HC ALLERGEN CASEIN IGE
|
Facility
|
OP
|
$15.00
|
|
Service Code
|
CPT 86003
|
Hospital Charge Code |
900912356
|
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 CASHEW, IGE
|
Facility
|
OP
|
$15.00
|
|
Service Code
|
CPT 86003
|
Hospital Charge Code |
900912357
|
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 CAT EPITHELIUM IGE
|
Facility
|
OP
|
$15.00
|
|
Service Code
|
CPT 86003
|
Hospital Charge Code |
900913507
|
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 CAULIFLOWER IGE
|
Facility
|
OP
|
$15.00
|
|
Service Code
|
CPT 86003
|
Hospital Charge Code |
900913576
|
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 CEDAR IGE
|
Facility
|
OP
|
$15.00
|
|
Service Code
|
CPT 86003
|
Hospital Charge Code |
900913577
|
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 CELERY IGE
|
Facility
|
OP
|
$15.00
|
|
Service Code
|
CPT 86003
|
Hospital Charge Code |
900913578
|
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 CHEESE CHEDDAR IGE
|
Facility
|
OP
|
$15.00
|
|
Service Code
|
CPT 86003
|
Hospital Charge Code |
900912358
|
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 C HERBARUM IGE
|
Facility
|
OP
|
$15.00
|
|
Service Code
|
CPT 86003
|
Hospital Charge Code |
900912354
|
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 CHICKEN IGE
|
Facility
|
OP
|
$15.00
|
|
Service Code
|
CPT 86003
|
Hospital Charge Code |
900912359
|
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 CINNAMON IGE
|
Facility
|
OP
|
$15.00
|
|
Service Code
|
CPT 86003
|
Hospital Charge Code |
900912360
|
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 CLADOSPORIUM IGE
|
Facility
|
OP
|
$15.00
|
|
Service Code
|
CPT 86003
|
Hospital Charge Code |
900913579
|
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 CLAM IGE
|
Facility
|
OP
|
$15.00
|
|
Service Code
|
CPT 86003
|
Hospital Charge Code |
900912361
|
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 COCKROACH IGE
|
Facility
|
OP
|
$15.00
|
|
Service Code
|
CPT 86003
|
Hospital Charge Code |
900912362
|
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 COCONUT IGE
|
Facility
|
OP
|
$15.00
|
|
Service Code
|
CPT 86003
|
Hospital Charge Code |
900912363
|
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 CODFISH IGE
|
Facility
|
OP
|
$15.00
|
|
Service Code
|
CPT 86003
|
Hospital Charge Code |
900912364
|
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 CORN IGE
|
Facility
|
OP
|
$15.00
|
|
Service Code
|
CPT 86003
|
Hospital Charge Code |
900912365
|
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 COTTON SEED IGE
|
Facility
|
OP
|
$15.00
|
|
Service Code
|
CPT 86003
|
Hospital Charge Code |
900913580
|
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 COTTONWOOD IGE
|
Facility
|
OP
|
$15.00
|
|
Service Code
|
CPT 86003
|
Hospital Charge Code |
900913565
|
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 COW IGE
|
Facility
|
OP
|
$15.00
|
|
Service Code
|
CPT 86003
|
Hospital Charge Code |
900912340
|
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 CRAB, IGE
|
Facility
|
OP
|
$15.00
|
|
Service Code
|
CPT 86003
|
Hospital Charge Code |
900912366
|
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 CULT OAT IGE
|
Facility
|
OP
|
$15.00
|
|
Service Code
|
CPT 86003
|
Hospital Charge Code |
900913550
|
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 DANDELION IGE
|
Facility
|
OP
|
$15.00
|
|
Service Code
|
CPT 86003
|
Hospital Charge Code |
900913582
|
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 DATE TREE IGE
|
Facility
|
OP
|
$15.00
|
|
Service Code
|
CPT 86003
|
Hospital Charge Code |
900913583
|
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 DOG EPITHELIUM IGE
|
Facility
|
OP
|
$15.00
|
|
Service Code
|
CPT 86003
|
Hospital Charge Code |
900912338
|
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 EGG WHITE IGE
|
Facility
|
OP
|
$15.00
|
|
Service Code
|
CPT 86003
|
Hospital Charge Code |
900912367
|
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
|
|