|
HC TESTICULAR SCAN
|
Facility
|
IP
|
$1,171.00
|
|
|
Service Code
|
CPT 78761
|
| Hospital Charge Code |
909301429
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$234.20 |
| Max. Negotiated Rate |
$995.35 |
| Rate for Payer: Adventist Health Commercial |
$234.20
|
| Rate for Payer: Cash Price |
$526.95
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$819.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$468.40
|
| Rate for Payer: EPIC Health Plan Senior |
$468.40
|
| Rate for Payer: Galaxy Health WC |
$995.35
|
| Rate for Payer: Global Benefits Group Commercial |
$702.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$743.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$690.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$281.04
|
| Rate for Payer: Multiplan Commercial |
$936.80
|
| Rate for Payer: Networks By Design Commercial |
$761.15
|
| Rate for Payer: Prime Health Services Commercial |
$995.35
|
|
|
HC TESTICULAR SCAN
|
Facility
|
OP
|
$1,171.00
|
|
|
Service Code
|
CPT 78761
|
| Hospital Charge Code |
909301429
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$145.35 |
| Max. Negotiated Rate |
$1,273.23 |
| Rate for Payer: Adventist Health Commercial |
$234.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,273.23
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$771.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$565.59
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$514.17
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$751.43
|
| Rate for Payer: Blue Shield of California Commercial |
$747.10
|
| Rate for Payer: Blue Shield of California Commercial |
$492.99
|
| Rate for Payer: Cash Price |
$526.95
|
| Rate for Payer: Cash Price |
$526.95
|
| Rate for Payer: Cigna of CA HMO |
$749.44
|
| Rate for Payer: Cigna of CA PPO |
$866.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$771.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$565.59
|
| Rate for Payer: Dignity Health Medicare Advantage |
$514.17
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$819.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$848.38
|
| Rate for Payer: EPIC Health Plan Senior |
$565.59
|
| Rate for Payer: Galaxy Health WC |
$995.35
|
| Rate for Payer: Global Benefits Group Commercial |
$702.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$843.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$145.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$514.17
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$743.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$164.39
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$719.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$281.04
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$647.85
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$688.99
|
| Rate for Payer: Multiplan Commercial |
$936.80
|
| Rate for Payer: Networks By Design Commercial |
$761.15
|
| Rate for Payer: Prime Health Services Commercial |
$995.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$702.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$702.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$815.78
|
| Rate for Payer: United Healthcare All Other HMO |
$815.78
|
| Rate for Payer: United Healthcare HMO Rider |
$815.78
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$815.78
|
| Rate for Payer: Upland Medical Group Pediatric |
$514.17
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$771.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$565.59
|
| Rate for Payer: Vantage Medical Group Senior |
$514.17
|
|
|
HC TESTOSTERONE TOTAL
|
Facility
|
OP
|
$120.00
|
|
|
Service Code
|
CPT 84403
|
| Hospital Charge Code |
900912134
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$20.91 |
| Max. Negotiated Rate |
$266.42 |
| Rate for Payer: Adventist Health Commercial |
$24.00
|
| Rate for Payer: Adventist Health Commercial |
$48.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$214.68
|
| Rate for Payer: Aetna of CA HMO/PPO |
$214.68
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$38.72
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$38.72
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$28.39
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$28.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$25.81
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$25.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$266.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$266.42
|
| Rate for Payer: Blue Shield of California Commercial |
$110.64
|
| Rate for Payer: Blue Shield of California Commercial |
$55.32
|
| Rate for Payer: Blue Shield of California Commercial |
$167.28
|
| Rate for Payer: Blue Shield of California Commercial |
$83.64
|
| Rate for Payer: Cash Price |
$108.00
|
| Rate for Payer: Cash Price |
$108.00
|
| Rate for Payer: Cash Price |
$54.00
|
| Rate for Payer: Cash Price |
$54.00
|
| Rate for Payer: Cigna of CA HMO |
$153.60
|
| Rate for Payer: Cigna of CA HMO |
$76.80
|
| Rate for Payer: Cigna of CA PPO |
$88.80
|
| Rate for Payer: Cigna of CA PPO |
$177.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$38.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$38.72
|
| Rate for Payer: Dignity Health Medi-Cal |
$28.39
|
| Rate for Payer: Dignity Health Medi-Cal |
$28.39
|
| Rate for Payer: Dignity Health Medicare Advantage |
$25.81
|
| Rate for Payer: Dignity Health Medicare Advantage |
$25.81
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$84.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$168.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$42.59
|
| Rate for Payer: EPIC Health Plan Commercial |
$42.59
|
| Rate for Payer: EPIC Health Plan Senior |
$28.39
|
| Rate for Payer: EPIC Health Plan Senior |
$28.39
|
| Rate for Payer: Galaxy Health WC |
$102.00
|
| Rate for Payer: Galaxy Health WC |
$204.00
|
| Rate for Payer: Global Benefits Group Commercial |
$72.00
|
| Rate for Payer: Global Benefits Group Commercial |
$144.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$42.33
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$42.33
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$38.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$38.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$25.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$25.81
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$76.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$152.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$43.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$43.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$36.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$36.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$28.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$57.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$32.52
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$32.52
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$34.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$34.59
|
| Rate for Payer: Multiplan Commercial |
$192.00
|
| Rate for Payer: Multiplan Commercial |
$96.00
|
| Rate for Payer: Networks By Design Commercial |
$156.00
|
| Rate for Payer: Networks By Design Commercial |
$78.00
|
| Rate for Payer: Prime Health Services Commercial |
$102.00
|
| Rate for Payer: Prime Health Services Commercial |
$204.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$72.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$144.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$72.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$144.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$20.91
|
| Rate for Payer: United Healthcare All Other Commercial |
$20.91
|
| Rate for Payer: United Healthcare All Other HMO |
$20.91
|
| Rate for Payer: United Healthcare All Other HMO |
$20.91
|
| Rate for Payer: United Healthcare HMO Rider |
$20.91
|
| Rate for Payer: United Healthcare HMO Rider |
$20.91
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$20.91
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$20.91
|
| Rate for Payer: Upland Medical Group Pediatric |
$25.81
|
| Rate for Payer: Upland Medical Group Pediatric |
$25.81
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$38.72
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$38.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$28.39
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$28.39
|
| Rate for Payer: Vantage Medical Group Senior |
$25.81
|
| Rate for Payer: Vantage Medical Group Senior |
$25.81
|
|
|
HC TESTOSTERONE TOTAL
|
Facility
|
IP
|
$240.00
|
|
|
Service Code
|
CPT 84403
|
| Hospital Charge Code |
900912134
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$48.00 |
| Max. Negotiated Rate |
$204.00 |
| Rate for Payer: Adventist Health Commercial |
$48.00
|
| Rate for Payer: Cash Price |
$108.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$168.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$96.00
|
| Rate for Payer: EPIC Health Plan Senior |
$96.00
|
| Rate for Payer: Galaxy Health WC |
$204.00
|
| Rate for Payer: Global Benefits Group Commercial |
$144.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$152.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$141.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$57.60
|
| Rate for Payer: Multiplan Commercial |
$192.00
|
| Rate for Payer: Networks By Design Commercial |
$156.00
|
| Rate for Payer: Prime Health Services Commercial |
$204.00
|
|
|
HC TEST URINE VOLUME
|
Facility
|
IP
|
$102.00
|
|
|
Service Code
|
CPT 81050
|
| Hospital Charge Code |
900910797
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$20.40 |
| Max. Negotiated Rate |
$86.70 |
| Rate for Payer: Adventist Health Commercial |
$20.40
|
| Rate for Payer: Cash Price |
$45.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$71.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$40.80
|
| Rate for Payer: EPIC Health Plan Senior |
$40.80
|
| Rate for Payer: Galaxy Health WC |
$86.70
|
| Rate for Payer: Global Benefits Group Commercial |
$61.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$64.77
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$60.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.48
|
| Rate for Payer: Multiplan Commercial |
$81.60
|
| Rate for Payer: Networks By Design Commercial |
$66.30
|
| Rate for Payer: Prime Health Services Commercial |
$86.70
|
|
|
HC TEST URINE VOLUME
|
Facility
|
OP
|
$102.00
|
|
|
Service Code
|
CPT 81050
|
| Hospital Charge Code |
900910797
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.37 |
| Max. Negotiated Rate |
$86.70 |
| Rate for Payer: Adventist Health Commercial |
$20.40
|
| Rate for Payer: Adventist Health Commercial |
$5.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$24.96
|
| Rate for Payer: Aetna of CA HMO/PPO |
$24.96
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5.46
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5.46
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3.64
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$26.27
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$26.27
|
| Rate for Payer: Blue Shield of California Commercial |
$11.99
|
| Rate for Payer: Blue Shield of California Commercial |
$47.02
|
| Rate for Payer: Blue Shield of California Commercial |
$18.12
|
| Rate for Payer: Blue Shield of California Commercial |
$71.09
|
| Rate for Payer: Cash Price |
$11.70
|
| Rate for Payer: Cash Price |
$11.70
|
| Rate for Payer: Cash Price |
$45.90
|
| Rate for Payer: Cash Price |
$45.90
|
| Rate for Payer: Cigna of CA HMO |
$16.64
|
| Rate for Payer: Cigna of CA HMO |
$65.28
|
| Rate for Payer: Cigna of CA PPO |
$75.48
|
| Rate for Payer: Cigna of CA PPO |
$19.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5.46
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5.46
|
| Rate for Payer: Dignity Health Medi-Cal |
$4.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$4.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3.64
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3.64
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$71.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$18.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.01
|
| Rate for Payer: EPIC Health Plan Senior |
$4.00
|
| Rate for Payer: EPIC Health Plan Senior |
$4.00
|
| Rate for Payer: Galaxy Health WC |
$86.70
|
| Rate for Payer: Galaxy Health WC |
$22.10
|
| Rate for Payer: Global Benefits Group Commercial |
$61.20
|
| Rate for Payer: Global Benefits Group Commercial |
$15.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$5.97
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$5.97
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$2.37
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$2.37
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3.64
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$64.77
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$16.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4.59
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4.88
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4.88
|
| Rate for Payer: Multiplan Commercial |
$20.80
|
| Rate for Payer: Multiplan Commercial |
$81.60
|
| Rate for Payer: Networks By Design Commercial |
$16.90
|
| Rate for Payer: Networks By Design Commercial |
$66.30
|
| Rate for Payer: Prime Health Services Commercial |
$86.70
|
| Rate for Payer: Prime Health Services Commercial |
$22.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$61.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$61.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$15.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.95
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.95
|
| Rate for Payer: United Healthcare All Other HMO |
$2.95
|
| Rate for Payer: United Healthcare All Other HMO |
$2.95
|
| Rate for Payer: United Healthcare HMO Rider |
$2.95
|
| Rate for Payer: United Healthcare HMO Rider |
$2.95
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.95
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.95
|
| Rate for Payer: Upland Medical Group Pediatric |
$3.64
|
| Rate for Payer: Upland Medical Group Pediatric |
$3.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5.46
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4.00
|
| Rate for Payer: Vantage Medical Group Senior |
$3.64
|
| Rate for Payer: Vantage Medical Group Senior |
$3.64
|
|
|
HC TETRACYCLINE E TEST
|
Facility
|
OP
|
$105.00
|
|
|
Service Code
|
CPT 87181
|
| Hospital Charge Code |
900912444
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$1.95 |
| Max. Negotiated Rate |
$89.25 |
| Rate for Payer: Aetna of CA HMO/PPO |
$13.56
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.22
|
| Rate for Payer: Vantage Medical Group Senior |
$4.75
|
| Rate for Payer: Vantage Medical Group Senior |
$4.75
|
| Rate for Payer: Adventist Health Commercial |
$21.00
|
| Rate for Payer: Adventist Health Commercial |
$3.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$13.56
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.12
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.12
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.22
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$23.28
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$23.28
|
| Rate for Payer: Blue Shield of California Commercial |
$12.55
|
| Rate for Payer: Blue Shield of California Commercial |
$48.41
|
| Rate for Payer: Blue Shield of California Commercial |
$8.30
|
| Rate for Payer: Blue Shield of California Commercial |
$73.19
|
| Rate for Payer: Cash Price |
$8.10
|
| Rate for Payer: Cash Price |
$8.10
|
| Rate for Payer: Cash Price |
$47.25
|
| Rate for Payer: Cash Price |
$47.25
|
| Rate for Payer: Cigna of CA HMO |
$11.52
|
| Rate for Payer: Cigna of CA HMO |
$67.20
|
| Rate for Payer: Cigna of CA PPO |
$77.70
|
| Rate for Payer: Cigna of CA PPO |
$13.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.22
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4.75
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$73.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$12.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.84
|
| Rate for Payer: EPIC Health Plan Senior |
$5.22
|
| Rate for Payer: EPIC Health Plan Senior |
$5.22
|
| Rate for Payer: Galaxy Health WC |
$89.25
|
| Rate for Payer: Galaxy Health WC |
$15.30
|
| Rate for Payer: Global Benefits Group Commercial |
$63.00
|
| Rate for Payer: Global Benefits Group Commercial |
$10.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7.79
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7.79
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4.75
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$66.67
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$11.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5.99
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5.99
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.37
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.37
|
| Rate for Payer: Multiplan Commercial |
$14.40
|
| Rate for Payer: Multiplan Commercial |
$84.00
|
| Rate for Payer: Networks By Design Commercial |
$11.70
|
| Rate for Payer: Networks By Design Commercial |
$68.25
|
| Rate for Payer: Prime Health Services Commercial |
$89.25
|
| Rate for Payer: Prime Health Services Commercial |
$15.30
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$63.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$63.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$10.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.85
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.85
|
| Rate for Payer: United Healthcare All Other HMO |
$3.85
|
| Rate for Payer: United Healthcare All Other HMO |
$3.85
|
| Rate for Payer: United Healthcare HMO Rider |
$3.85
|
| Rate for Payer: United Healthcare HMO Rider |
$3.85
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.85
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.85
|
| Rate for Payer: Upland Medical Group Pediatric |
$4.75
|
| Rate for Payer: Upland Medical Group Pediatric |
$4.75
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.12
|
|
|
HC TETRACYCLINE E TEST
|
Facility
|
IP
|
$105.00
|
|
|
Service Code
|
CPT 87181
|
| Hospital Charge Code |
900912444
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$21.00 |
| Max. Negotiated Rate |
$89.25 |
| Rate for Payer: Adventist Health Commercial |
$21.00
|
| Rate for Payer: Cash Price |
$47.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$73.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$42.00
|
| Rate for Payer: EPIC Health Plan Senior |
$42.00
|
| Rate for Payer: Galaxy Health WC |
$89.25
|
| Rate for Payer: Global Benefits Group Commercial |
$63.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$66.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$61.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.20
|
| Rate for Payer: Multiplan Commercial |
$84.00
|
| Rate for Payer: Networks By Design Commercial |
$68.25
|
| Rate for Payer: Prime Health Services Commercial |
$89.25
|
|
|
HC THAL-QUICK 18FR CHEST TUBE
|
Facility
|
IP
|
$889.13
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901698529
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$177.83 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$177.83
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$400.11
|
| Rate for Payer: Cash Price |
$400.11
|
| Rate for Payer: Cigna of CA HMO |
$622.39
|
| Rate for Payer: Cigna of CA PPO |
$622.39
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$622.39
|
| Rate for Payer: EPIC Health Plan Commercial |
$355.65
|
| Rate for Payer: EPIC Health Plan Senior |
$355.65
|
| Rate for Payer: Galaxy Health WC |
$755.76
|
| Rate for Payer: Global Benefits Group Commercial |
$533.48
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$564.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$524.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$213.39
|
| Rate for Payer: Multiplan Commercial |
$711.30
|
| Rate for Payer: Networks By Design Commercial |
$444.56
|
| Rate for Payer: Prime Health Services Commercial |
$755.76
|
| Rate for Payer: United Healthcare All Other Commercial |
$333.69
|
| Rate for Payer: United Healthcare All Other HMO |
$324.80
|
| Rate for Payer: United Healthcare HMO Rider |
$317.78
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$291.19
|
|
|
HC THAL-QUICK 18FR CHEST TUBE
|
Facility
|
OP
|
$889.13
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901698529
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$177.83 |
| Max. Negotiated Rate |
$755.76 |
| Rate for Payer: Adventist Health Commercial |
$177.83
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$755.76
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$489.02
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$666.85
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$538.19
|
| Rate for Payer: Blue Shield of California Commercial |
$450.79
|
| Rate for Payer: Blue Shield of California Commercial |
$683.74
|
| Rate for Payer: Cash Price |
$400.11
|
| Rate for Payer: Cigna of CA HMO |
$622.39
|
| Rate for Payer: Cigna of CA PPO |
$622.39
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$755.76
|
| Rate for Payer: Dignity Health Medi-Cal |
$755.76
|
| Rate for Payer: Dignity Health Medicare Advantage |
$755.76
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$622.39
|
| Rate for Payer: EPIC Health Plan Commercial |
$355.65
|
| Rate for Payer: EPIC Health Plan Senior |
$355.65
|
| Rate for Payer: Galaxy Health WC |
$755.76
|
| Rate for Payer: Global Benefits Group Commercial |
$533.48
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$564.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$322.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$524.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$213.39
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$622.39
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$622.39
|
| Rate for Payer: Multiplan Commercial |
$711.30
|
| Rate for Payer: Networks By Design Commercial |
$444.56
|
| Rate for Payer: Prime Health Services Commercial |
$755.76
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$533.48
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$533.48
|
| Rate for Payer: United Healthcare All Other Commercial |
$333.69
|
| Rate for Payer: United Healthcare All Other HMO |
$324.80
|
| Rate for Payer: United Healthcare HMO Rider |
$317.78
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$291.19
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$755.76
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$755.76
|
| Rate for Payer: Vantage Medical Group Senior |
$755.76
|
|
|
HC THAWING COMPONENT
|
Facility
|
IP
|
$301.00
|
|
|
Service Code
|
CPT 86927
|
| Hospital Charge Code |
900904700
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$60.20 |
| Max. Negotiated Rate |
$255.85 |
| Rate for Payer: Adventist Health Commercial |
$60.20
|
| Rate for Payer: Cash Price |
$135.45
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$210.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$120.40
|
| Rate for Payer: EPIC Health Plan Senior |
$120.40
|
| Rate for Payer: Galaxy Health WC |
$255.85
|
| Rate for Payer: Global Benefits Group Commercial |
$180.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$191.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$177.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$72.24
|
| Rate for Payer: Multiplan Commercial |
$240.80
|
| Rate for Payer: Networks By Design Commercial |
$195.65
|
| Rate for Payer: Prime Health Services Commercial |
$255.85
|
|
|
HC THAWING COMPONENT
|
Facility
|
OP
|
$301.00
|
|
|
Service Code
|
CPT 86927
|
| Hospital Charge Code |
900904700
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$60.20 |
| Max. Negotiated Rate |
$361.55 |
| Rate for Payer: Adventist Health Commercial |
$60.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$95.52
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$328.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$241.03
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$219.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$92.91
|
| Rate for Payer: Blue Shield of California Commercial |
$138.76
|
| Rate for Payer: Blue Shield of California Commercial |
$209.80
|
| Rate for Payer: Cash Price |
$135.45
|
| Rate for Payer: Cash Price |
$135.45
|
| Rate for Payer: Cigna of CA HMO |
$192.64
|
| Rate for Payer: Cigna of CA PPO |
$222.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$328.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$241.03
|
| Rate for Payer: Dignity Health Medicare Advantage |
$219.12
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$210.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$361.55
|
| Rate for Payer: EPIC Health Plan Senior |
$241.03
|
| Rate for Payer: Galaxy Health WC |
$255.85
|
| Rate for Payer: Global Benefits Group Commercial |
$180.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$359.36
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$219.12
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$191.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$306.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$72.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$276.09
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$293.62
|
| Rate for Payer: Multiplan Commercial |
$240.80
|
| Rate for Payer: Networks By Design Commercial |
$195.65
|
| Rate for Payer: Prime Health Services Commercial |
$255.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$180.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$180.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$123.38
|
| Rate for Payer: United Healthcare All Other HMO |
$123.38
|
| Rate for Payer: United Healthcare HMO Rider |
$123.38
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$123.38
|
| Rate for Payer: Upland Medical Group Pediatric |
$219.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$328.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$241.03
|
| Rate for Payer: Vantage Medical Group Senior |
$219.12
|
|
|
HC THAWING COMPONENT CRYO
|
Facility
|
OP
|
$301.00
|
|
|
Service Code
|
CPT 86999
|
| Hospital Charge Code |
900904698
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$20.44 |
| Max. Negotiated Rate |
$255.85 |
| Rate for Payer: Cigna of CA PPO |
$222.74
|
| Rate for Payer: Adventist Health Commercial |
$60.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$197.43
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$55.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$40.92
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$37.20
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$193.15
|
| Rate for Payer: Blue Shield of California Commercial |
$138.76
|
| Rate for Payer: Blue Shield of California Commercial |
$209.80
|
| Rate for Payer: Cash Price |
$135.45
|
| Rate for Payer: Cash Price |
$135.45
|
| Rate for Payer: Cigna of CA HMO |
$192.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$55.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$40.92
|
| Rate for Payer: Dignity Health Medicare Advantage |
$37.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$210.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$61.38
|
| Rate for Payer: EPIC Health Plan Senior |
$40.92
|
| Rate for Payer: Galaxy Health WC |
$255.85
|
| Rate for Payer: Global Benefits Group Commercial |
$180.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$61.01
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$37.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$191.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$52.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$72.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$46.87
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$49.85
|
| Rate for Payer: Multiplan Commercial |
$240.80
|
| Rate for Payer: Networks By Design Commercial |
$195.65
|
| Rate for Payer: Prime Health Services Commercial |
$255.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$180.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$180.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$20.44
|
| Rate for Payer: United Healthcare All Other HMO |
$20.44
|
| Rate for Payer: United Healthcare HMO Rider |
$20.44
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$20.44
|
| Rate for Payer: Upland Medical Group Pediatric |
$37.20
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$55.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$40.92
|
| Rate for Payer: Vantage Medical Group Senior |
$37.20
|
|
|
HC THAWING COMPONENT CRYO
|
Facility
|
IP
|
$301.00
|
|
|
Service Code
|
CPT 86999
|
| Hospital Charge Code |
900904698
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$60.20 |
| Max. Negotiated Rate |
$255.85 |
| Rate for Payer: Adventist Health Commercial |
$60.20
|
| Rate for Payer: Cash Price |
$135.45
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$210.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$120.40
|
| Rate for Payer: EPIC Health Plan Senior |
$120.40
|
| Rate for Payer: Galaxy Health WC |
$255.85
|
| Rate for Payer: Global Benefits Group Commercial |
$180.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$191.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$177.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$72.24
|
| Rate for Payer: Multiplan Commercial |
$240.80
|
| Rate for Payer: Networks By Design Commercial |
$195.65
|
| Rate for Payer: Prime Health Services Commercial |
$255.85
|
|
|
HC THEOPHYLLINE
|
Facility
|
OP
|
$120.00
|
|
|
Service Code
|
CPT 80198
|
| Hospital Charge Code |
900910457
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.46 |
| Max. Negotiated Rate |
$146.07 |
| Rate for Payer: Adventist Health Commercial |
$24.00
|
| Rate for Payer: Adventist Health Commercial |
$40.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$117.63
|
| Rate for Payer: Aetna of CA HMO/PPO |
$117.63
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21.21
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21.21
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14.14
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14.14
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$146.07
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$146.07
|
| Rate for Payer: Blue Shield of California Commercial |
$139.40
|
| Rate for Payer: Blue Shield of California Commercial |
$55.32
|
| Rate for Payer: Blue Shield of California Commercial |
$92.20
|
| Rate for Payer: Blue Shield of California Commercial |
$83.64
|
| Rate for Payer: Cash Price |
$90.00
|
| Rate for Payer: Cash Price |
$90.00
|
| Rate for Payer: Cash Price |
$54.00
|
| Rate for Payer: Cash Price |
$54.00
|
| Rate for Payer: Cigna of CA HMO |
$128.00
|
| Rate for Payer: Cigna of CA HMO |
$76.80
|
| Rate for Payer: Cigna of CA PPO |
$88.80
|
| Rate for Payer: Cigna of CA PPO |
$148.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21.21
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21.21
|
| Rate for Payer: Dignity Health Medi-Cal |
$15.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$15.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$14.14
|
| Rate for Payer: Dignity Health Medicare Advantage |
$14.14
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$84.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$140.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$23.33
|
| Rate for Payer: EPIC Health Plan Commercial |
$23.33
|
| Rate for Payer: EPIC Health Plan Senior |
$15.55
|
| Rate for Payer: EPIC Health Plan Senior |
$15.55
|
| Rate for Payer: Galaxy Health WC |
$102.00
|
| Rate for Payer: Galaxy Health WC |
$170.00
|
| Rate for Payer: Global Benefits Group Commercial |
$72.00
|
| Rate for Payer: Global Benefits Group Commercial |
$120.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$23.19
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$23.19
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$21.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$21.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$14.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$14.14
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$76.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$127.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$23.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$23.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$19.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$19.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$28.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$48.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17.82
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17.82
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18.95
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18.95
|
| Rate for Payer: Multiplan Commercial |
$160.00
|
| Rate for Payer: Multiplan Commercial |
$96.00
|
| Rate for Payer: Networks By Design Commercial |
$130.00
|
| Rate for Payer: Networks By Design Commercial |
$78.00
|
| Rate for Payer: Prime Health Services Commercial |
$102.00
|
| Rate for Payer: Prime Health Services Commercial |
$170.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$72.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$120.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$72.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$120.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$11.46
|
| Rate for Payer: United Healthcare All Other Commercial |
$11.46
|
| Rate for Payer: United Healthcare All Other HMO |
$11.46
|
| Rate for Payer: United Healthcare All Other HMO |
$11.46
|
| Rate for Payer: United Healthcare HMO Rider |
$11.46
|
| Rate for Payer: United Healthcare HMO Rider |
$11.46
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.46
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.46
|
| Rate for Payer: Upland Medical Group Pediatric |
$14.14
|
| Rate for Payer: Upland Medical Group Pediatric |
$14.14
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21.21
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21.21
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15.55
|
| Rate for Payer: Vantage Medical Group Senior |
$14.14
|
| Rate for Payer: Vantage Medical Group Senior |
$14.14
|
|
|
HC THEOPHYLLINE
|
Facility
|
IP
|
$200.00
|
|
|
Service Code
|
CPT 80198
|
| Hospital Charge Code |
900910457
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$40.00 |
| Max. Negotiated Rate |
$170.00 |
| Rate for Payer: Adventist Health Commercial |
$40.00
|
| Rate for Payer: Cash Price |
$90.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$140.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$80.00
|
| Rate for Payer: EPIC Health Plan Senior |
$80.00
|
| Rate for Payer: Galaxy Health WC |
$170.00
|
| Rate for Payer: Global Benefits Group Commercial |
$120.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$127.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$118.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$48.00
|
| Rate for Payer: Multiplan Commercial |
$160.00
|
| Rate for Payer: Networks By Design Commercial |
$130.00
|
| Rate for Payer: Prime Health Services Commercial |
$170.00
|
|
|
HC THERAPEUTIC ACTIVITY 15 MIN MCAL
|
Facility
|
IP
|
$323.00
|
|
|
Service Code
|
CPT 97530
|
| Hospital Charge Code |
901300061
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$64.60 |
| Max. Negotiated Rate |
$274.55 |
| Rate for Payer: Adventist Health Commercial |
$64.60
|
| Rate for Payer: Cash Price |
$145.35
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$226.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$129.20
|
| Rate for Payer: EPIC Health Plan Senior |
$129.20
|
| Rate for Payer: Galaxy Health WC |
$274.55
|
| Rate for Payer: Global Benefits Group Commercial |
$193.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$205.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$190.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$77.52
|
| Rate for Payer: Multiplan Commercial |
$258.40
|
| Rate for Payer: Networks By Design Commercial |
$209.95
|
| Rate for Payer: Prime Health Services Commercial |
$274.55
|
|
|
HC THERAPEUTIC ACTIVITY 15 MIN MCAL
|
Facility
|
OP
|
$323.00
|
|
|
Service Code
|
CPT 97530
|
| Hospital Charge Code |
901300061
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$18.72 |
| Max. Negotiated Rate |
$478.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$164.98
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$274.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$177.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$242.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$478.00
|
| Rate for Payer: Blue Shield of California Commercial |
$291.00
|
| Rate for Payer: Blue Shield of California Commercial |
$439.00
|
| Rate for Payer: Cash Price |
$145.35
|
| Rate for Payer: Cash Price |
$145.35
|
| Rate for Payer: Cash Price |
$145.35
|
| Rate for Payer: Cash Price |
$145.35
|
| Rate for Payer: Cigna of CA HMO |
$206.72
|
| Rate for Payer: Cigna of CA PPO |
$239.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$274.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$274.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$274.55
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$226.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$129.20
|
| Rate for Payer: EPIC Health Plan Senior |
$129.20
|
| Rate for Payer: Galaxy Health WC |
$274.55
|
| Rate for Payer: Global Benefits Group Commercial |
$193.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$18.72
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$205.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$21.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$190.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$77.52
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$226.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$226.10
|
| Rate for Payer: Multiplan Commercial |
$258.40
|
| Rate for Payer: Networks By Design Commercial |
$209.95
|
| Rate for Payer: Prime Health Services Commercial |
$274.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$193.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$193.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$274.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$274.55
|
| Rate for Payer: Vantage Medical Group Senior |
$274.55
|
| Rate for Payer: Adventist Health Commercial |
$132.43
|
|
|
HC THERAPEUTIC ACTIVITY 15MIN MCAL
|
Facility
|
OP
|
$323.00
|
|
|
Service Code
|
CPT 97530
|
| Hospital Charge Code |
900400073
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$18.72 |
| Max. Negotiated Rate |
$478.00 |
| Rate for Payer: Adventist Health Commercial |
$132.43
|
| Rate for Payer: Aetna of CA HMO/PPO |
$164.98
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$274.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$177.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$242.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$478.00
|
| Rate for Payer: Blue Shield of California Commercial |
$291.00
|
| Rate for Payer: Blue Shield of California Commercial |
$439.00
|
| Rate for Payer: Cash Price |
$145.35
|
| Rate for Payer: Cash Price |
$145.35
|
| Rate for Payer: Cash Price |
$145.35
|
| Rate for Payer: Cash Price |
$145.35
|
| Rate for Payer: Cigna of CA HMO |
$206.72
|
| Rate for Payer: Cigna of CA PPO |
$239.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$274.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$274.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$274.55
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$226.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$129.20
|
| Rate for Payer: EPIC Health Plan Senior |
$129.20
|
| Rate for Payer: Galaxy Health WC |
$274.55
|
| Rate for Payer: Global Benefits Group Commercial |
$193.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$18.72
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$205.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$21.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$190.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$77.52
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$226.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$226.10
|
| Rate for Payer: Multiplan Commercial |
$258.40
|
| Rate for Payer: Networks By Design Commercial |
$209.95
|
| Rate for Payer: Prime Health Services Commercial |
$274.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$193.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$193.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$274.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$274.55
|
| Rate for Payer: Vantage Medical Group Senior |
$274.55
|
|
|
HC THERAPEUTIC ACTIVITY 15MIN MCAL
|
Facility
|
IP
|
$323.00
|
|
|
Service Code
|
CPT 97530
|
| Hospital Charge Code |
900400073
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$64.60 |
| Max. Negotiated Rate |
$274.55 |
| Rate for Payer: Adventist Health Commercial |
$64.60
|
| Rate for Payer: Cash Price |
$145.35
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$226.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$129.20
|
| Rate for Payer: EPIC Health Plan Senior |
$129.20
|
| Rate for Payer: Galaxy Health WC |
$274.55
|
| Rate for Payer: Global Benefits Group Commercial |
$193.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$205.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$190.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$77.52
|
| Rate for Payer: Multiplan Commercial |
$258.40
|
| Rate for Payer: Networks By Design Commercial |
$209.95
|
| Rate for Payer: Prime Health Services Commercial |
$274.55
|
|
|
HC THERAPEUTIC ASPIR BRONCH INITL
|
Facility
|
OP
|
$3,335.00
|
|
|
Service Code
|
CPT 31645
|
| Hospital Charge Code |
900803510
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$250.19 |
| Max. Negotiated Rate |
$5,641.00 |
| Rate for Payer: Adventist Health Commercial |
$667.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$995.69
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,433.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,518.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,289.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Cash Price |
$1,500.75
|
| Rate for Payer: Cash Price |
$1,500.75
|
| Rate for Payer: Cash Price |
$1,500.75
|
| Rate for Payer: Cigna of CA HMO |
$2,134.40
|
| Rate for Payer: Cigna of CA PPO |
$2,467.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,433.88
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,518.18
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,289.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,334.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,777.26
|
| Rate for Payer: EPIC Health Plan Senior |
$2,518.18
|
| Rate for Payer: Galaxy Health WC |
$2,834.75
|
| Rate for Payer: Global Benefits Group Commercial |
$2,001.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,754.37
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$250.19
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,289.25
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,117.72
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$282.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,204.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$800.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,884.45
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,067.59
|
| Rate for Payer: Multiplan Commercial |
$2,668.00
|
| Rate for Payer: Networks By Design Commercial |
$2,167.75
|
| Rate for Payer: Prime Health Services Commercial |
$2,834.75
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,001.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,001.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,667.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,667.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,667.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,667.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,289.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,433.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,518.18
|
| Rate for Payer: Vantage Medical Group Senior |
$2,289.25
|
|
|
HC THERAPEUTIC ASPIR BRONCH INITL
|
Facility
|
IP
|
$3,335.00
|
|
|
Service Code
|
CPT 31645
|
| Hospital Charge Code |
900803510
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$667.00 |
| Max. Negotiated Rate |
$2,834.75 |
| Rate for Payer: Adventist Health Commercial |
$667.00
|
| Rate for Payer: Cash Price |
$1,500.75
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,334.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,334.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,334.00
|
| Rate for Payer: Galaxy Health WC |
$2,834.75
|
| Rate for Payer: Global Benefits Group Commercial |
$2,001.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,117.72
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,967.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$800.40
|
| Rate for Payer: Multiplan Commercial |
$2,668.00
|
| Rate for Payer: Networks By Design Commercial |
$2,167.75
|
| Rate for Payer: Prime Health Services Commercial |
$2,834.75
|
|
|
HC THERAPEUTIC INJECTION IA
|
Facility
|
IP
|
$518.00
|
|
|
Service Code
|
CPT 96373
|
| Hospital Charge Code |
909020041
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$103.60 |
| Max. Negotiated Rate |
$440.30 |
| Rate for Payer: Adventist Health Commercial |
$103.60
|
| Rate for Payer: Cash Price |
$233.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$362.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$207.20
|
| Rate for Payer: EPIC Health Plan Senior |
$207.20
|
| Rate for Payer: Galaxy Health WC |
$440.30
|
| Rate for Payer: Global Benefits Group Commercial |
$310.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$328.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$305.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$124.32
|
| Rate for Payer: Multiplan Commercial |
$414.40
|
| Rate for Payer: Networks By Design Commercial |
$336.70
|
| Rate for Payer: Prime Health Services Commercial |
$440.30
|
|
|
HC THERAPEUTIC INJECTION IA
|
Facility
|
OP
|
$518.00
|
|
|
Service Code
|
CPT 96373
|
| Hospital Charge Code |
909020041
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$28.29 |
| Max. Negotiated Rate |
$1,036.00 |
| Rate for Payer: Adventist Health Commercial |
$103.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$133.07
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$410.36
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$300.93
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$273.57
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,036.00
|
| Rate for Payer: Cash Price |
$233.10
|
| Rate for Payer: Cash Price |
$233.10
|
| Rate for Payer: Cash Price |
$233.10
|
| Rate for Payer: Cigna of CA HMO |
$331.52
|
| Rate for Payer: Cigna of CA PPO |
$383.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$410.36
|
| Rate for Payer: Dignity Health Medi-Cal |
$300.93
|
| Rate for Payer: Dignity Health Medicare Advantage |
$273.57
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$362.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$451.39
|
| Rate for Payer: EPIC Health Plan Senior |
$300.93
|
| Rate for Payer: Galaxy Health WC |
$440.30
|
| Rate for Payer: Global Benefits Group Commercial |
$310.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$448.65
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$28.29
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$273.57
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$328.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$32.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$383.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$124.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$344.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$366.58
|
| Rate for Payer: Multiplan Commercial |
$414.40
|
| Rate for Payer: Networks By Design Commercial |
$336.70
|
| Rate for Payer: Prime Health Services Commercial |
$440.30
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$310.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$328.28
|
| Rate for Payer: United Healthcare All Other Commercial |
$676.00
|
| Rate for Payer: United Healthcare All Other HMO |
$663.00
|
| Rate for Payer: United Healthcare HMO Rider |
$662.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$605.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$273.57
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$410.36
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$300.93
|
| Rate for Payer: Vantage Medical Group Senior |
$273.57
|
|
|
HC THERAPEUTIC PROCEDURE 15 MIN MCAL
|
Facility
|
OP
|
$331.00
|
|
|
Service Code
|
CPT 97110
|
| Hospital Charge Code |
907000036
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$18.41 |
| Max. Negotiated Rate |
$478.00 |
| Rate for Payer: Adventist Health Commercial |
$135.71
|
| Rate for Payer: Aetna of CA HMO/PPO |
$149.68
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$281.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$182.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$248.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$478.00
|
| Rate for Payer: Blue Shield of California Commercial |
$291.00
|
| Rate for Payer: Blue Shield of California Commercial |
$439.00
|
| Rate for Payer: Cash Price |
$148.95
|
| Rate for Payer: Cash Price |
$148.95
|
| Rate for Payer: Cash Price |
$148.95
|
| Rate for Payer: Cash Price |
$148.95
|
| Rate for Payer: Cigna of CA HMO |
$211.84
|
| Rate for Payer: Cigna of CA PPO |
$244.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$281.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$281.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$281.35
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$231.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$132.40
|
| Rate for Payer: EPIC Health Plan Senior |
$132.40
|
| Rate for Payer: Galaxy Health WC |
$281.35
|
| Rate for Payer: Global Benefits Group Commercial |
$198.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$18.41
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$210.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$20.82
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$195.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$79.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$231.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$231.70
|
| Rate for Payer: Multiplan Commercial |
$264.80
|
| Rate for Payer: Networks By Design Commercial |
$215.15
|
| Rate for Payer: Prime Health Services Commercial |
$281.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$198.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$198.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$281.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$281.35
|
| Rate for Payer: Vantage Medical Group Senior |
$281.35
|
|
