Plan Senior |
$24.44
|
| Rate for Payer: Galaxy Health WC |
$51.94
|
| Rate for Payer: Global Benefits Group Commercial |
$36.67
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$38.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$36.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.67
|
| Rate for Payer: Multiplan Commercial |
$48.89
|
| Rate for Payer: Networks By Design Commercial |
$39.72
|
| Rate for Payer: Prime Health Services Commercial |
$51.94
|
|
|
HC SOM PARANEOPL EVAL ANNA2
|
Facility
|
OP
|
$61.11
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
900914650
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.77 |
| Max. Negotiated Rate |
$124.45 |
| Rate for Payer: Adventist Health Commercial |
$12.22
|
| Rate for Payer: Aetna of CA HMO/PPO |
$100.25
|
| 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 |
$124.45
|
| Rate for Payer: Blue Shield of California Commercial |
$28.17
|
| Rate for Payer: Blue Shield of California Commercial |
$42.59
|
| Rate for Payer: Cash Price |
$61.11
|
| Rate for Payer: Cash Price |
$61.11
|
| Rate for Payer: Cigna of CA HMO |
$39.11
|
| Rate for Payer: Cigna of CA PPO |
$45.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$18.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.26
|
| Rate for Payer: Dignity Health Medicare Advantage |
$12.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$42.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.88
|
| Rate for Payer: EPIC Health Plan Senior |
$13.26
|
| Rate for Payer: Galaxy Health WC |
$51.94
|
| Rate for Payer: Global Benefits Group Commercial |
$36.67
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$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 Foundation Hospitals Commercial/Self Funded |
$38.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$16.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$16.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.67
|
| 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 |
$48.89
|
| Rate for Payer: Networks By Design Commercial |
$39.72
|
| Rate for Payer: Prime Health Services Commercial |
$51.94
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$36.67
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$36.67
|
| 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
|
$61.11
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
900914651
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.22 |
| Max. Negotiated Rate |
$51.94 |
| Rate for Payer: Adventist Health Commercial |
$12.22
|
| Rate for Payer: Cash Price |
$61.11
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$42.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$24.44
|
| Rate for Payer: EPIC Health Plan Senior |
$24.44
|
| Rate for Payer: Galaxy Health WC |
$51.94
|
| Rate for Payer: Global Benefits Group Commercial |
$36.67
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$38.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$36.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.67
|
| Rate for Payer: Multiplan Commercial |
$48.89
|
| Rate for Payer: Networks By Design Commercial |
$39.72
|
| Rate for Payer: Prime Health Services Commercial |
$51.94
|
|
|
HC SOM PARANEOPL EVAL ANNA3
|
Facility
|
OP
|
$61.11
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
900914651
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.77 |
| Max. Negotiated Rate |
$124.45 |
| Rate for Payer: Cigna of CA PPO |
$45.22
|
| Rate for Payer: Adventist Health Commercial |
$12.22
|
| Rate for Payer: Aetna of CA HMO/PPO |
$100.25
|
| 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 |
$124.45
|
| Rate for Payer: Blue Shield of California Commercial |
$28.17
|
| Rate for Payer: Blue Shield of California Commercial |
$42.59
|
| Rate for Payer: Cash Price |
$61.11
|
| Rate for Payer: Cash Price |
$61.11
|
| Rate for Payer: Cigna of CA HMO |
$39.11
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$18.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.26
|
| Rate for Payer: Dignity Health Medicare Advantage |
$12.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$42.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.88
|
| Rate for Payer: EPIC Health Plan Senior |
$13.26
|
| Rate for Payer: Galaxy Health WC |
$51.94
|
| Rate for Payer: Global Benefits Group Commercial |
$36.67
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$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 Foundation Hospitals Commercial/Self Funded |
$38.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$16.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$16.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.67
|
| 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 |
$48.89
|
| Rate for Payer: Networks By Design Commercial |
$39.72
|
| Rate for Payer: Prime Health Services Commercial |
$51.94
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$36.67
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$36.67
|
| 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 CRMP5 AB
|
Facility
|
OP
|
$61.12
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
900914657
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.77 |
| Max. Negotiated Rate |
$124.45 |
| Rate for Payer: Adventist Health Commercial |
$12.22
|
| Rate for Payer: Aetna of CA HMO/PPO |
$100.25
|
| 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 |
$124.45
|
| Rate for Payer: Blue Shield of California Commercial |
$28.18
|
| Rate for Payer: Blue Shield of California Commercial |
$42.60
|
| Rate for Payer: Cash Price |
$61.12
|
| Rate for Payer: Cash Price |
$61.12
|
| Rate for Payer: Cigna of CA HMO |
$39.12
|
| Rate for Payer: Cigna of CA PPO |
$45.23
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$18.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.26
|
| Rate for Payer: Dignity Health Medicare Advantage |
$12.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$42.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.88
|
| Rate for Payer: EPIC Health Plan Senior |
$13.26
|
| Rate for Payer: Galaxy Health WC |
$51.95
|
| Rate for Payer: Global Benefits Group Commercial |
$36.67
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$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 Foundation Hospitals Commercial/Self Funded |
$38.81
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$16.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$16.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.67
|
| 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 |
$48.90
|
| Rate for Payer: Networks By Design Commercial |
$39.73
|
| Rate for Payer: Prime Health Services Commercial |
$51.95
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$36.67
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$36.67
|
| 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 CRMP5 AB
|
Facility
|
IP
|
$61.12
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
900914657
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.22 |
| Max. Negotiated Rate |
$51.95 |
| Rate for Payer: Adventist Health Commercial |
$12.22
|
| Rate for Payer: Cash Price |
$61.12
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$42.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$24.45
|
| Rate for Payer: EPIC Health Plan Senior |
$24.45
|
| Rate for Payer: Galaxy Health WC |
$51.95
|
| Rate for Payer: Global Benefits Group Commercial |
$36.67
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$38.81
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$36.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.67
|
| Rate for Payer: Multiplan Commercial |
$48.90
|
| Rate for Payer: Networks By Design Commercial |
$39.73
|
| Rate for Payer: Prime Health Services Commercial |
$51.95
|
|
|
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: Emerging Therapy Solutions (LifeTrac) Transplant |
$32.45
|
| 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 Foundation Hospitals Commercial/Self Funded |
$29.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$27.35
|
| 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 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 |
$139.46 |
| Rate for Payer: Aetna of CA HMO/PPO |
$112.35
|
| Rate for Payer: Adventist Health Commercial |
$9.27
|
| 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 |
$139.46
|
| Rate for Payer: Blue Shield of California Commercial |
$21.37
|
| Rate for Payer: Blue Shield of California Commercial |
$32.31
|
| 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: Emerging Therapy Solutions (LifeTrac) Transplant |
$32.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$30.36
|
| Rate for Payer: EPIC Health Plan Senior |
$20.24
|
| Rate for Payer: Galaxy Health WC |
$39.41
|
| Rate for Payer: Global Benefits Group Commercial |
$27.82
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$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 Foundation Hospitals Commercial/Self Funded |
$29.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$23.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$25.76
|
| 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 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 |
$139.46 |
| Rate for Payer: Adventist Health Commercial |
$6.46
|
| Rate for Payer: Aetna of CA HMO/PPO |
$112.35
|
| 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 |
$139.46
|
| Rate for Payer: Blue Shield of California Commercial |
$14.89
|
| Rate for Payer: Blue Shield of California Commercial |
$22.52
|
| 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: Emerging Therapy Solutions (LifeTrac) Transplant |
$22.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$30.36
|
| Rate for Payer: EPIC Health Plan Senior |
$20.24
|
| Rate for Payer: Galaxy Health WC |
$27.46
|
| Rate for Payer: Global Benefits Group Commercial |
$19.39
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$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 Foundation Hospitals Commercial/Self Funded |
$20.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$23.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$25.76
|
| 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 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: Emerging Therapy Solutions (LifeTrac) Transplant |
$22.62
|
| 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 Foundation Hospitals Commercial/Self Funded |
$20.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$19.06
|
| 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 PCA1
|
Facility
|
OP
|
$61.11
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
900914653
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.77 |
| Max. Negotiated Rate |
$124.45 |
| Rate for Payer: Adventist Health Commercial |
$12.22
|
| Rate for Payer: Aetna of CA HMO/PPO |
$100.25
|
| 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 |
$124.45
|
| Rate for Payer: Blue Shield of California Commercial |
$28.17
|
| Rate for Payer: Blue Shield of California Commercial |
$42.59
|
| Rate for Payer: Cash Price |
$61.11
|
| Rate for Payer: Cash Price |
$61.11
|
| Rate for Payer: Cigna of CA HMO |
$39.11
|
| Rate for Payer: Cigna of CA PPO |
$45.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$18.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.26
|
| Rate for Payer: Dignity Health Medicare Advantage |
$12.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$42.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.88
|
| Rate for Payer: EPIC Health Plan Senior |
$13.26
|
| Rate for Payer: Galaxy Health WC |
$51.94
|
| Rate for Payer: Global Benefits Group Commercial |
$36.67
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$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 Foundation Hospitals Commercial/Self Funded |
$38.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$16.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$16.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.67
|
| 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 |
$48.89
|
| Rate for Payer: Networks By Design Commercial |
$39.72
|
| Rate for Payer: Prime Health Services Commercial |
$51.94
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$36.67
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$36.67
|
| 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 PCA1
|
Facility
|
IP
|
$61.11
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
900914653
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.22 |
| Max. Negotiated Rate |
$51.94 |
| Rate for Payer: Adventist Health Commercial |
$12.22
|
| Rate for Payer: Cash Price |
$61.11
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$42.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$24.44
|
| Rate for Payer: EPIC Health Plan Senior |
$24.44
|
| Rate for Payer: Galaxy Health WC |
$51.94
|
| Rate for Payer: Global Benefits Group Commercial |
$36.67
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$38.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$36.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.67
|
| Rate for Payer: Multiplan Commercial |
$48.89
|
| Rate for Payer: Networks By Design Commercial |
$39.72
|
| Rate for Payer: Prime Health Services Commercial |
$51.94
|
|
|
HC SOM PARANEOPL EVAL PCA2
|
Facility
|
IP
|
$61.11
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
900914654
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.22 |
| Max. Negotiated Rate |
$51.94 |
| Rate for Payer: Adventist Health Commercial |
$12.22
|
| Rate for Payer: Cash Price |
$61.11
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$42.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$24.44
|
| Rate for Payer: EPIC Health Plan Senior |
$24.44
|
| Rate for Payer: Galaxy Health WC |
$51.94
|
| Rate for Payer: Global Benefits Group Commercial |
$36.67
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$38.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$36.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.67
|
| Rate for Payer: Multiplan Commercial |
$48.89
|
| Rate for Payer: Networks By Design Commercial |
$39.72
|
| Rate for Payer: Prime Health Services Commercial |
$51.94
|
|
|
HC SOM PARANEOPL EVAL PCA2
|
Facility
|
OP
|
$61.11
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
900914654
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.77 |
| Max. Negotiated Rate |
$124.45 |
| Rate for Payer: Aetna of CA HMO/PPO |
$100.25
|
| Rate for Payer: Adventist Health Commercial |
$12.22
|
| 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 |
$124.45
|
| Rate for Payer: Blue Shield of California Commercial |
$28.17
|
| Rate for Payer: Blue Shield of California Commercial |
$42.59
|
| Rate for Payer: Cash Price |
$61.11
|
| Rate for Payer: Cash Price |
$61.11
|
| Rate for Payer: Cigna of CA HMO |
$39.11
|
| Rate for Payer: Cigna of CA PPO |
$45.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$18.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.26
|
| Rate for Payer: Dignity Health Medicare Advantage |
$12.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$42.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.88
|
| Rate for Payer: EPIC Health Plan Senior |
$13.26
|
| Rate for Payer: Galaxy Health WC |
$51.94
|
| Rate for Payer: Global Benefits Group Commercial |
$36.67
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$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 Foundation Hospitals Commercial/Self Funded |
$38.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$16.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$16.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.67
|
| 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 |
$48.89
|
| Rate for Payer: Networks By Design Commercial |
$39.72
|
| Rate for Payer: Prime Health Services Commercial |
$51.94
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$36.67
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$36.67
|
| 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 PCATR
|
Facility
|
OP
|
$61.11
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
900914655
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.77 |
| Max. Negotiated Rate |
$124.45 |
| Rate for Payer: Adventist Health Commercial |
$12.22
|
| Rate for Payer: Aetna of CA HMO/PPO |
$100.25
|
| 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 |
$124.45
|
| Rate for Payer: Blue Shield of California Commercial |
$28.17
|
| Rate for Payer: Blue Shield of California Commercial |
$42.59
|
| Rate for Payer: Cash Price |
$61.11
|
| Rate for Payer: Cash Price |
$61.11
|
| Rate for Payer: Cigna of CA HMO |
$39.11
|
| Rate for Payer: Cigna of CA PPO |
$45.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$18.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.26
|
| Rate for Payer: Dignity Health Medicare Advantage |
$12.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$42.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.88
|
| Rate for Payer: EPIC Health Plan Senior |
$13.26
|
| Rate for Payer: Galaxy Health WC |
$51.94
|
| Rate for Payer: Global Benefits Group Commercial |
$36.67
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$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 Foundation Hospitals Commercial/Self Funded |
$38.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$16.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$16.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.67
|
| 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 |
$48.89
|
| Rate for Payer: Networks By Design Commercial |
$39.72
|
| Rate for Payer: Prime Health Services Commercial |
$51.94
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$36.67
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$36.67
|
| 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 PCATR
|
Facility
|
IP
|
$61.11
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
900914655
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.22 |
| Max. Negotiated Rate |
$51.94 |
| Rate for Payer: Adventist Health Commercial |
$12.22
|
| Rate for Payer: Cash Price |
$61.11
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$42.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$24.44
|
| Rate for Payer: EPIC Health Plan Senior |
$24.44
|
| Rate for Payer: Galaxy Health WC |
$51.94
|
| Rate for Payer: Global Benefits Group Commercial |
$36.67
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$38.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$36.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.67
|
| Rate for Payer: Multiplan Commercial |
$48.89
|
| Rate for Payer: Networks By Design Commercial |
$39.72
|
| Rate for Payer: Prime Health Services Commercial |
$51.94
|
|
