|
HC ANTIGEN TYPING PATIENT
|
Facility
|
IP
|
$331.00
|
|
|
Service Code
|
CPT 86905
|
| Hospital Charge Code |
900904701
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$66.20 |
| Max. Negotiated Rate |
$281.35 |
| Rate for Payer: Adventist Health Commercial |
$66.20
|
| Rate for Payer: Cash Price |
$148.95
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$231.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$132.40
|
| Rate for Payer: EPIC Health Plan Senior |
$132.40
|
| Rate for Payer: Galaxy Health WC |
$281.35
|
| Rate for Payer: Global Benefits Group Commercial |
$198.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$210.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$195.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$79.44
|
| Rate for Payer: Multiplan Commercial |
$264.80
|
| Rate for Payer: Networks By Design Commercial |
$215.15
|
| Rate for Payer: Prime Health Services Commercial |
$281.35
|
|
|
HC ANTIGEN TYPING PATIENT
|
Facility
|
OP
|
$331.00
|
|
|
Service Code
|
CPT 86905
|
| Hospital Charge Code |
900904701
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$3.10 |
| Max. Negotiated Rate |
$281.35 |
| Rate for Payer: Adventist Health Commercial |
$66.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$31.77
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4.21
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3.83
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$39.47
|
| Rate for Payer: Blue Shield of California Commercial |
$152.59
|
| Rate for Payer: Blue Shield of California Commercial |
$230.71
|
| Rate for Payer: Cash Price |
$148.95
|
| Rate for Payer: Cash Price |
$148.95
|
| Rate for Payer: Cigna of CA HMO |
$211.84
|
| Rate for Payer: Cigna of CA PPO |
$244.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$4.21
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3.83
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$231.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.32
|
| Rate for Payer: EPIC Health Plan Senior |
$4.21
|
| Rate for Payer: Galaxy Health WC |
$281.35
|
| Rate for Payer: Global Benefits Group Commercial |
$198.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6.28
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$5.63
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3.83
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$210.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$6.37
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$79.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4.83
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5.13
|
| Rate for Payer: Multiplan Commercial |
$264.80
|
| Rate for Payer: Networks By Design Commercial |
$215.15
|
| Rate for Payer: Prime Health Services Commercial |
$281.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$198.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$198.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.10
|
| Rate for Payer: United Healthcare All Other HMO |
$3.10
|
| Rate for Payer: United Healthcare HMO Rider |
$3.10
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.10
|
| Rate for Payer: Upland Medical Group Pediatric |
$3.83
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4.21
|
| Rate for Payer: Vantage Medical Group Senior |
$3.83
|
|
|
HC ANTIGEN TYPING UNIT
|
Facility
|
OP
|
$331.00
|
|
|
Service Code
|
CPT 86902
|
| Hospital Charge Code |
900904410
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.15 |
| Max. Negotiated Rate |
$281.35 |
| Rate for Payer: Vantage Medical Group Senior |
$6.35
|
| Rate for Payer: Adventist Health Commercial |
$66.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$31.77
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$9.53
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6.99
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6.35
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$31.27
|
| Rate for Payer: Blue Shield of California Commercial |
$152.59
|
| Rate for Payer: Blue Shield of California Commercial |
$230.71
|
| Rate for Payer: Cash Price |
$148.95
|
| Rate for Payer: Cash Price |
$148.95
|
| Rate for Payer: Cigna of CA HMO |
$211.84
|
| Rate for Payer: Cigna of CA PPO |
$244.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9.53
|
| Rate for Payer: Dignity Health Medi-Cal |
$6.99
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6.35
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$231.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.48
|
| Rate for Payer: EPIC Health Plan Senior |
$6.99
|
| Rate for Payer: Galaxy Health WC |
$281.35
|
| Rate for Payer: Global Benefits Group Commercial |
$198.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$10.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$5.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6.35
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$210.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$6.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$79.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8.51
|
| Rate for Payer: Multiplan Commercial |
$264.80
|
| Rate for Payer: Networks By Design Commercial |
$215.15
|
| Rate for Payer: Prime Health Services Commercial |
$281.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$198.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$198.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.15
|
| Rate for Payer: United Healthcare All Other HMO |
$5.15
|
| Rate for Payer: United Healthcare HMO Rider |
$5.15
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.15
|
| Rate for Payer: Upland Medical Group Pediatric |
$6.35
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$9.53
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6.99
|
|
|
HC ANTIGEN TYPING UNIT
|
Facility
|
IP
|
$331.00
|
|
|
Service Code
|
CPT 86902
|
| Hospital Charge Code |
900904410
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$66.20 |
| Max. Negotiated Rate |
$281.35 |
| Rate for Payer: Adventist Health Commercial |
$66.20
|
| Rate for Payer: Cash Price |
$148.95
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$231.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$132.40
|
| Rate for Payer: EPIC Health Plan Senior |
$132.40
|
| Rate for Payer: Galaxy Health WC |
$281.35
|
| Rate for Payer: Global Benefits Group Commercial |
$198.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$210.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$195.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$79.44
|
| Rate for Payer: Multiplan Commercial |
$264.80
|
| Rate for Payer: Networks By Design Commercial |
$215.15
|
| Rate for Payer: Prime Health Services Commercial |
$281.35
|
|
|
HC ANTIMICROB SUSCEPTIBILITY TEST
|
Facility
|
OP
|
$18.00
|
|
|
Service Code
|
CPT 87181
|
| Hospital Charge Code |
900911660
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$1.95 |
| Max. Negotiated Rate |
$23.28 |
| Rate for Payer: Adventist Health Commercial |
$3.60
|
| Rate for Payer: Adventist Health Commercial |
$42.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$13.56
|
| Rate for Payer: Aetna of CA HMO/PPO |
$13.56
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.12
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.12
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.22
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$23.28
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$23.28
|
| Rate for Payer: Blue Shield of California Commercial |
$146.37
|
| Rate for Payer: Blue Shield of California Commercial |
$12.55
|
| Rate for Payer: Blue Shield of California Commercial |
$96.81
|
| Rate for Payer: Blue Shield of California Commercial |
$8.30
|
| Rate for Payer: Cash Price |
$94.50
|
| Rate for Payer: Cash Price |
$94.50
|
| Rate for Payer: Cash Price |
$8.10
|
| Rate for Payer: Cash Price |
$8.10
|
| Rate for Payer: Cigna of CA HMO |
$134.40
|
| Rate for Payer: Cigna of CA HMO |
$11.52
|
| Rate for Payer: Cigna of CA PPO |
$13.32
|
| Rate for Payer: Cigna of CA PPO |
$155.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.22
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4.75
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$12.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$147.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.84
|
| Rate for Payer: EPIC Health Plan Senior |
$5.22
|
| Rate for Payer: EPIC Health Plan Senior |
$5.22
|
| Rate for Payer: Galaxy Health WC |
$15.30
|
| Rate for Payer: Galaxy Health WC |
$178.50
|
| Rate for Payer: Global Benefits Group Commercial |
$10.80
|
| Rate for Payer: Global Benefits Group Commercial |
$126.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7.79
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7.79
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4.75
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$11.43
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$133.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$50.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5.99
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5.99
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.37
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.37
|
| Rate for Payer: Multiplan Commercial |
$168.00
|
| Rate for Payer: Multiplan Commercial |
$14.40
|
| Rate for Payer: Networks By Design Commercial |
$136.50
|
| Rate for Payer: Networks By Design Commercial |
$11.70
|
| Rate for Payer: Prime Health Services Commercial |
$15.30
|
| Rate for Payer: Prime Health Services Commercial |
$178.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$126.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$10.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$126.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.85
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.85
|
| Rate for Payer: United Healthcare All Other HMO |
$3.85
|
| Rate for Payer: United Healthcare All Other HMO |
$3.85
|
| Rate for Payer: United Healthcare HMO Rider |
$3.85
|
| Rate for Payer: United Healthcare HMO Rider |
$3.85
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.85
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.85
|
| Rate for Payer: Upland Medical Group Pediatric |
$4.75
|
| Rate for Payer: Upland Medical Group Pediatric |
$4.75
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.22
|
| Rate for Payer: Vantage Medical Group Senior |
$4.75
|
| Rate for Payer: Vantage Medical Group Senior |
$4.75
|
|
|
HC ANTIMICROB SUSCEPTIBILITY TEST
|
Facility
|
IP
|
$210.00
|
|
|
Service Code
|
CPT 87181
|
| Hospital Charge Code |
900911660
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$42.00 |
| Max. Negotiated Rate |
$178.50 |
| Rate for Payer: Adventist Health Commercial |
$42.00
|
| Rate for Payer: Cash Price |
$94.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$147.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$84.00
|
| Rate for Payer: EPIC Health Plan Senior |
$84.00
|
| Rate for Payer: Galaxy Health WC |
$178.50
|
| Rate for Payer: Global Benefits Group Commercial |
$126.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$133.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$123.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$50.40
|
| Rate for Payer: Multiplan Commercial |
$168.00
|
| Rate for Payer: Networks By Design Commercial |
$136.50
|
| Rate for Payer: Prime Health Services Commercial |
$178.50
|
|
|
HC ANTINUCLEAR ANTIBODIES (ANA)
|
Facility
|
OP
|
$223.00
|
|
|
Service Code
|
CPT 86038
|
| Hospital Charge Code |
900910969
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.79 |
| Max. Negotiated Rate |
$189.55 |
| Rate for Payer: Cash Price |
$23.85
|
| Rate for Payer: Cash Price |
$100.35
|
| Rate for Payer: Cash Price |
$100.35
|
| Rate for Payer: Cigna of CA HMO |
$33.92
|
| Rate for Payer: Cigna of CA HMO |
$142.72
|
| Rate for Payer: Cigna of CA PPO |
$165.02
|
| Rate for Payer: Cigna of CA PPO |
$39.22
|
| Rate for Payer: Cash Price |
$23.85
|
| Rate for Payer: Adventist Health Commercial |
$44.60
|
| Rate for Payer: Adventist Health Commercial |
$10.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$100.53
|
| Rate for Payer: Aetna of CA HMO/PPO |
$100.53
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$18.14
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$18.14
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13.30
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12.09
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$124.73
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$124.73
|
| Rate for Payer: Blue Shield of California Commercial |
$24.43
|
| Rate for Payer: Blue Shield of California Commercial |
$102.80
|
| Rate for Payer: Blue Shield of California Commercial |
$36.94
|
| Rate for Payer: Blue Shield of California Commercial |
$155.43
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$18.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$18.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.30
|
| Rate for Payer: Dignity Health Medicare Advantage |
$12.09
|
| Rate for Payer: Dignity Health Medicare Advantage |
$12.09
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$156.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$37.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.95
|
| Rate for Payer: EPIC Health Plan Senior |
$13.30
|
| Rate for Payer: EPIC Health Plan Senior |
$13.30
|
| Rate for Payer: Galaxy Health WC |
$189.55
|
| Rate for Payer: Galaxy Health WC |
$45.05
|
| Rate for Payer: Global Benefits Group Commercial |
$133.80
|
| Rate for Payer: Global Benefits Group Commercial |
$31.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$19.83
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$19.83
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$17.86
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$17.86
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$12.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$12.09
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$141.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$33.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$20.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$20.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$16.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$16.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$53.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.72
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$15.23
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$15.23
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16.20
|
| Rate for Payer: Multiplan Commercial |
$42.40
|
| Rate for Payer: Multiplan Commercial |
$178.40
|
| Rate for Payer: Networks By Design Commercial |
$34.45
|
| Rate for Payer: Networks By Design Commercial |
$144.95
|
| Rate for Payer: Prime Health Services Commercial |
$189.55
|
| Rate for Payer: Prime Health Services Commercial |
$45.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$133.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$31.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$133.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$31.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.79
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.79
|
| Rate for Payer: United Healthcare All Other HMO |
$9.79
|
| Rate for Payer: United Healthcare All Other HMO |
$9.79
|
| Rate for Payer: United Healthcare HMO Rider |
$9.79
|
| Rate for Payer: United Healthcare HMO Rider |
$9.79
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.79
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.79
|
| Rate for Payer: Upland Medical Group Pediatric |
$12.09
|
| Rate for Payer: Upland Medical Group Pediatric |
$12.09
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$18.14
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$18.14
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.30
|
| Rate for Payer: Vantage Medical Group Senior |
$12.09
|
| Rate for Payer: Vantage Medical Group Senior |
$12.09
|
|
|
HC ANTINUCLEAR ANTIBODIES (ANA)
|
Facility
|
IP
|
$223.00
|
|
|
Service Code
|
CPT 86038
|
| Hospital Charge Code |
900910969
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$44.60 |
| Max. Negotiated Rate |
$189.55 |
| Rate for Payer: Adventist Health Commercial |
$44.60
|
| Rate for Payer: Cash Price |
$100.35
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$156.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$89.20
|
| Rate for Payer: EPIC Health Plan Senior |
$89.20
|
| Rate for Payer: Galaxy Health WC |
$189.55
|
| Rate for Payer: Global Benefits Group Commercial |
$133.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$141.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$131.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$53.52
|
| Rate for Payer: Multiplan Commercial |
$178.40
|
| Rate for Payer: Networks By Design Commercial |
$144.95
|
| Rate for Payer: Prime Health Services Commercial |
$189.55
|
|
|
HC ANTI-REFLUX FILTER W/NG TUBES
|
Facility
|
OP
|
$34.69
|
|
| Hospital Charge Code |
901698758
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.94 |
| Max. Negotiated Rate |
$29.49 |
| Rate for Payer: Adventist Health Commercial |
$6.94
|
| Rate for Payer: Aetna of CA HMO/PPO |
$22.75
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$29.49
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$26.02
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$22.26
|
| Rate for Payer: Cash Price |
$15.61
|
| Rate for Payer: Cigna of CA HMO |
$22.20
|
| Rate for Payer: Cigna of CA PPO |
$25.67
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$29.49
|
| Rate for Payer: Dignity Health Medi-Cal |
$29.49
|
| Rate for Payer: Dignity Health Medicare Advantage |
$29.49
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$24.28
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.88
|
| Rate for Payer: EPIC Health Plan Senior |
$13.88
|
| Rate for Payer: Galaxy Health WC |
$29.49
|
| Rate for Payer: Global Benefits Group Commercial |
$20.81
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$22.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$12.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$20.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.33
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$24.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$24.28
|
| Rate for Payer: Multiplan Commercial |
$27.75
|
| Rate for Payer: Networks By Design Commercial |
$22.55
|
| Rate for Payer: Prime Health Services Commercial |
$29.49
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$20.81
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$20.81
|
| Rate for Payer: United Healthcare All Other Commercial |
$17.34
|
| Rate for Payer: United Healthcare All Other HMO |
$17.34
|
| Rate for Payer: United Healthcare HMO Rider |
$17.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$17.34
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$29.49
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$29.49
|
| Rate for Payer: Vantage Medical Group Senior |
$29.49
|
|
|
HC ANTI-REFLUX FILTER W/NG TUBES
|
Facility
|
IP
|
$34.69
|
|
| Hospital Charge Code |
901698758
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.94 |
| Max. Negotiated Rate |
$29.49 |
| Rate for Payer: EPIC Health Plan Senior |
$13.88
|
| Rate for Payer: Galaxy Health WC |
$29.49
|
| Rate for Payer: Adventist Health Commercial |
$6.94
|
| Rate for Payer: Cash Price |
$15.61
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$24.28
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.88
|
| Rate for Payer: Global Benefits Group Commercial |
$20.81
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$22.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$20.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.33
|
| Rate for Payer: Multiplan Commercial |
$27.75
|
| Rate for Payer: Networks By Design Commercial |
$22.55
|
| Rate for Payer: Prime Health Services Commercial |
$29.49
|
|
|
HC ANTI REFLUX VALVE SALEM SUMP
|
Facility
|
IP
|
$12.22
|
|
| Hospital Charge Code |
901698823
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.44 |
| Max. Negotiated Rate |
$10.39 |
| Rate for Payer: Galaxy Health WC |
$10.39
|
| Rate for Payer: EPIC Health Plan Senior |
$4.89
|
| Rate for Payer: Adventist Health Commercial |
$2.44
|
| Rate for Payer: Cash Price |
$5.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.89
|
| Rate for Payer: Global Benefits Group Commercial |
$7.33
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7.76
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.93
|
| Rate for Payer: Multiplan Commercial |
$9.78
|
| Rate for Payer: Networks By Design Commercial |
$7.94
|
| Rate for Payer: Prime Health Services Commercial |
$10.39
|
|
|
HC ANTI REFLUX VALVE SALEM SUMP
|
Facility
|
OP
|
$12.22
|
|
| Hospital Charge Code |
901698823
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.44 |
| Max. Negotiated Rate |
$10.39 |
| Rate for Payer: Adventist Health Commercial |
$2.44
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8.02
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10.39
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6.72
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9.16
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7.84
|
| Rate for Payer: Cash Price |
$5.50
|
| Rate for Payer: Cigna of CA HMO |
$7.82
|
| Rate for Payer: Cigna of CA PPO |
$9.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.39
|
| Rate for Payer: Dignity Health Medi-Cal |
$10.39
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10.39
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.89
|
| Rate for Payer: EPIC Health Plan Senior |
$4.89
|
| Rate for Payer: Galaxy Health WC |
$10.39
|
| Rate for Payer: Global Benefits Group Commercial |
$7.33
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7.76
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$4.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.93
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8.55
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8.55
|
| Rate for Payer: Multiplan Commercial |
$9.78
|
| Rate for Payer: Networks By Design Commercial |
$7.94
|
| Rate for Payer: Prime Health Services Commercial |
$10.39
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7.33
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7.33
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.11
|
| Rate for Payer: United Healthcare All Other HMO |
$6.11
|
| Rate for Payer: United Healthcare HMO Rider |
$6.11
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.11
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10.39
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.39
|
| Rate for Payer: Vantage Medical Group Senior |
$10.39
|
|
|
HC ANTISTREPTOLYSIN O
|
Facility
|
IP
|
$186.00
|
|
|
Service Code
|
CPT 83883
|
| Hospital Charge Code |
900910881
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$37.20 |
| Max. Negotiated Rate |
$158.10 |
| Rate for Payer: Adventist Health Commercial |
$37.20
|
| Rate for Payer: Cash Price |
$83.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$130.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$74.40
|
| Rate for Payer: EPIC Health Plan Senior |
$74.40
|
| Rate for Payer: Galaxy Health WC |
$158.10
|
| Rate for Payer: Global Benefits Group Commercial |
$111.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$118.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$109.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$44.64
|
| Rate for Payer: Multiplan Commercial |
$148.80
|
| Rate for Payer: Networks By Design Commercial |
$120.90
|
| Rate for Payer: Prime Health Services Commercial |
$158.10
|
|
|
HC ANTISTREPTOLYSIN O
|
Facility
|
OP
|
$186.00
|
|
|
Service Code
|
CPT 83883
|
| Hospital Charge Code |
900910881
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.02 |
| Max. Negotiated Rate |
$158.10 |
| Rate for Payer: Adventist Health Commercial |
$37.20
|
| Rate for Payer: Adventist Health Commercial |
$15.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$113.04
|
| Rate for Payer: Aetna of CA HMO/PPO |
$113.04
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20.40
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.96
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.96
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$140.51
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$140.51
|
| Rate for Payer: Blue Shield of California Commercial |
$34.58
|
| Rate for Payer: Blue Shield of California Commercial |
$129.64
|
| Rate for Payer: Blue Shield of California Commercial |
$52.27
|
| Rate for Payer: Blue Shield of California Commercial |
$85.75
|
| Rate for Payer: Cash Price |
$33.75
|
| Rate for Payer: Cash Price |
$33.75
|
| Rate for Payer: Cash Price |
$83.70
|
| Rate for Payer: Cash Price |
$83.70
|
| Rate for Payer: Cigna of CA HMO |
$48.00
|
| Rate for Payer: Cigna of CA HMO |
$119.04
|
| Rate for Payer: Cigna of CA PPO |
$137.64
|
| Rate for Payer: Cigna of CA PPO |
$55.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.96
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.96
|
| Rate for Payer: Dignity Health Medicare Advantage |
$13.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$13.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$130.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$52.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$22.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$22.44
|
| Rate for Payer: EPIC Health Plan Senior |
$14.96
|
| Rate for Payer: EPIC Health Plan Senior |
$14.96
|
| Rate for Payer: Galaxy Health WC |
$158.10
|
| Rate for Payer: Galaxy Health WC |
$63.75
|
| Rate for Payer: Global Benefits Group Commercial |
$111.60
|
| Rate for Payer: Global Benefits Group Commercial |
$45.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$22.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$22.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$20.31
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$20.31
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$118.11
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$47.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$22.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$22.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$19.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$19.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$44.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17.14
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17.14
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18.22
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18.22
|
| Rate for Payer: Multiplan Commercial |
$60.00
|
| Rate for Payer: Multiplan Commercial |
$148.80
|
| Rate for Payer: Networks By Design Commercial |
$48.75
|
| Rate for Payer: Networks By Design Commercial |
$120.90
|
| Rate for Payer: Prime Health Services Commercial |
$158.10
|
| Rate for Payer: Prime Health Services Commercial |
$63.75
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$111.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$45.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$111.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$45.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$11.02
|
| Rate for Payer: United Healthcare All Other Commercial |
$11.02
|
| Rate for Payer: United Healthcare All Other HMO |
$11.02
|
| Rate for Payer: United Healthcare All Other HMO |
$11.02
|
| Rate for Payer: United Healthcare HMO Rider |
$11.02
|
| Rate for Payer: United Healthcare HMO Rider |
$11.02
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.02
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.02
|
| Rate for Payer: Upland Medical Group Pediatric |
$13.60
|
| Rate for Payer: Upland Medical Group Pediatric |
$13.60
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20.40
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.96
|
| Rate for Payer: Vantage Medical Group Senior |
$13.60
|
| Rate for Payer: Vantage Medical Group Senior |
$13.60
|
|
|
HC ANTITHROMBIN III ACTIVITY
|
Facility
|
IP
|
$242.00
|
|
|
Service Code
|
CPT 85300
|
| Hospital Charge Code |
900912010
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$48.40 |
| Max. Negotiated Rate |
$205.70 |
| Rate for Payer: Adventist Health Commercial |
$48.40
|
| Rate for Payer: Cash Price |
$108.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$169.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$96.80
|
| Rate for Payer: EPIC Health Plan Senior |
$96.80
|
| Rate for Payer: Galaxy Health WC |
$205.70
|
| Rate for Payer: Global Benefits Group Commercial |
$145.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$153.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$142.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$58.08
|
| Rate for Payer: Multiplan Commercial |
$193.60
|
| Rate for Payer: Networks By Design Commercial |
$157.30
|
| Rate for Payer: Prime Health Services Commercial |
$205.70
|
|
|
HC ANTITHROMBIN III ACTIVITY
|
Facility
|
OP
|
$110.00
|
|
|
Service Code
|
CPT 85300
|
| Hospital Charge Code |
900912010
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$9.60 |
| Max. Negotiated Rate |
$122.30 |
| Rate for Payer: Adventist Health Commercial |
$22.00
|
| Rate for Payer: Adventist Health Commercial |
$48.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$98.58
|
| Rate for Payer: Aetna of CA HMO/PPO |
$98.58
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$17.77
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$17.77
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13.04
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11.85
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$122.30
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$122.30
|
| Rate for Payer: Blue Shield of California Commercial |
$111.56
|
| Rate for Payer: Blue Shield of California Commercial |
$50.71
|
| Rate for Payer: Blue Shield of California Commercial |
$168.67
|
| Rate for Payer: Blue Shield of California Commercial |
$76.67
|
| Rate for Payer: Cash Price |
$108.90
|
| Rate for Payer: Cash Price |
$108.90
|
| Rate for Payer: Cash Price |
$49.50
|
| Rate for Payer: Cash Price |
$49.50
|
| Rate for Payer: Cigna of CA HMO |
$154.88
|
| Rate for Payer: Cigna of CA HMO |
$70.40
|
| Rate for Payer: Cigna of CA PPO |
$81.40
|
| Rate for Payer: Cigna of CA PPO |
$179.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$17.77
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$17.77
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.04
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.04
|
| Rate for Payer: Dignity Health Medicare Advantage |
$11.85
|
| Rate for Payer: Dignity Health Medicare Advantage |
$11.85
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$77.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$169.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.55
|
| Rate for Payer: EPIC Health Plan Senior |
$13.04
|
| Rate for Payer: EPIC Health Plan Senior |
$13.04
|
| Rate for Payer: Galaxy Health WC |
$93.50
|
| Rate for Payer: Galaxy Health WC |
$205.70
|
| Rate for Payer: Global Benefits Group Commercial |
$66.00
|
| Rate for Payer: Global Benefits Group Commercial |
$145.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$19.43
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$19.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$17.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$17.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$11.85
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$11.85
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$69.85
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$153.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$19.89
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$19.89
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$16.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$16.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$26.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$58.08
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$14.93
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$14.93
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$15.88
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$15.88
|
| Rate for Payer: Multiplan Commercial |
$193.60
|
| Rate for Payer: Multiplan Commercial |
$88.00
|
| Rate for Payer: Networks By Design Commercial |
$157.30
|
| Rate for Payer: Networks By Design Commercial |
$71.50
|
| Rate for Payer: Prime Health Services Commercial |
$93.50
|
| Rate for Payer: Prime Health Services Commercial |
$205.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$66.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$145.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$66.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$145.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.60
|
| Rate for Payer: United Healthcare All Other HMO |
$9.60
|
| Rate for Payer: United Healthcare All Other HMO |
$9.60
|
| Rate for Payer: United Healthcare HMO Rider |
$9.60
|
| Rate for Payer: United Healthcare HMO Rider |
$9.60
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.60
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.60
|
| Rate for Payer: Upland Medical Group Pediatric |
$11.85
|
| Rate for Payer: Upland Medical Group Pediatric |
$11.85
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$17.77
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$17.77
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.04
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.04
|
| Rate for Payer: Vantage Medical Group Senior |
$11.85
|
| Rate for Payer: Vantage Medical Group Senior |
$11.85
|
|
|
HC ANTITHROMBIN III ANTIGEN
|
Facility
|
OP
|
$102.00
|
|
|
Service Code
|
CPT 85301
|
| Hospital Charge Code |
900912011
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$8.76 |
| Max. Negotiated Rate |
$111.60 |
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11.89
|
| Rate for Payer: Vantage Medical Group Senior |
$10.81
|
| Rate for Payer: Vantage Medical Group Senior |
$10.81
|
| Rate for Payer: Adventist Health Commercial |
$20.40
|
| Rate for Payer: Adventist Health Commercial |
$32.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$89.89
|
| Rate for Payer: Aetna of CA HMO/PPO |
$89.89
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$16.21
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$16.21
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11.89
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10.81
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$111.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$111.60
|
| Rate for Payer: Blue Shield of California Commercial |
$113.61
|
| Rate for Payer: Blue Shield of California Commercial |
$47.02
|
| Rate for Payer: Blue Shield of California Commercial |
$75.14
|
| Rate for Payer: Blue Shield of California Commercial |
$71.09
|
| Rate for Payer: Cash Price |
$73.35
|
| Rate for Payer: Cash Price |
$73.35
|
| Rate for Payer: Cash Price |
$45.90
|
| Rate for Payer: Cash Price |
$45.90
|
| Rate for Payer: Cigna of CA HMO |
$104.32
|
| Rate for Payer: Cigna of CA HMO |
$65.28
|
| Rate for Payer: Cigna of CA PPO |
$75.48
|
| Rate for Payer: Cigna of CA PPO |
$120.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$16.21
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$16.21
|
| Rate for Payer: Dignity Health Medi-Cal |
$11.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$11.89
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10.81
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10.81
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$71.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$114.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$17.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$17.84
|
| Rate for Payer: EPIC Health Plan Senior |
$11.89
|
| Rate for Payer: EPIC Health Plan Senior |
$11.89
|
| Rate for Payer: Galaxy Health WC |
$86.70
|
| Rate for Payer: Galaxy Health WC |
$138.55
|
| Rate for Payer: Global Benefits Group Commercial |
$61.20
|
| Rate for Payer: Global Benefits Group Commercial |
$97.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$17.73
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$17.73
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$16.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$16.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10.81
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$64.77
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$103.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$18.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$18.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$15.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$15.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$39.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$13.62
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$13.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14.49
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14.49
|
| Rate for Payer: Multiplan Commercial |
$130.40
|
| Rate for Payer: Multiplan Commercial |
$81.60
|
| Rate for Payer: Networks By Design Commercial |
$105.95
|
| Rate for Payer: Networks By Design Commercial |
$66.30
|
| Rate for Payer: Prime Health Services Commercial |
$86.70
|
| Rate for Payer: Prime Health Services Commercial |
$138.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$61.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$97.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$61.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$97.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$8.76
|
| Rate for Payer: United Healthcare All Other Commercial |
$8.76
|
| Rate for Payer: United Healthcare All Other HMO |
$8.76
|
| Rate for Payer: United Healthcare All Other HMO |
$8.76
|
| Rate for Payer: United Healthcare HMO Rider |
$8.76
|
| Rate for Payer: United Healthcare HMO Rider |
$8.76
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8.76
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8.76
|
| Rate for Payer: Upland Medical Group Pediatric |
$10.81
|
| Rate for Payer: Upland Medical Group Pediatric |
$10.81
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$16.21
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$16.21
|
|
|
HC ANTITHROMBIN III ANTIGEN
|
Facility
|
IP
|
$163.00
|
|
|
Service Code
|
CPT 85301
|
| Hospital Charge Code |
900912011
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$32.60 |
| Max. Negotiated Rate |
$138.55 |
| Rate for Payer: Adventist Health Commercial |
$32.60
|
| Rate for Payer: Cash Price |
$73.35
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$114.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$65.20
|
| Rate for Payer: EPIC Health Plan Senior |
$65.20
|
| Rate for Payer: Galaxy Health WC |
$138.55
|
| Rate for Payer: Global Benefits Group Commercial |
$97.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$103.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$96.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$39.12
|
| Rate for Payer: Multiplan Commercial |
$130.40
|
| Rate for Payer: Networks By Design Commercial |
$105.95
|
| Rate for Payer: Prime Health Services Commercial |
$138.55
|
|
|
HC ANTI-XA APIXABAN
|
Facility
|
OP
|
$58.00
|
|
|
Service Code
|
CPT 85520
|
| Hospital Charge Code |
900912042
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$10.60 |
| Max. Negotiated Rate |
$114.80 |
| Rate for Payer: Adventist Health Commercial |
$11.60
|
| Rate for Payer: Adventist Health Commercial |
$12.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$108.94
|
| Rate for Payer: Aetna of CA HMO/PPO |
$108.94
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19.64
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19.64
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13.09
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$114.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$114.80
|
| Rate for Payer: Blue Shield of California Commercial |
$29.50
|
| Rate for Payer: Blue Shield of California Commercial |
$26.74
|
| Rate for Payer: Blue Shield of California Commercial |
$44.61
|
| Rate for Payer: Blue Shield of California Commercial |
$40.43
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Cash Price |
$26.10
|
| Rate for Payer: Cash Price |
$26.10
|
| Rate for Payer: Cigna of CA HMO |
$40.96
|
| Rate for Payer: Cigna of CA HMO |
$37.12
|
| Rate for Payer: Cigna of CA PPO |
$42.92
|
| Rate for Payer: Cigna of CA PPO |
$47.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.64
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$13.09
|
| Rate for Payer: Dignity Health Medicare Advantage |
$13.09
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$40.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$44.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$21.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$21.60
|
| Rate for Payer: EPIC Health Plan Senior |
$14.40
|
| Rate for Payer: EPIC Health Plan Senior |
$14.40
|
| Rate for Payer: Galaxy Health WC |
$49.30
|
| Rate for Payer: Galaxy Health WC |
$54.40
|
| Rate for Payer: Global Benefits Group Commercial |
$34.80
|
| Rate for Payer: Global Benefits Group Commercial |
$38.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$21.47
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$21.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$19.27
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$19.27
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13.09
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$36.83
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$40.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$21.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$21.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$18.33
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$18.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16.49
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16.49
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17.54
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17.54
|
| Rate for Payer: Multiplan Commercial |
$51.20
|
| Rate for Payer: Multiplan Commercial |
$46.40
|
| Rate for Payer: Networks By Design Commercial |
$41.60
|
| Rate for Payer: Networks By Design Commercial |
$37.70
|
| Rate for Payer: Prime Health Services Commercial |
$49.30
|
| Rate for Payer: Prime Health Services Commercial |
$54.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$34.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$38.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$34.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$38.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.60
|
| Rate for Payer: United Healthcare All Other HMO |
$10.60
|
| Rate for Payer: United Healthcare All Other HMO |
$10.60
|
| Rate for Payer: United Healthcare HMO Rider |
$10.60
|
| Rate for Payer: United Healthcare HMO Rider |
$10.60
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.60
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.60
|
| Rate for Payer: Upland Medical Group Pediatric |
$13.09
|
| Rate for Payer: Upland Medical Group Pediatric |
$13.09
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.64
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.40
|
| Rate for Payer: Vantage Medical Group Senior |
$13.09
|
| Rate for Payer: Vantage Medical Group Senior |
$13.09
|
|
|
HC ANTI-XA APIXABAN
|
Facility
|
IP
|
$64.00
|
|
|
Service Code
|
CPT 85520
|
| Hospital Charge Code |
900912042
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$12.80 |
| Max. Negotiated Rate |
$54.40 |
| Rate for Payer: Adventist Health Commercial |
$12.80
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$44.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$25.60
|
| Rate for Payer: EPIC Health Plan Senior |
$25.60
|
| Rate for Payer: Galaxy Health WC |
$54.40
|
| Rate for Payer: Global Benefits Group Commercial |
$38.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$40.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$37.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.36
|
| Rate for Payer: Multiplan Commercial |
$51.20
|
| Rate for Payer: Networks By Design Commercial |
$41.60
|
| Rate for Payer: Prime Health Services Commercial |
$54.40
|
|
|
HC ANTI-XA UNFRACTIONATED HEPARIN
|
Facility
|
OP
|
$119.00
|
|
|
Service Code
|
CPT 85520
|
| Hospital Charge Code |
900912030
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$10.60 |
| Max. Negotiated Rate |
$114.80 |
| Rate for Payer: EPIC Health Plan Senior |
$14.40
|
| Rate for Payer: EPIC Health Plan Senior |
$14.40
|
| Rate for Payer: Galaxy Health WC |
$101.15
|
| Rate for Payer: Galaxy Health WC |
$104.55
|
| Rate for Payer: Adventist Health Commercial |
$23.80
|
| Rate for Payer: Adventist Health Commercial |
$24.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$108.94
|
| Rate for Payer: Aetna of CA HMO/PPO |
$108.94
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19.64
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19.64
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13.09
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$114.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$114.80
|
| Rate for Payer: Blue Shield of California Commercial |
$56.70
|
| Rate for Payer: Blue Shield of California Commercial |
$54.86
|
| Rate for Payer: Blue Shield of California Commercial |
$85.73
|
| Rate for Payer: Blue Shield of California Commercial |
$82.94
|
| Rate for Payer: Cash Price |
$55.35
|
| Rate for Payer: Cash Price |
$55.35
|
| Rate for Payer: Cash Price |
$53.55
|
| Rate for Payer: Cash Price |
$53.55
|
| Rate for Payer: Cigna of CA HMO |
$78.72
|
| Rate for Payer: Cigna of CA HMO |
$76.16
|
| Rate for Payer: Cigna of CA PPO |
$88.06
|
| Rate for Payer: Cigna of CA PPO |
$91.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.64
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$13.09
|
| Rate for Payer: Dignity Health Medicare Advantage |
$13.09
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$83.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$86.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$21.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$21.60
|
| Rate for Payer: Global Benefits Group Commercial |
$71.40
|
| Rate for Payer: Global Benefits Group Commercial |
$73.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$21.47
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$21.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$19.27
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$19.27
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13.09
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$75.56
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$78.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$21.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$21.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$18.33
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$18.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$28.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$29.52
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16.49
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16.49
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17.54
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17.54
|
| Rate for Payer: Multiplan Commercial |
$98.40
|
| Rate for Payer: Multiplan Commercial |
$95.20
|
| Rate for Payer: Networks By Design Commercial |
$79.95
|
| Rate for Payer: Networks By Design Commercial |
$77.35
|
| Rate for Payer: Prime Health Services Commercial |
$101.15
|
| Rate for Payer: Prime Health Services Commercial |
$104.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$71.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$73.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$71.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$73.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.60
|
| Rate for Payer: United Healthcare All Other HMO |
$10.60
|
| Rate for Payer: United Healthcare All Other HMO |
$10.60
|
| Rate for Payer: United Healthcare HMO Rider |
$10.60
|
| Rate for Payer: United Healthcare HMO Rider |
$10.60
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.60
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.60
|
| Rate for Payer: Upland Medical Group Pediatric |
$13.09
|
| Rate for Payer: Upland Medical Group Pediatric |
$13.09
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.64
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.40
|
| Rate for Payer: Vantage Medical Group Senior |
$13.09
|
| Rate for Payer: Vantage Medical Group Senior |
$13.09
|
|
|
HC ANTI-XA UNFRACTIONATED HEPARIN
|
Facility
|
IP
|
$123.00
|
|
|
Service Code
|
CPT 85520
|
| Hospital Charge Code |
900912030
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$24.60 |
| Max. Negotiated Rate |
$104.55 |
| Rate for Payer: Adventist Health Commercial |
$24.60
|
| Rate for Payer: Cash Price |
$55.35
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$86.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$49.20
|
| Rate for Payer: EPIC Health Plan Senior |
$49.20
|
| Rate for Payer: Galaxy Health WC |
$104.55
|
| Rate for Payer: Global Benefits Group Commercial |
$73.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$78.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$72.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$29.52
|
| Rate for Payer: Multiplan Commercial |
$98.40
|
| Rate for Payer: Networks By Design Commercial |
$79.95
|
| Rate for Payer: Prime Health Services Commercial |
$104.55
|
|
|
HC AORTA CATHETER (FEMORAL/AX
|
Facility
|
OP
|
$1,204.00
|
|
|
Service Code
|
CPT 36200
|
| Hospital Charge Code |
909081318
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$240.80 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$240.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,023.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$662.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$903.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,240.00
|
| Rate for Payer: Blue Shield of California Commercial |
$7,196.06
|
| Rate for Payer: Blue Shield of California Commercial |
$4,753.44
|
| Rate for Payer: Cash Price |
$541.80
|
| Rate for Payer: Cash Price |
$541.80
|
| Rate for Payer: Cash Price |
$541.80
|
| Rate for Payer: Cigna of CA HMO |
$770.56
|
| Rate for Payer: Cigna of CA PPO |
$890.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,023.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,023.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,023.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$842.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$481.60
|
| Rate for Payer: EPIC Health Plan Senior |
$481.60
|
| Rate for Payer: Galaxy Health WC |
$1,023.40
|
| Rate for Payer: Global Benefits Group Commercial |
$722.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$250.19
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$764.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$282.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$710.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$288.96
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$842.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$842.80
|
| Rate for Payer: Multiplan Commercial |
$963.20
|
| Rate for Payer: Networks By Design Commercial |
$782.60
|
| Rate for Payer: Prime Health Services Commercial |
$1,023.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$722.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$602.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,023.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,023.40
|
| Rate for Payer: Vantage Medical Group Senior |
$1,023.40
|
|
|
HC AORTA CATHETER (FEMORAL/AX
|
Facility
|
IP
|
$1,204.00
|
|
|
Service Code
|
CPT 36200
|
| Hospital Charge Code |
909081318
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$240.80 |
| Max. Negotiated Rate |
$1,023.40 |
| Rate for Payer: Adventist Health Commercial |
$240.80
|
| Rate for Payer: Cash Price |
$541.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$842.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$481.60
|
| Rate for Payer: EPIC Health Plan Senior |
$481.60
|
| Rate for Payer: Galaxy Health WC |
$1,023.40
|
| Rate for Payer: Global Benefits Group Commercial |
$722.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$764.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$710.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$288.96
|
| Rate for Payer: Multiplan Commercial |
$963.20
|
| Rate for Payer: Networks By Design Commercial |
$782.60
|
| Rate for Payer: Prime Health Services Commercial |
$1,023.40
|
|
|
HC AORTOGRAM/SUPRAVALVULAR
|
Facility
|
OP
|
$2,473.00
|
|
|
Service Code
|
CPT 93567
|
| Hospital Charge Code |
906811416
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$156.58 |
| Max. Negotiated Rate |
$7,196.06 |
| Rate for Payer: Adventist Health Commercial |
$494.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,102.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,360.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,854.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,716.00
|
| Rate for Payer: Blue Shield of California Commercial |
$7,196.06
|
| Rate for Payer: Blue Shield of California Commercial |
$4,753.44
|
| Rate for Payer: Cash Price |
$1,112.85
|
| Rate for Payer: Cash Price |
$1,112.85
|
| Rate for Payer: Cash Price |
$1,112.85
|
| Rate for Payer: Cigna of CA HMO |
$1,607.45
|
| Rate for Payer: Cigna of CA PPO |
$1,830.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,102.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,102.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,102.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,731.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$989.20
|
| Rate for Payer: EPIC Health Plan Senior |
$989.20
|
| Rate for Payer: Galaxy Health WC |
$2,102.05
|
| Rate for Payer: Global Benefits Group Commercial |
$1,483.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$156.58
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,570.36
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$177.08
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,459.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$593.52
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,731.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,731.10
|
| Rate for Payer: Multiplan Commercial |
$1,978.40
|
| Rate for Payer: Networks By Design Commercial |
$1,607.45
|
| Rate for Payer: Prime Health Services Commercial |
$2,102.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,483.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,483.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,236.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,102.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,102.05
|
| Rate for Payer: Vantage Medical Group Senior |
$2,102.05
|
|
