HC ALLELRGEN GREEN PEPPER IGE
|
Facility
|
OP
|
$15.00
|
|
Service Code
|
CPT 86003
|
Hospital Charge Code |
900913601
|
Hospital Revenue Code
|
302
|
Min. Negotiated Rate |
$3.60 |
Max. Negotiated Rate |
$144.22 |
Rate for Payer: Aetna of CA HMO/PPO |
$43.38
|
Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.83
|
Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.74
|
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.22
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$144.22
|
Rate for Payer: Blue Distinction Transplant |
$9.00
|
Rate for Payer: Blue Shield of California Commercial |
$9.69
|
Rate for Payer: Blue Shield of California EPN |
$7.68
|
Rate for Payer: Cash Price |
$6.75
|
Rate for Payer: Cash Price |
$6.75
|
Rate for Payer: Cigna of CA HMO |
$9.60
|
Rate for Payer: Cigna of CA PPO |
$11.10
|
Rate for Payer: Dignity Health Commercial/Exchange |
$7.83
|
Rate for Payer: Dignity Health Media |
$5.22
|
Rate for Payer: Dignity Health Medi-Cal |
$5.74
|
Rate for Payer: EPIC Health Plan Commercial |
$7.05
|
Rate for Payer: EPIC Health Plan Medicare/Senior |
$5.22
|
Rate for Payer: EPIC Health Plan Transplant |
$5.22
|
Rate for Payer: Galaxy Health WC |
$12.75
|
Rate for Payer: Global Benefits Group Commercial |
$9.00
|
Rate for Payer: Health Plan of Nevada (Sierra) Other |
$11.25
|
Rate for Payer: Heritage Provider Network Commercial |
$8.56
|
Rate for Payer: Heritage Provider Network Transplant |
$8.56
|
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$8.46
|
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$8.46
|
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.22
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.00
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.82
|
Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.22
|
Rate for Payer: LLUH Dept of Risk Management WC |
$3.60
|
Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.58
|
Rate for Payer: Molina Healthcare of CA Medicare |
$6.99
|
Rate for Payer: Multiplan Commercial |
$12.00
|
Rate for Payer: Networks By Design Commercial |
$9.75
|
Rate for Payer: Prime Health Services Commercial |
$12.75
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.00
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.00
|
Rate for Payer: United Healthcare All Other Commercial |
$4.23
|
Rate for Payer: United Healthcare All Other HMO |
$4.23
|
Rate for Payer: United Healthcare HMO Rider |
$4.23
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$4.23
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.83
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$5.74
|
Rate for Payer: Vantage Medical Group Senior |
$5.22
|
|
HC ALLERGEN A ALTERNATA IGE
|
Facility
|
OP
|
$15.00
|
|
Service Code
|
CPT 86003
|
Hospital Charge Code |
900912344
|
Hospital Revenue Code
|
302
|
Min. Negotiated Rate |
$3.60 |
Max. Negotiated Rate |
$144.22 |
Rate for Payer: Aetna of CA HMO/PPO |
$43.38
|
Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.83
|
Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.74
|
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.22
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$144.22
|
Rate for Payer: Blue Distinction Transplant |
$9.00
|
Rate for Payer: Blue Shield of California Commercial |
$9.69
|
Rate for Payer: Blue Shield of California EPN |
$7.68
|
Rate for Payer: Cash Price |
$6.75
|
Rate for Payer: Cash Price |
$6.75
|
Rate for Payer: Cigna of CA HMO |
$9.60
|
Rate for Payer: Cigna of CA PPO |
$11.10
|
Rate for Payer: Dignity Health Commercial/Exchange |
$7.83
|
Rate for Payer: Dignity Health Media |
$5.22
|
Rate for Payer: Dignity Health Medi-Cal |
$5.74
|
Rate for Payer: EPIC Health Plan Commercial |
$7.05
|
Rate for Payer: EPIC Health Plan Medicare/Senior |
$5.22
|
Rate for Payer: EPIC Health Plan Transplant |
$5.22
|
Rate for Payer: Galaxy Health WC |
$12.75
|
Rate for Payer: Global Benefits Group Commercial |
$9.00
|
Rate for Payer: Health Plan of Nevada (Sierra) Other |
$11.25
|
Rate for Payer: Heritage Provider Network Commercial |
$8.56
|
Rate for Payer: Heritage Provider Network Transplant |
$8.56
|
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$8.46
|
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$8.46
|
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.22
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.00
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.82
|
Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.22
|
Rate for Payer: LLUH Dept of Risk Management WC |
$3.60
|
Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.58
|
Rate for Payer: Molina Healthcare of CA Medicare |
$6.99
|
Rate for Payer: Multiplan Commercial |
$12.00
|
Rate for Payer: Networks By Design Commercial |
$9.75
|
Rate for Payer: Prime Health Services Commercial |
$12.75
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.00
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.00
|
Rate for Payer: United Healthcare All Other Commercial |
$4.23
|
Rate for Payer: United Healthcare All Other HMO |
$4.23
|
Rate for Payer: United Healthcare HMO Rider |
$4.23
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$4.23
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.83
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$5.74
|
Rate for Payer: Vantage Medical Group Senior |
$5.22
|
|
HC ALLERGEN ALDER E IGE
|
Facility
|
OP
|
$15.00
|
|
Service Code
|
CPT 86003
|
Hospital Charge Code |
900912345
|
Hospital Revenue Code
|
302
|
Min. Negotiated Rate |
$3.60 |
Max. Negotiated Rate |
$144.22 |
Rate for Payer: Aetna of CA HMO/PPO |
$43.38
|
Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.83
|
Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.74
|
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.22
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$144.22
|
Rate for Payer: Blue Distinction Transplant |
$9.00
|
Rate for Payer: Blue Shield of California Commercial |
$9.69
|
Rate for Payer: Blue Shield of California EPN |
$7.68
|
Rate for Payer: Cash Price |
$6.75
|
Rate for Payer: Cash Price |
$6.75
|
Rate for Payer: Cigna of CA HMO |
$9.60
|
Rate for Payer: Cigna of CA PPO |
$11.10
|
Rate for Payer: Dignity Health Commercial/Exchange |
$7.83
|
Rate for Payer: Dignity Health Media |
$5.22
|
Rate for Payer: Dignity Health Medi-Cal |
$5.74
|
Rate for Payer: EPIC Health Plan Commercial |
$7.05
|
Rate for Payer: EPIC Health Plan Medicare/Senior |
$5.22
|
Rate for Payer: EPIC Health Plan Transplant |
$5.22
|
Rate for Payer: Galaxy Health WC |
$12.75
|
Rate for Payer: Global Benefits Group Commercial |
$9.00
|
Rate for Payer: Health Plan of Nevada (Sierra) Other |
$11.25
|
Rate for Payer: Heritage Provider Network Commercial |
$8.56
|
Rate for Payer: Heritage Provider Network Transplant |
$8.56
|
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$8.46
|
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$8.46
|
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.22
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.00
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.82
|
Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.22
|
Rate for Payer: LLUH Dept of Risk Management WC |
$3.60
|
Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.58
|
Rate for Payer: Molina Healthcare of CA Medicare |
$6.99
|
Rate for Payer: Multiplan Commercial |
$12.00
|
Rate for Payer: Networks By Design Commercial |
$9.75
|
Rate for Payer: Prime Health Services Commercial |
$12.75
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.00
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.00
|
Rate for Payer: United Healthcare All Other Commercial |
$4.23
|
Rate for Payer: United Healthcare All Other HMO |
$4.23
|
Rate for Payer: United Healthcare HMO Rider |
$4.23
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$4.23
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.83
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$5.74
|
Rate for Payer: Vantage Medical Group Senior |
$5.22
|
|
HC ALLERGEN ALMOND IGE
|
Facility
|
OP
|
$15.00
|
|
Service Code
|
CPT 86003
|
Hospital Charge Code |
900912346
|
Hospital Revenue Code
|
302
|
Min. Negotiated Rate |
$3.60 |
Max. Negotiated Rate |
$144.22 |
Rate for Payer: Aetna of CA HMO/PPO |
$43.38
|
Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.83
|
Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.74
|
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.22
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$144.22
|
Rate for Payer: Blue Distinction Transplant |
$9.00
|
Rate for Payer: Blue Shield of California Commercial |
$9.69
|
Rate for Payer: Blue Shield of California EPN |
$7.68
|
Rate for Payer: Cash Price |
$6.75
|
Rate for Payer: Cash Price |
$6.75
|
Rate for Payer: Cigna of CA HMO |
$9.60
|
Rate for Payer: Cigna of CA PPO |
$11.10
|
Rate for Payer: Dignity Health Commercial/Exchange |
$7.83
|
Rate for Payer: Dignity Health Media |
$5.22
|
Rate for Payer: Dignity Health Medi-Cal |
$5.74
|
Rate for Payer: EPIC Health Plan Commercial |
$7.05
|
Rate for Payer: EPIC Health Plan Medicare/Senior |
$5.22
|
Rate for Payer: EPIC Health Plan Transplant |
$5.22
|
Rate for Payer: Galaxy Health WC |
$12.75
|
Rate for Payer: Global Benefits Group Commercial |
$9.00
|
Rate for Payer: Health Plan of Nevada (Sierra) Other |
$11.25
|
Rate for Payer: Heritage Provider Network Commercial |
$8.56
|
Rate for Payer: Heritage Provider Network Transplant |
$8.56
|
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$8.46
|
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$8.46
|
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.22
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.00
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.82
|
Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.22
|
Rate for Payer: LLUH Dept of Risk Management WC |
$3.60
|
Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.58
|
Rate for Payer: Molina Healthcare of CA Medicare |
$6.99
|
Rate for Payer: Multiplan Commercial |
$12.00
|
Rate for Payer: Networks By Design Commercial |
$9.75
|
Rate for Payer: Prime Health Services Commercial |
$12.75
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.00
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.00
|
Rate for Payer: United Healthcare All Other Commercial |
$4.23
|
Rate for Payer: United Healthcare All Other HMO |
$4.23
|
Rate for Payer: United Healthcare HMO Rider |
$4.23
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$4.23
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.83
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$5.74
|
Rate for Payer: Vantage Medical Group Senior |
$5.22
|
|
HC ALLERGEN ALPHA-LACTOALBUMIN IGE
|
Facility
|
OP
|
$15.00
|
|
Service Code
|
CPT 86008
|
Hospital Charge Code |
900913570
|
Hospital Revenue Code
|
302
|
Min. Negotiated Rate |
$3.60 |
Max. Negotiated Rate |
$150.92 |
Rate for Payer: Aetna of CA HMO/PPO |
$130.84
|
Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$26.90
|
Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19.72
|
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$17.93
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$150.92
|
Rate for Payer: Blue Distinction Transplant |
$9.00
|
Rate for Payer: Blue Shield of California Commercial |
$9.69
|
Rate for Payer: Blue Shield of California EPN |
$7.68
|
Rate for Payer: Cash Price |
$6.75
|
Rate for Payer: Cash Price |
$6.75
|
Rate for Payer: Cigna of CA HMO |
$9.60
|
Rate for Payer: Cigna of CA PPO |
$11.10
|
Rate for Payer: Dignity Health Commercial/Exchange |
$26.90
|
Rate for Payer: Dignity Health Media |
$17.93
|
Rate for Payer: Dignity Health Medi-Cal |
$19.72
|
Rate for Payer: EPIC Health Plan Commercial |
$24.21
|
Rate for Payer: EPIC Health Plan Medicare/Senior |
$17.93
|
Rate for Payer: EPIC Health Plan Transplant |
$17.93
|
Rate for Payer: Galaxy Health WC |
$12.75
|
Rate for Payer: Global Benefits Group Commercial |
$9.00
|
Rate for Payer: Health Plan of Nevada (Sierra) Other |
$11.25
|
Rate for Payer: Heritage Provider Network Commercial |
$29.41
|
Rate for Payer: Heritage Provider Network Transplant |
$29.41
|
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$29.05
|
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$29.05
|
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$17.93
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.00
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$30.29
|
Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$17.93
|
Rate for Payer: LLUH Dept of Risk Management WC |
$3.60
|
Rate for Payer: Molina Healthcare of CA Medi-Cal |
$22.59
|
Rate for Payer: Molina Healthcare of CA Medicare |
$24.03
|
Rate for Payer: Multiplan Commercial |
$12.00
|
Rate for Payer: Networks By Design Commercial |
$9.75
|
Rate for Payer: Prime Health Services Commercial |
$12.75
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.00
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.00
|
Rate for Payer: United Healthcare All Other Commercial |
$14.53
|
Rate for Payer: United Healthcare All Other HMO |
$14.53
|
Rate for Payer: United Healthcare HMO Rider |
$14.53
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$14.53
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$26.90
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$19.72
|
Rate for Payer: Vantage Medical Group Senior |
$17.93
|
|
HC ALLERGEN APPLE IGE
|
Facility
|
OP
|
$15.00
|
|
Service Code
|
CPT 86003
|
Hospital Charge Code |
900912347
|
Hospital Revenue Code
|
302
|
Min. Negotiated Rate |
$3.60 |
Max. Negotiated Rate |
$144.22 |
Rate for Payer: Aetna of CA HMO/PPO |
$43.38
|
Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.83
|
Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.74
|
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.22
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$144.22
|
Rate for Payer: Blue Distinction Transplant |
$9.00
|
Rate for Payer: Blue Shield of California Commercial |
$9.69
|
Rate for Payer: Blue Shield of California EPN |
$7.68
|
Rate for Payer: Cash Price |
$6.75
|
Rate for Payer: Cash Price |
$6.75
|
Rate for Payer: Cigna of CA HMO |
$9.60
|
Rate for Payer: Cigna of CA PPO |
$11.10
|
Rate for Payer: Dignity Health Commercial/Exchange |
$7.83
|
Rate for Payer: Dignity Health Media |
$5.22
|
Rate for Payer: Dignity Health Medi-Cal |
$5.74
|
Rate for Payer: EPIC Health Plan Commercial |
$7.05
|
Rate for Payer: EPIC Health Plan Medicare/Senior |
$5.22
|
Rate for Payer: EPIC Health Plan Transplant |
$5.22
|
Rate for Payer: Galaxy Health WC |
$12.75
|
Rate for Payer: Global Benefits Group Commercial |
$9.00
|
Rate for Payer: Health Plan of Nevada (Sierra) Other |
$11.25
|
Rate for Payer: Heritage Provider Network Commercial |
$8.56
|
Rate for Payer: Heritage Provider Network Transplant |
$8.56
|
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$8.46
|
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$8.46
|
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.22
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.00
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.82
|
Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.22
|
Rate for Payer: LLUH Dept of Risk Management WC |
$3.60
|
Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.58
|
Rate for Payer: Molina Healthcare of CA Medicare |
$6.99
|
Rate for Payer: Multiplan Commercial |
$12.00
|
Rate for Payer: Networks By Design Commercial |
$9.75
|
Rate for Payer: Prime Health Services Commercial |
$12.75
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.00
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.00
|
Rate for Payer: United Healthcare All Other Commercial |
$4.23
|
Rate for Payer: United Healthcare All Other HMO |
$4.23
|
Rate for Payer: United Healthcare HMO Rider |
$4.23
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$4.23
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.83
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$5.74
|
Rate for Payer: Vantage Medical Group Senior |
$5.22
|
|
HC ALLERGEN ASPERGILLUS FUM IGE
|
Facility
|
OP
|
$15.00
|
|
Service Code
|
CPT 86003
|
Hospital Charge Code |
900913547
|
Hospital Revenue Code
|
302
|
Min. Negotiated Rate |
$3.60 |
Max. Negotiated Rate |
$144.22 |
Rate for Payer: Aetna of CA HMO/PPO |
$43.38
|
Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.83
|
Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.74
|
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.22
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$144.22
|
Rate for Payer: Blue Distinction Transplant |
$9.00
|
Rate for Payer: Blue Shield of California Commercial |
$9.69
|
Rate for Payer: Blue Shield of California EPN |
$7.68
|
Rate for Payer: Cash Price |
$6.75
|
Rate for Payer: Cash Price |
$6.75
|
Rate for Payer: Cigna of CA HMO |
$9.60
|
Rate for Payer: Cigna of CA PPO |
$11.10
|
Rate for Payer: Dignity Health Commercial/Exchange |
$7.83
|
Rate for Payer: Dignity Health Media |
$5.22
|
Rate for Payer: Dignity Health Medi-Cal |
$5.74
|
Rate for Payer: EPIC Health Plan Commercial |
$7.05
|
Rate for Payer: EPIC Health Plan Medicare/Senior |
$5.22
|
Rate for Payer: EPIC Health Plan Transplant |
$5.22
|
Rate for Payer: Galaxy Health WC |
$12.75
|
Rate for Payer: Global Benefits Group Commercial |
$9.00
|
Rate for Payer: Health Plan of Nevada (Sierra) Other |
$11.25
|
Rate for Payer: Heritage Provider Network Commercial |
$8.56
|
Rate for Payer: Heritage Provider Network Transplant |
$8.56
|
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$8.46
|
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$8.46
|
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.22
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.00
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.82
|
Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.22
|
Rate for Payer: LLUH Dept of Risk Management WC |
$3.60
|
Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.58
|
Rate for Payer: Molina Healthcare of CA Medicare |
$6.99
|
Rate for Payer: Multiplan Commercial |
$12.00
|
Rate for Payer: Networks By Design Commercial |
$9.75
|
Rate for Payer: Prime Health Services Commercial |
$12.75
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.00
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.00
|
Rate for Payer: United Healthcare All Other Commercial |
$4.23
|
Rate for Payer: United Healthcare All Other HMO |
$4.23
|
Rate for Payer: United Healthcare HMO Rider |
$4.23
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$4.23
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.83
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$5.74
|
Rate for Payer: Vantage Medical Group Senior |
$5.22
|
|
HC ALLERGEN AVOCADO IGE
|
Facility
|
OP
|
$15.00
|
|
Service Code
|
CPT 86003
|
Hospital Charge Code |
900912348
|
Hospital Revenue Code
|
302
|
Min. Negotiated Rate |
$3.60 |
Max. Negotiated Rate |
$144.22 |
Rate for Payer: Aetna of CA HMO/PPO |
$43.38
|
Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.83
|
Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.74
|
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.22
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$144.22
|
Rate for Payer: Blue Distinction Transplant |
$9.00
|
Rate for Payer: Blue Shield of California Commercial |
$9.69
|
Rate for Payer: Blue Shield of California EPN |
$7.68
|
Rate for Payer: Cash Price |
$6.75
|
Rate for Payer: Cash Price |
$6.75
|
Rate for Payer: Cigna of CA HMO |
$9.60
|
Rate for Payer: Cigna of CA PPO |
$11.10
|
Rate for Payer: Dignity Health Commercial/Exchange |
$7.83
|
Rate for Payer: Dignity Health Media |
$5.22
|
Rate for Payer: Dignity Health Medi-Cal |
$5.74
|
Rate for Payer: EPIC Health Plan Commercial |
$7.05
|
Rate for Payer: EPIC Health Plan Medicare/Senior |
$5.22
|
Rate for Payer: EPIC Health Plan Transplant |
$5.22
|
Rate for Payer: Galaxy Health WC |
$12.75
|
Rate for Payer: Global Benefits Group Commercial |
$9.00
|
Rate for Payer: Health Plan of Nevada (Sierra) Other |
$11.25
|
Rate for Payer: Heritage Provider Network Commercial |
$8.56
|
Rate for Payer: Heritage Provider Network Transplant |
$8.56
|
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$8.46
|
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$8.46
|
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.22
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.00
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.82
|
Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.22
|
Rate for Payer: LLUH Dept of Risk Management WC |
$3.60
|
Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.58
|
Rate for Payer: Molina Healthcare of CA Medicare |
$6.99
|
Rate for Payer: Multiplan Commercial |
$12.00
|
Rate for Payer: Networks By Design Commercial |
$9.75
|
Rate for Payer: Prime Health Services Commercial |
$12.75
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.00
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.00
|
Rate for Payer: United Healthcare All Other Commercial |
$4.23
|
Rate for Payer: United Healthcare All Other HMO |
$4.23
|
Rate for Payer: United Healthcare HMO Rider |
$4.23
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$4.23
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.83
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$5.74
|
Rate for Payer: Vantage Medical Group Senior |
$5.22
|
|
HC ALLERGEN BAHIA GRASS IGE
|
Facility
|
OP
|
$15.00
|
|
Service Code
|
CPT 86003
|
Hospital Charge Code |
900912339
|
Hospital Revenue Code
|
302
|
Min. Negotiated Rate |
$3.60 |
Max. Negotiated Rate |
$144.22 |
Rate for Payer: Aetna of CA HMO/PPO |
$43.38
|
Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.83
|
Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.74
|
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.22
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$144.22
|
Rate for Payer: Blue Distinction Transplant |
$9.00
|
Rate for Payer: Blue Shield of California Commercial |
$9.69
|
Rate for Payer: Blue Shield of California EPN |
$7.68
|
Rate for Payer: Cash Price |
$6.75
|
Rate for Payer: Cash Price |
$6.75
|
Rate for Payer: Cigna of CA HMO |
$9.60
|
Rate for Payer: Cigna of CA PPO |
$11.10
|
Rate for Payer: Dignity Health Commercial/Exchange |
$7.83
|
Rate for Payer: Dignity Health Media |
$5.22
|
Rate for Payer: Dignity Health Medi-Cal |
$5.74
|
Rate for Payer: EPIC Health Plan Commercial |
$7.05
|
Rate for Payer: EPIC Health Plan Medicare/Senior |
$5.22
|
Rate for Payer: EPIC Health Plan Transplant |
$5.22
|
Rate for Payer: Galaxy Health WC |
$12.75
|
Rate for Payer: Global Benefits Group Commercial |
$9.00
|
Rate for Payer: Health Plan of Nevada (Sierra) Other |
$11.25
|
Rate for Payer: Heritage Provider Network Commercial |
$8.56
|
Rate for Payer: Heritage Provider Network Transplant |
$8.56
|
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$8.46
|
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$8.46
|
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.22
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.00
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.82
|
Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.22
|
Rate for Payer: LLUH Dept of Risk Management WC |
$3.60
|
Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.58
|
Rate for Payer: Molina Healthcare of CA Medicare |
$6.99
|
Rate for Payer: Multiplan Commercial |
$12.00
|
Rate for Payer: Networks By Design Commercial |
$9.75
|
Rate for Payer: Prime Health Services Commercial |
$12.75
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.00
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.00
|
Rate for Payer: United Healthcare All Other Commercial |
$4.23
|
Rate for Payer: United Healthcare All Other HMO |
$4.23
|
Rate for Payer: United Healthcare HMO Rider |
$4.23
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$4.23
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.83
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$5.74
|
Rate for Payer: Vantage Medical Group Senior |
$5.22
|
|
HC ALLERGEN BANANA IGE
|
Facility
|
OP
|
$15.00
|
|
Service Code
|
CPT 86003
|
Hospital Charge Code |
900912349
|
Hospital Revenue Code
|
302
|
Min. Negotiated Rate |
$3.60 |
Max. Negotiated Rate |
$144.22 |
Rate for Payer: Aetna of CA HMO/PPO |
$43.38
|
Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.83
|
Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.74
|
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.22
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$144.22
|
Rate for Payer: Blue Distinction Transplant |
$9.00
|
Rate for Payer: Blue Shield of California Commercial |
$9.69
|
Rate for Payer: Blue Shield of California EPN |
$7.68
|
Rate for Payer: Cash Price |
$6.75
|
Rate for Payer: Cash Price |
$6.75
|
Rate for Payer: Cigna of CA HMO |
$9.60
|
Rate for Payer: Cigna of CA PPO |
$11.10
|
Rate for Payer: Dignity Health Commercial/Exchange |
$7.83
|
Rate for Payer: Dignity Health Media |
$5.22
|
Rate for Payer: Dignity Health Medi-Cal |
$5.74
|
Rate for Payer: EPIC Health Plan Commercial |
$7.05
|
Rate for Payer: EPIC Health Plan Medicare/Senior |
$5.22
|
Rate for Payer: EPIC Health Plan Transplant |
$5.22
|
Rate for Payer: Galaxy Health WC |
$12.75
|
Rate for Payer: Global Benefits Group Commercial |
$9.00
|
Rate for Payer: Health Plan of Nevada (Sierra) Other |
$11.25
|
Rate for Payer: Heritage Provider Network Commercial |
$8.56
|
Rate for Payer: Heritage Provider Network Transplant |
$8.56
|
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$8.46
|
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$8.46
|
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.22
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.00
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.82
|
Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.22
|
Rate for Payer: LLUH Dept of Risk Management WC |
$3.60
|
Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.58
|
Rate for Payer: Molina Healthcare of CA Medicare |
$6.99
|
Rate for Payer: Multiplan Commercial |
$12.00
|
Rate for Payer: Networks By Design Commercial |
$9.75
|
Rate for Payer: Prime Health Services Commercial |
$12.75
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.00
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.00
|
Rate for Payer: United Healthcare All Other Commercial |
$4.23
|
Rate for Payer: United Healthcare All Other HMO |
$4.23
|
Rate for Payer: United Healthcare HMO Rider |
$4.23
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$4.23
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.83
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$5.74
|
Rate for Payer: Vantage Medical Group Senior |
$5.22
|
|
HC ALLERGEN BARLEY IGE
|
Facility
|
OP
|
$15.00
|
|
Service Code
|
CPT 86003
|
Hospital Charge Code |
900912350
|
Hospital Revenue Code
|
302
|
Min. Negotiated Rate |
$3.60 |
Max. Negotiated Rate |
$144.22 |
Rate for Payer: Aetna of CA HMO/PPO |
$43.38
|
Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.83
|
Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.74
|
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.22
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$144.22
|
Rate for Payer: Blue Distinction Transplant |
$9.00
|
Rate for Payer: Blue Shield of California Commercial |
$9.69
|
Rate for Payer: Blue Shield of California EPN |
$7.68
|
Rate for Payer: Cash Price |
$6.75
|
Rate for Payer: Cash Price |
$6.75
|
Rate for Payer: Cigna of CA HMO |
$9.60
|
Rate for Payer: Cigna of CA PPO |
$11.10
|
Rate for Payer: Dignity Health Commercial/Exchange |
$7.83
|
Rate for Payer: Dignity Health Media |
$5.22
|
Rate for Payer: Dignity Health Medi-Cal |
$5.74
|
Rate for Payer: EPIC Health Plan Commercial |
$7.05
|
Rate for Payer: EPIC Health Plan Medicare/Senior |
$5.22
|
Rate for Payer: EPIC Health Plan Transplant |
$5.22
|
Rate for Payer: Galaxy Health WC |
$12.75
|
Rate for Payer: Global Benefits Group Commercial |
$9.00
|
Rate for Payer: Health Plan of Nevada (Sierra) Other |
$11.25
|
Rate for Payer: Heritage Provider Network Commercial |
$8.56
|
Rate for Payer: Heritage Provider Network Transplant |
$8.56
|
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$8.46
|
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$8.46
|
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.22
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.00
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.82
|
Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.22
|
Rate for Payer: LLUH Dept of Risk Management WC |
$3.60
|
Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.58
|
Rate for Payer: Molina Healthcare of CA Medicare |
$6.99
|
Rate for Payer: Multiplan Commercial |
$12.00
|
Rate for Payer: Networks By Design Commercial |
$9.75
|
Rate for Payer: Prime Health Services Commercial |
$12.75
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.00
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.00
|
Rate for Payer: United Healthcare All Other Commercial |
$4.23
|
Rate for Payer: United Healthcare All Other HMO |
$4.23
|
Rate for Payer: United Healthcare HMO Rider |
$4.23
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$4.23
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.83
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$5.74
|
Rate for Payer: Vantage Medical Group Senior |
$5.22
|
|
HC ALLERGEN BEEF IGE
|
Facility
|
OP
|
$15.00
|
|
Service Code
|
CPT 86003
|
Hospital Charge Code |
900912351
|
Hospital Revenue Code
|
302
|
Min. Negotiated Rate |
$3.60 |
Max. Negotiated Rate |
$144.22 |
Rate for Payer: Aetna of CA HMO/PPO |
$43.38
|
Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.83
|
Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.74
|
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.22
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$144.22
|
Rate for Payer: Blue Distinction Transplant |
$9.00
|
Rate for Payer: Blue Shield of California Commercial |
$9.69
|
Rate for Payer: Blue Shield of California EPN |
$7.68
|
Rate for Payer: Cash Price |
$6.75
|
Rate for Payer: Cash Price |
$6.75
|
Rate for Payer: Cigna of CA HMO |
$9.60
|
Rate for Payer: Cigna of CA PPO |
$11.10
|
Rate for Payer: Dignity Health Commercial/Exchange |
$7.83
|
Rate for Payer: Dignity Health Media |
$5.22
|
Rate for Payer: Dignity Health Medi-Cal |
$5.74
|
Rate for Payer: EPIC Health Plan Commercial |
$7.05
|
Rate for Payer: EPIC Health Plan Medicare/Senior |
$5.22
|
Rate for Payer: EPIC Health Plan Transplant |
$5.22
|
Rate for Payer: Galaxy Health WC |
$12.75
|
Rate for Payer: Global Benefits Group Commercial |
$9.00
|
Rate for Payer: Health Plan of Nevada (Sierra) Other |
$11.25
|
Rate for Payer: Heritage Provider Network Commercial |
$8.56
|
Rate for Payer: Heritage Provider Network Transplant |
$8.56
|
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$8.46
|
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$8.46
|
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.22
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.00
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.82
|
Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.22
|
Rate for Payer: LLUH Dept of Risk Management WC |
$3.60
|
Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.58
|
Rate for Payer: Molina Healthcare of CA Medicare |
$6.99
|
Rate for Payer: Multiplan Commercial |
$12.00
|
Rate for Payer: Networks By Design Commercial |
$9.75
|
Rate for Payer: Prime Health Services Commercial |
$12.75
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.00
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.00
|
Rate for Payer: United Healthcare All Other Commercial |
$4.23
|
Rate for Payer: United Healthcare All Other HMO |
$4.23
|
Rate for Payer: United Healthcare HMO Rider |
$4.23
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$4.23
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.83
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$5.74
|
Rate for Payer: Vantage Medical Group Senior |
$5.22
|
|
HC ALLERGEN BEETS IGE
|
Facility
|
OP
|
$15.00
|
|
Service Code
|
CPT 86003
|
Hospital Charge Code |
900913571
|
Hospital Revenue Code
|
302
|
Min. Negotiated Rate |
$3.60 |
Max. Negotiated Rate |
$144.22 |
Rate for Payer: Aetna of CA HMO/PPO |
$43.38
|
Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.83
|
Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.74
|
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.22
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$144.22
|
Rate for Payer: Blue Distinction Transplant |
$9.00
|
Rate for Payer: Blue Shield of California Commercial |
$9.69
|
Rate for Payer: Blue Shield of California EPN |
$7.68
|
Rate for Payer: Cash Price |
$6.75
|
Rate for Payer: Cash Price |
$6.75
|
Rate for Payer: Cigna of CA HMO |
$9.60
|
Rate for Payer: Cigna of CA PPO |
$11.10
|
Rate for Payer: Dignity Health Commercial/Exchange |
$7.83
|
Rate for Payer: Dignity Health Media |
$5.22
|
Rate for Payer: Dignity Health Medi-Cal |
$5.74
|
Rate for Payer: EPIC Health Plan Commercial |
$7.05
|
Rate for Payer: EPIC Health Plan Medicare/Senior |
$5.22
|
Rate for Payer: EPIC Health Plan Transplant |
$5.22
|
Rate for Payer: Galaxy Health WC |
$12.75
|
Rate for Payer: Global Benefits Group Commercial |
$9.00
|
Rate for Payer: Health Plan of Nevada (Sierra) Other |
$11.25
|
Rate for Payer: Heritage Provider Network Commercial |
$8.56
|
Rate for Payer: Heritage Provider Network Transplant |
$8.56
|
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$8.46
|
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$8.46
|
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.22
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.00
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.82
|
Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.22
|
Rate for Payer: LLUH Dept of Risk Management WC |
$3.60
|
Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.58
|
Rate for Payer: Molina Healthcare of CA Medicare |
$6.99
|
Rate for Payer: Multiplan Commercial |
$12.00
|
Rate for Payer: Networks By Design Commercial |
$9.75
|
Rate for Payer: Prime Health Services Commercial |
$12.75
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.00
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.00
|
Rate for Payer: United Healthcare All Other Commercial |
$4.23
|
Rate for Payer: United Healthcare All Other HMO |
$4.23
|
Rate for Payer: United Healthcare HMO Rider |
$4.23
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$4.23
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.83
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$5.74
|
Rate for Payer: Vantage Medical Group Senior |
$5.22
|
|
HC ALLERGEN BERMUDA GRASS IGE
|
Facility
|
OP
|
$15.00
|
|
Service Code
|
CPT 86003
|
Hospital Charge Code |
900912352
|
Hospital Revenue Code
|
302
|
Min. Negotiated Rate |
$3.60 |
Max. Negotiated Rate |
$144.22 |
Rate for Payer: Aetna of CA HMO/PPO |
$43.38
|
Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.83
|
Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.74
|
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.22
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$144.22
|
Rate for Payer: Blue Distinction Transplant |
$9.00
|
Rate for Payer: Blue Shield of California Commercial |
$9.69
|
Rate for Payer: Blue Shield of California EPN |
$7.68
|
Rate for Payer: Cash Price |
$6.75
|
Rate for Payer: Cash Price |
$6.75
|
Rate for Payer: Cigna of CA HMO |
$9.60
|
Rate for Payer: Cigna of CA PPO |
$11.10
|
Rate for Payer: Dignity Health Commercial/Exchange |
$7.83
|
Rate for Payer: Dignity Health Media |
$5.22
|
Rate for Payer: Dignity Health Medi-Cal |
$5.74
|
Rate for Payer: EPIC Health Plan Commercial |
$7.05
|
Rate for Payer: EPIC Health Plan Medicare/Senior |
$5.22
|
Rate for Payer: EPIC Health Plan Transplant |
$5.22
|
Rate for Payer: Galaxy Health WC |
$12.75
|
Rate for Payer: Global Benefits Group Commercial |
$9.00
|
Rate for Payer: Health Plan of Nevada (Sierra) Other |
$11.25
|
Rate for Payer: Heritage Provider Network Commercial |
$8.56
|
Rate for Payer: Heritage Provider Network Transplant |
$8.56
|
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$8.46
|
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$8.46
|
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.22
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.00
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.82
|
Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.22
|
Rate for Payer: LLUH Dept of Risk Management WC |
$3.60
|
Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.58
|
Rate for Payer: Molina Healthcare of CA Medicare |
$6.99
|
Rate for Payer: Multiplan Commercial |
$12.00
|
Rate for Payer: Networks By Design Commercial |
$9.75
|
Rate for Payer: Prime Health Services Commercial |
$12.75
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.00
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.00
|
Rate for Payer: United Healthcare All Other Commercial |
$4.23
|
Rate for Payer: United Healthcare All Other HMO |
$4.23
|
Rate for Payer: United Healthcare HMO Rider |
$4.23
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$4.23
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.83
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$5.74
|
Rate for Payer: Vantage Medical Group Senior |
$5.22
|
|
HC ALLERGEN BETA LACTOALBUMIN IGE
|
Facility
|
OP
|
$15.00
|
|
Service Code
|
CPT 86008
|
Hospital Charge Code |
900913572
|
Hospital Revenue Code
|
302
|
Min. Negotiated Rate |
$3.60 |
Max. Negotiated Rate |
$150.92 |
Rate for Payer: Aetna of CA HMO/PPO |
$130.84
|
Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$26.90
|
Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19.72
|
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$17.93
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$150.92
|
Rate for Payer: Blue Distinction Transplant |
$9.00
|
Rate for Payer: Blue Shield of California Commercial |
$9.69
|
Rate for Payer: Blue Shield of California EPN |
$7.68
|
Rate for Payer: Cash Price |
$6.75
|
Rate for Payer: Cash Price |
$6.75
|
Rate for Payer: Cigna of CA HMO |
$9.60
|
Rate for Payer: Cigna of CA PPO |
$11.10
|
Rate for Payer: Dignity Health Commercial/Exchange |
$26.90
|
Rate for Payer: Dignity Health Media |
$17.93
|
Rate for Payer: Dignity Health Medi-Cal |
$19.72
|
Rate for Payer: EPIC Health Plan Commercial |
$24.21
|
Rate for Payer: EPIC Health Plan Medicare/Senior |
$17.93
|
Rate for Payer: EPIC Health Plan Transplant |
$17.93
|
Rate for Payer: Galaxy Health WC |
$12.75
|
Rate for Payer: Global Benefits Group Commercial |
$9.00
|
Rate for Payer: Health Plan of Nevada (Sierra) Other |
$11.25
|
Rate for Payer: Heritage Provider Network Commercial |
$29.41
|
Rate for Payer: Heritage Provider Network Transplant |
$29.41
|
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$29.05
|
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$29.05
|
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$17.93
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.00
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$30.29
|
Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$17.93
|
Rate for Payer: LLUH Dept of Risk Management WC |
$3.60
|
Rate for Payer: Molina Healthcare of CA Medi-Cal |
$22.59
|
Rate for Payer: Molina Healthcare of CA Medicare |
$24.03
|
Rate for Payer: Multiplan Commercial |
$12.00
|
Rate for Payer: Networks By Design Commercial |
$9.75
|
Rate for Payer: Prime Health Services Commercial |
$12.75
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.00
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.00
|
Rate for Payer: United Healthcare All Other Commercial |
$14.53
|
Rate for Payer: United Healthcare All Other HMO |
$14.53
|
Rate for Payer: United Healthcare HMO Rider |
$14.53
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$14.53
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$26.90
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$19.72
|
Rate for Payer: Vantage Medical Group Senior |
$17.93
|
|
HC ALLERGEN BLUE MUSSEL IGE
|
Facility
|
OP
|
$15.00
|
|
Service Code
|
CPT 86003
|
Hospital Charge Code |
900913510
|
Hospital Revenue Code
|
302
|
Min. Negotiated Rate |
$3.60 |
Max. Negotiated Rate |
$144.22 |
Rate for Payer: Aetna of CA HMO/PPO |
$43.38
|
Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.83
|
Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.74
|
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.22
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$144.22
|
Rate for Payer: Blue Distinction Transplant |
$9.00
|
Rate for Payer: Blue Shield of California Commercial |
$9.69
|
Rate for Payer: Blue Shield of California EPN |
$7.68
|
Rate for Payer: Cash Price |
$6.75
|
Rate for Payer: Cash Price |
$6.75
|
Rate for Payer: Cigna of CA HMO |
$9.60
|
Rate for Payer: Cigna of CA PPO |
$11.10
|
Rate for Payer: Dignity Health Commercial/Exchange |
$7.83
|
Rate for Payer: Dignity Health Media |
$5.22
|
Rate for Payer: Dignity Health Medi-Cal |
$5.74
|
Rate for Payer: EPIC Health Plan Commercial |
$7.05
|
Rate for Payer: EPIC Health Plan Medicare/Senior |
$5.22
|
Rate for Payer: EPIC Health Plan Transplant |
$5.22
|
Rate for Payer: Galaxy Health WC |
$12.75
|
Rate for Payer: Global Benefits Group Commercial |
$9.00
|
Rate for Payer: Health Plan of Nevada (Sierra) Other |
$11.25
|
Rate for Payer: Heritage Provider Network Commercial |
$8.56
|
Rate for Payer: Heritage Provider Network Transplant |
$8.56
|
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$8.46
|
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$8.46
|
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.22
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.00
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.82
|
Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.22
|
Rate for Payer: LLUH Dept of Risk Management WC |
$3.60
|
Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.58
|
Rate for Payer: Molina Healthcare of CA Medicare |
$6.99
|
Rate for Payer: Multiplan Commercial |
$12.00
|
Rate for Payer: Networks By Design Commercial |
$9.75
|
Rate for Payer: Prime Health Services Commercial |
$12.75
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.00
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.00
|
Rate for Payer: United Healthcare All Other Commercial |
$4.23
|
Rate for Payer: United Healthcare All Other HMO |
$4.23
|
Rate for Payer: United Healthcare HMO Rider |
$4.23
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$4.23
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.83
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$5.74
|
Rate for Payer: Vantage Medical Group Senior |
$5.22
|
|
HC ALLERGEN BOX ELDER IGE
|
Facility
|
OP
|
$15.00
|
|
Service Code
|
CPT 86003
|
Hospital Charge Code |
900913546
|
Hospital Revenue Code
|
302
|
Min. Negotiated Rate |
$3.60 |
Max. Negotiated Rate |
$144.22 |
Rate for Payer: Aetna of CA HMO/PPO |
$43.38
|
Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.83
|
Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.74
|
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.22
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$144.22
|
Rate for Payer: Blue Distinction Transplant |
$9.00
|
Rate for Payer: Blue Shield of California Commercial |
$9.69
|
Rate for Payer: Blue Shield of California EPN |
$7.68
|
Rate for Payer: Cash Price |
$6.75
|
Rate for Payer: Cash Price |
$6.75
|
Rate for Payer: Cigna of CA HMO |
$9.60
|
Rate for Payer: Cigna of CA PPO |
$11.10
|
Rate for Payer: Dignity Health Commercial/Exchange |
$7.83
|
Rate for Payer: Dignity Health Media |
$5.22
|
Rate for Payer: Dignity Health Medi-Cal |
$5.74
|
Rate for Payer: EPIC Health Plan Commercial |
$7.05
|
Rate for Payer: EPIC Health Plan Medicare/Senior |
$5.22
|
Rate for Payer: EPIC Health Plan Transplant |
$5.22
|
Rate for Payer: Galaxy Health WC |
$12.75
|
Rate for Payer: Global Benefits Group Commercial |
$9.00
|
Rate for Payer: Health Plan of Nevada (Sierra) Other |
$11.25
|
Rate for Payer: Heritage Provider Network Commercial |
$8.56
|
Rate for Payer: Heritage Provider Network Transplant |
$8.56
|
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$8.46
|
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$8.46
|
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.22
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.00
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.82
|
Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.22
|
Rate for Payer: LLUH Dept of Risk Management WC |
$3.60
|
Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.58
|
Rate for Payer: Molina Healthcare of CA Medicare |
$6.99
|
Rate for Payer: Multiplan Commercial |
$12.00
|
Rate for Payer: Networks By Design Commercial |
$9.75
|
Rate for Payer: Prime Health Services Commercial |
$12.75
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.00
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.00
|
Rate for Payer: United Healthcare All Other Commercial |
$4.23
|
Rate for Payer: United Healthcare All Other HMO |
$4.23
|
Rate for Payer: United Healthcare HMO Rider |
$4.23
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$4.23
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.83
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$5.74
|
Rate for Payer: Vantage Medical Group Senior |
$5.22
|
|
HC ALLERGEN BRAZILNUT IGE
|
Facility
|
OP
|
$15.00
|
|
Service Code
|
CPT 86003
|
Hospital Charge Code |
900913542
|
Hospital Revenue Code
|
302
|
Min. Negotiated Rate |
$3.60 |
Max. Negotiated Rate |
$144.22 |
Rate for Payer: Aetna of CA HMO/PPO |
$43.38
|
Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.83
|
Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.74
|
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.22
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$144.22
|
Rate for Payer: Blue Distinction Transplant |
$9.00
|
Rate for Payer: Blue Shield of California Commercial |
$9.69
|
Rate for Payer: Blue Shield of California EPN |
$7.68
|
Rate for Payer: Cash Price |
$6.75
|
Rate for Payer: Cash Price |
$6.75
|
Rate for Payer: Cigna of CA HMO |
$9.60
|
Rate for Payer: Cigna of CA PPO |
$11.10
|
Rate for Payer: Dignity Health Commercial/Exchange |
$7.83
|
Rate for Payer: Dignity Health Media |
$5.22
|
Rate for Payer: Dignity Health Medi-Cal |
$5.74
|
Rate for Payer: EPIC Health Plan Commercial |
$7.05
|
Rate for Payer: EPIC Health Plan Medicare/Senior |
$5.22
|
Rate for Payer: EPIC Health Plan Transplant |
$5.22
|
Rate for Payer: Galaxy Health WC |
$12.75
|
Rate for Payer: Global Benefits Group Commercial |
$9.00
|
Rate for Payer: Health Plan of Nevada (Sierra) Other |
$11.25
|
Rate for Payer: Heritage Provider Network Commercial |
$8.56
|
Rate for Payer: Heritage Provider Network Transplant |
$8.56
|
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$8.46
|
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$8.46
|
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.22
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.00
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.82
|
Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.22
|
Rate for Payer: LLUH Dept of Risk Management WC |
$3.60
|
Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.58
|
Rate for Payer: Molina Healthcare of CA Medicare |
$6.99
|
Rate for Payer: Multiplan Commercial |
$12.00
|
Rate for Payer: Networks By Design Commercial |
$9.75
|
Rate for Payer: Prime Health Services Commercial |
$12.75
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.00
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.00
|
Rate for Payer: United Healthcare All Other Commercial |
$4.23
|
Rate for Payer: United Healthcare All Other HMO |
$4.23
|
Rate for Payer: United Healthcare HMO Rider |
$4.23
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$4.23
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.83
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$5.74
|
Rate for Payer: Vantage Medical Group Senior |
$5.22
|
|
HC ALLERGEN BROCCOLI IGE
|
Facility
|
OP
|
$15.00
|
|
Service Code
|
CPT 86003
|
Hospital Charge Code |
900912353
|
Hospital Revenue Code
|
302
|
Min. Negotiated Rate |
$3.60 |
Max. Negotiated Rate |
$144.22 |
Rate for Payer: Aetna of CA HMO/PPO |
$43.38
|
Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.83
|
Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.74
|
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.22
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$144.22
|
Rate for Payer: Blue Distinction Transplant |
$9.00
|
Rate for Payer: Blue Shield of California Commercial |
$9.69
|
Rate for Payer: Blue Shield of California EPN |
$7.68
|
Rate for Payer: Cash Price |
$6.75
|
Rate for Payer: Cash Price |
$6.75
|
Rate for Payer: Cigna of CA HMO |
$9.60
|
Rate for Payer: Cigna of CA PPO |
$11.10
|
Rate for Payer: Dignity Health Commercial/Exchange |
$7.83
|
Rate for Payer: Dignity Health Media |
$5.22
|
Rate for Payer: Dignity Health Medi-Cal |
$5.74
|
Rate for Payer: EPIC Health Plan Commercial |
$7.05
|
Rate for Payer: EPIC Health Plan Medicare/Senior |
$5.22
|
Rate for Payer: EPIC Health Plan Transplant |
$5.22
|
Rate for Payer: Galaxy Health WC |
$12.75
|
Rate for Payer: Global Benefits Group Commercial |
$9.00
|
Rate for Payer: Health Plan of Nevada (Sierra) Other |
$11.25
|
Rate for Payer: Heritage Provider Network Commercial |
$8.56
|
Rate for Payer: Heritage Provider Network Transplant |
$8.56
|
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$8.46
|
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$8.46
|
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.22
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.00
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.82
|
Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.22
|
Rate for Payer: LLUH Dept of Risk Management WC |
$3.60
|
Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.58
|
Rate for Payer: Molina Healthcare of CA Medicare |
$6.99
|
Rate for Payer: Multiplan Commercial |
$12.00
|
Rate for Payer: Networks By Design Commercial |
$9.75
|
Rate for Payer: Prime Health Services Commercial |
$12.75
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.00
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.00
|
Rate for Payer: United Healthcare All Other Commercial |
$4.23
|
Rate for Payer: United Healthcare All Other HMO |
$4.23
|
Rate for Payer: United Healthcare HMO Rider |
$4.23
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$4.23
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.83
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$5.74
|
Rate for Payer: Vantage Medical Group Senior |
$5.22
|
|
HC ALLERGEN BROME GRASS IGE
|
Facility
|
OP
|
$15.00
|
|
Service Code
|
CPT 86003
|
Hospital Charge Code |
900913549
|
Hospital Revenue Code
|
302
|
Min. Negotiated Rate |
$3.60 |
Max. Negotiated Rate |
$144.22 |
Rate for Payer: Aetna of CA HMO/PPO |
$43.38
|
Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.83
|
Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.74
|
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.22
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$144.22
|
Rate for Payer: Blue Distinction Transplant |
$9.00
|
Rate for Payer: Blue Shield of California Commercial |
$9.69
|
Rate for Payer: Blue Shield of California EPN |
$7.68
|
Rate for Payer: Cash Price |
$6.75
|
Rate for Payer: Cash Price |
$6.75
|
Rate for Payer: Cigna of CA HMO |
$9.60
|
Rate for Payer: Cigna of CA PPO |
$11.10
|
Rate for Payer: Dignity Health Commercial/Exchange |
$7.83
|
Rate for Payer: Dignity Health Media |
$5.22
|
Rate for Payer: Dignity Health Medi-Cal |
$5.74
|
Rate for Payer: EPIC Health Plan Commercial |
$7.05
|
Rate for Payer: EPIC Health Plan Medicare/Senior |
$5.22
|
Rate for Payer: EPIC Health Plan Transplant |
$5.22
|
Rate for Payer: Galaxy Health WC |
$12.75
|
Rate for Payer: Global Benefits Group Commercial |
$9.00
|
Rate for Payer: Health Plan of Nevada (Sierra) Other |
$11.25
|
Rate for Payer: Heritage Provider Network Commercial |
$8.56
|
Rate for Payer: Heritage Provider Network Transplant |
$8.56
|
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$8.46
|
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$8.46
|
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.22
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.00
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.82
|
Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.22
|
Rate for Payer: LLUH Dept of Risk Management WC |
$3.60
|
Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.58
|
Rate for Payer: Molina Healthcare of CA Medicare |
$6.99
|
Rate for Payer: Multiplan Commercial |
$12.00
|
Rate for Payer: Networks By Design Commercial |
$9.75
|
Rate for Payer: Prime Health Services Commercial |
$12.75
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.00
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.00
|
Rate for Payer: United Healthcare All Other Commercial |
$4.23
|
Rate for Payer: United Healthcare All Other HMO |
$4.23
|
Rate for Payer: United Healthcare HMO Rider |
$4.23
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$4.23
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.83
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$5.74
|
Rate for Payer: Vantage Medical Group Senior |
$5.22
|
|
HC ALLERGEN BRUSSEL SPROUT IGE
|
Facility
|
OP
|
$15.00
|
|
Service Code
|
CPT 86003
|
Hospital Charge Code |
900913573
|
Hospital Revenue Code
|
302
|
Min. Negotiated Rate |
$3.60 |
Max. Negotiated Rate |
$144.22 |
Rate for Payer: Aetna of CA HMO/PPO |
$43.38
|
Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.83
|
Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.74
|
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.22
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$144.22
|
Rate for Payer: Blue Distinction Transplant |
$9.00
|
Rate for Payer: Blue Shield of California Commercial |
$9.69
|
Rate for Payer: Blue Shield of California EPN |
$7.68
|
Rate for Payer: Cash Price |
$6.75
|
Rate for Payer: Cash Price |
$6.75
|
Rate for Payer: Cigna of CA HMO |
$9.60
|
Rate for Payer: Cigna of CA PPO |
$11.10
|
Rate for Payer: Dignity Health Commercial/Exchange |
$7.83
|
Rate for Payer: Dignity Health Media |
$5.22
|
Rate for Payer: Dignity Health Medi-Cal |
$5.74
|
Rate for Payer: EPIC Health Plan Commercial |
$7.05
|
Rate for Payer: EPIC Health Plan Medicare/Senior |
$5.22
|
Rate for Payer: EPIC Health Plan Transplant |
$5.22
|
Rate for Payer: Galaxy Health WC |
$12.75
|
Rate for Payer: Global Benefits Group Commercial |
$9.00
|
Rate for Payer: Health Plan of Nevada (Sierra) Other |
$11.25
|
Rate for Payer: Heritage Provider Network Commercial |
$8.56
|
Rate for Payer: Heritage Provider Network Transplant |
$8.56
|
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$8.46
|
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$8.46
|
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.22
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.00
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.82
|
Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.22
|
Rate for Payer: LLUH Dept of Risk Management WC |
$3.60
|
Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.58
|
Rate for Payer: Molina Healthcare of CA Medicare |
$6.99
|
Rate for Payer: Multiplan Commercial |
$12.00
|
Rate for Payer: Networks By Design Commercial |
$9.75
|
Rate for Payer: Prime Health Services Commercial |
$12.75
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.00
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.00
|
Rate for Payer: United Healthcare All Other Commercial |
$4.23
|
Rate for Payer: United Healthcare All Other HMO |
$4.23
|
Rate for Payer: United Healthcare HMO Rider |
$4.23
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$4.23
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.83
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$5.74
|
Rate for Payer: Vantage Medical Group Senior |
$5.22
|
|
HC ALLERGEN BUCKWHEAT IGE
|
Facility
|
OP
|
$15.00
|
|
Service Code
|
CPT 86003
|
Hospital Charge Code |
900913574
|
Hospital Revenue Code
|
302
|
Min. Negotiated Rate |
$3.60 |
Max. Negotiated Rate |
$144.22 |
Rate for Payer: Aetna of CA HMO/PPO |
$43.38
|
Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.83
|
Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.74
|
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.22
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$144.22
|
Rate for Payer: Blue Distinction Transplant |
$9.00
|
Rate for Payer: Blue Shield of California Commercial |
$9.69
|
Rate for Payer: Blue Shield of California EPN |
$7.68
|
Rate for Payer: Cash Price |
$6.75
|
Rate for Payer: Cash Price |
$6.75
|
Rate for Payer: Cigna of CA HMO |
$9.60
|
Rate for Payer: Cigna of CA PPO |
$11.10
|
Rate for Payer: Dignity Health Commercial/Exchange |
$7.83
|
Rate for Payer: Dignity Health Media |
$5.22
|
Rate for Payer: Dignity Health Medi-Cal |
$5.74
|
Rate for Payer: EPIC Health Plan Commercial |
$7.05
|
Rate for Payer: EPIC Health Plan Medicare/Senior |
$5.22
|
Rate for Payer: EPIC Health Plan Transplant |
$5.22
|
Rate for Payer: Galaxy Health WC |
$12.75
|
Rate for Payer: Global Benefits Group Commercial |
$9.00
|
Rate for Payer: Health Plan of Nevada (Sierra) Other |
$11.25
|
Rate for Payer: Heritage Provider Network Commercial |
$8.56
|
Rate for Payer: Heritage Provider Network Transplant |
$8.56
|
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$8.46
|
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$8.46
|
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.22
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.00
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.82
|
Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.22
|
Rate for Payer: LLUH Dept of Risk Management WC |
$3.60
|
Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.58
|
Rate for Payer: Molina Healthcare of CA Medicare |
$6.99
|
Rate for Payer: Multiplan Commercial |
$12.00
|
Rate for Payer: Networks By Design Commercial |
$9.75
|
Rate for Payer: Prime Health Services Commercial |
$12.75
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.00
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.00
|
Rate for Payer: United Healthcare All Other Commercial |
$4.23
|
Rate for Payer: United Healthcare All Other HMO |
$4.23
|
Rate for Payer: United Healthcare HMO Rider |
$4.23
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$4.23
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.83
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$5.74
|
Rate for Payer: Vantage Medical Group Senior |
$5.22
|
|
HC ALLERGEN CABBAGE IGE
|
Facility
|
OP
|
$15.00
|
|
Service Code
|
CPT 86003
|
Hospital Charge Code |
900913512
|
Hospital Revenue Code
|
302
|
Min. Negotiated Rate |
$3.60 |
Max. Negotiated Rate |
$144.22 |
Rate for Payer: Aetna of CA HMO/PPO |
$43.38
|
Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.83
|
Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.74
|
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.22
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$144.22
|
Rate for Payer: Blue Distinction Transplant |
$9.00
|
Rate for Payer: Blue Shield of California Commercial |
$9.69
|
Rate for Payer: Blue Shield of California EPN |
$7.68
|
Rate for Payer: Cash Price |
$6.75
|
Rate for Payer: Cash Price |
$6.75
|
Rate for Payer: Cigna of CA HMO |
$9.60
|
Rate for Payer: Cigna of CA PPO |
$11.10
|
Rate for Payer: Dignity Health Commercial/Exchange |
$7.83
|
Rate for Payer: Dignity Health Media |
$5.22
|
Rate for Payer: Dignity Health Medi-Cal |
$5.74
|
Rate for Payer: EPIC Health Plan Commercial |
$7.05
|
Rate for Payer: EPIC Health Plan Medicare/Senior |
$5.22
|
Rate for Payer: EPIC Health Plan Transplant |
$5.22
|
Rate for Payer: Galaxy Health WC |
$12.75
|
Rate for Payer: Global Benefits Group Commercial |
$9.00
|
Rate for Payer: Health Plan of Nevada (Sierra) Other |
$11.25
|
Rate for Payer: Heritage Provider Network Commercial |
$8.56
|
Rate for Payer: Heritage Provider Network Transplant |
$8.56
|
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$8.46
|
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$8.46
|
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.22
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.00
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.82
|
Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.22
|
Rate for Payer: LLUH Dept of Risk Management WC |
$3.60
|
Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.58
|
Rate for Payer: Molina Healthcare of CA Medicare |
$6.99
|
Rate for Payer: Multiplan Commercial |
$12.00
|
Rate for Payer: Networks By Design Commercial |
$9.75
|
Rate for Payer: Prime Health Services Commercial |
$12.75
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.00
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.00
|
Rate for Payer: United Healthcare All Other Commercial |
$4.23
|
Rate for Payer: United Healthcare All Other HMO |
$4.23
|
Rate for Payer: United Healthcare HMO Rider |
$4.23
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$4.23
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.83
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$5.74
|
Rate for Payer: Vantage Medical Group Senior |
$5.22
|
|
HC ALLERGEN CANDIDA ALBICANS IGE
|
Facility
|
OP
|
$15.00
|
|
Service Code
|
CPT 86003
|
Hospital Charge Code |
900913575
|
Hospital Revenue Code
|
302
|
Min. Negotiated Rate |
$3.60 |
Max. Negotiated Rate |
$144.22 |
Rate for Payer: Aetna of CA HMO/PPO |
$43.38
|
Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.83
|
Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.74
|
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.22
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$144.22
|
Rate for Payer: Blue Distinction Transplant |
$9.00
|
Rate for Payer: Blue Shield of California Commercial |
$9.69
|
Rate for Payer: Blue Shield of California EPN |
$7.68
|
Rate for Payer: Cash Price |
$6.75
|
Rate for Payer: Cash Price |
$6.75
|
Rate for Payer: Cigna of CA HMO |
$9.60
|
Rate for Payer: Cigna of CA PPO |
$11.10
|
Rate for Payer: Dignity Health Commercial/Exchange |
$7.83
|
Rate for Payer: Dignity Health Media |
$5.22
|
Rate for Payer: Dignity Health Medi-Cal |
$5.74
|
Rate for Payer: EPIC Health Plan Commercial |
$7.05
|
Rate for Payer: EPIC Health Plan Medicare/Senior |
$5.22
|
Rate for Payer: EPIC Health Plan Transplant |
$5.22
|
Rate for Payer: Galaxy Health WC |
$12.75
|
Rate for Payer: Global Benefits Group Commercial |
$9.00
|
Rate for Payer: Health Plan of Nevada (Sierra) Other |
$11.25
|
Rate for Payer: Heritage Provider Network Commercial |
$8.56
|
Rate for Payer: Heritage Provider Network Transplant |
$8.56
|
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$8.46
|
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$8.46
|
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.22
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.00
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.82
|
Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.22
|
Rate for Payer: LLUH Dept of Risk Management WC |
$3.60
|
Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.58
|
Rate for Payer: Molina Healthcare of CA Medicare |
$6.99
|
Rate for Payer: Multiplan Commercial |
$12.00
|
Rate for Payer: Networks By Design Commercial |
$9.75
|
Rate for Payer: Prime Health Services Commercial |
$12.75
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.00
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.00
|
Rate for Payer: United Healthcare All Other Commercial |
$4.23
|
Rate for Payer: United Healthcare All Other HMO |
$4.23
|
Rate for Payer: United Healthcare HMO Rider |
$4.23
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$4.23
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.83
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$5.74
|
Rate for Payer: Vantage Medical Group Senior |
$5.22
|
|
HC ALLERGEN CARROT IGE
|
Facility
|
OP
|
$15.00
|
|
Service Code
|
CPT 86003
|
Hospital Charge Code |
900912355
|
Hospital Revenue Code
|
302
|
Min. Negotiated Rate |
$3.60 |
Max. Negotiated Rate |
$144.22 |
Rate for Payer: Aetna of CA HMO/PPO |
$43.38
|
Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.83
|
Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.74
|
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.22
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$144.22
|
Rate for Payer: Blue Distinction Transplant |
$9.00
|
Rate for Payer: Blue Shield of California Commercial |
$9.69
|
Rate for Payer: Blue Shield of California EPN |
$7.68
|
Rate for Payer: Cash Price |
$6.75
|
Rate for Payer: Cash Price |
$6.75
|
Rate for Payer: Cigna of CA HMO |
$9.60
|
Rate for Payer: Cigna of CA PPO |
$11.10
|
Rate for Payer: Dignity Health Commercial/Exchange |
$7.83
|
Rate for Payer: Dignity Health Media |
$5.22
|
Rate for Payer: Dignity Health Medi-Cal |
$5.74
|
Rate for Payer: EPIC Health Plan Commercial |
$7.05
|
Rate for Payer: EPIC Health Plan Medicare/Senior |
$5.22
|
Rate for Payer: EPIC Health Plan Transplant |
$5.22
|
Rate for Payer: Galaxy Health WC |
$12.75
|
Rate for Payer: Global Benefits Group Commercial |
$9.00
|
Rate for Payer: Health Plan of Nevada (Sierra) Other |
$11.25
|
Rate for Payer: Heritage Provider Network Commercial |
$8.56
|
Rate for Payer: Heritage Provider Network Transplant |
$8.56
|
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$8.46
|
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$8.46
|
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.22
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.00
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.82
|
Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.22
|
Rate for Payer: LLUH Dept of Risk Management WC |
$3.60
|
Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.58
|
Rate for Payer: Molina Healthcare of CA Medicare |
$6.99
|
Rate for Payer: Multiplan Commercial |
$12.00
|
Rate for Payer: Networks By Design Commercial |
$9.75
|
Rate for Payer: Prime Health Services Commercial |
$12.75
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.00
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.00
|
Rate for Payer: United Healthcare All Other Commercial |
$4.23
|
Rate for Payer: United Healthcare All Other HMO |
$4.23
|
Rate for Payer: United Healthcare HMO Rider |
$4.23
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$4.23
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.83
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$5.74
|
Rate for Payer: Vantage Medical Group Senior |
$5.22
|
|