|
HC CULTURE STREPTOCARD
|
Facility
|
OP
|
$20.00
|
|
|
Service Code
|
CPT 87147
|
| Hospital Charge Code |
900912420
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$4.19 |
| Max. Negotiated Rate |
$42.69 |
| Rate for Payer: Aetna of CA HMO/PPO |
$40.81
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.77
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.18
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$42.69
|
| Rate for Payer: Blue Distinction Transplant |
$12.00
|
| Rate for Payer: Blue Shield of California Commercial |
$12.92
|
| Rate for Payer: Blue Shield of California EPN |
$10.24
|
| Rate for Payer: Cash Price |
$9.00
|
| Rate for Payer: Cash Price |
$9.00
|
| Rate for Payer: Cigna of CA HMO |
$12.80
|
| Rate for Payer: Cigna of CA PPO |
$14.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.77
|
| Rate for Payer: Dignity Health Media |
$5.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.99
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$5.18
|
| Rate for Payer: EPIC Health Plan Transplant |
$5.18
|
| Rate for Payer: Galaxy Health WC |
$17.00
|
| Rate for Payer: Global Benefits Group Commercial |
$12.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$15.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$8.50
|
| Rate for Payer: Heritage Provider Network Transplant |
$8.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$8.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$8.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.18
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$13.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.94
|
| Rate for Payer: Multiplan Commercial |
$16.00
|
| Rate for Payer: Networks By Design Commercial |
$13.00
|
| Rate for Payer: Prime Health Services Commercial |
$17.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$12.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$12.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.19
|
| Rate for Payer: United Healthcare All Other HMO |
$4.19
|
| Rate for Payer: United Healthcare HMO Rider |
$4.19
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.19
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.77
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.70
|
| Rate for Payer: Vantage Medical Group Senior |
$5.18
|
|
|
HC CULTURE SURGICAL WOUND
|
Facility
|
OP
|
$52.00
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
900912436
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.98 |
| Max. Negotiated Rate |
$225.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$71.61
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9.48
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.62
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$78.50
|
| Rate for Payer: Blue Distinction Transplant |
$31.20
|
| Rate for Payer: Blue Shield of California Commercial |
$33.59
|
| Rate for Payer: Blue Shield of California EPN |
$26.62
|
| Rate for Payer: Cash Price |
$23.40
|
| Rate for Payer: Cash Price |
$23.40
|
| Rate for Payer: Cash Price |
$23.40
|
| Rate for Payer: Cigna of CA HMO |
$33.28
|
| Rate for Payer: Cigna of CA PPO |
$38.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.93
|
| Rate for Payer: Dignity Health Media |
$8.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.64
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$8.62
|
| Rate for Payer: EPIC Health Plan Transplant |
$8.62
|
| Rate for Payer: Galaxy Health WC |
$44.20
|
| Rate for Payer: Global Benefits Group Commercial |
$31.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$39.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$14.14
|
| Rate for Payer: Heritage Provider Network Transplant |
$14.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$13.96
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$13.96
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.62
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$34.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14.27
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.48
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11.55
|
| Rate for Payer: Multiplan Commercial |
$41.60
|
| Rate for Payer: Networks By Design Commercial |
$33.80
|
| Rate for Payer: Prime Health Services Commercial |
$44.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$31.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$225.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.98
|
| Rate for Payer: United Healthcare All Other HMO |
$6.98
|
| Rate for Payer: United Healthcare HMO Rider |
$6.98
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.98
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.48
|
| Rate for Payer: Vantage Medical Group Senior |
$8.62
|
|
|
HC CULTURE THROAT
|
Facility
|
OP
|
$28.00
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
900911515
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.72 |
| Max. Negotiated Rate |
$225.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$71.61
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9.48
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.62
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$78.50
|
| Rate for Payer: Blue Distinction Transplant |
$16.80
|
| Rate for Payer: Blue Shield of California Commercial |
$18.09
|
| Rate for Payer: Blue Shield of California EPN |
$14.34
|
| Rate for Payer: Cash Price |
$12.60
|
| Rate for Payer: Cash Price |
$12.60
|
| Rate for Payer: Cash Price |
$12.60
|
| Rate for Payer: Cigna of CA HMO |
$17.92
|
| Rate for Payer: Cigna of CA PPO |
$20.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.93
|
| Rate for Payer: Dignity Health Media |
$8.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.64
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$8.62
|
| Rate for Payer: EPIC Health Plan Transplant |
$8.62
|
| Rate for Payer: Galaxy Health WC |
$23.80
|
| Rate for Payer: Global Benefits Group Commercial |
$16.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$21.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$14.14
|
| Rate for Payer: Heritage Provider Network Transplant |
$14.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$13.96
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$13.96
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.62
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$18.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14.27
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.72
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11.55
|
| Rate for Payer: Multiplan Commercial |
$22.40
|
| Rate for Payer: Networks By Design Commercial |
$18.20
|
| Rate for Payer: Prime Health Services Commercial |
$23.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$16.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$225.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.98
|
| Rate for Payer: United Healthcare All Other HMO |
$6.98
|
| Rate for Payer: United Healthcare HMO Rider |
$6.98
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.98
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.48
|
| Rate for Payer: Vantage Medical Group Senior |
$8.62
|
|
|
HC CULTURE TISSUE
|
Facility
|
OP
|
$32.00
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
900911516
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.98 |
| Max. Negotiated Rate |
$225.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$71.61
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9.48
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.62
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$78.50
|
| Rate for Payer: Blue Distinction Transplant |
$19.20
|
| Rate for Payer: Blue Shield of California Commercial |
$20.67
|
| Rate for Payer: Blue Shield of California EPN |
$16.38
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Cigna of CA HMO |
$20.48
|
| Rate for Payer: Cigna of CA PPO |
$23.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.93
|
| Rate for Payer: Dignity Health Media |
$8.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.64
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$8.62
|
| Rate for Payer: EPIC Health Plan Transplant |
$8.62
|
| Rate for Payer: Galaxy Health WC |
$27.20
|
| Rate for Payer: Global Benefits Group Commercial |
$19.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$24.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$14.14
|
| Rate for Payer: Heritage Provider Network Transplant |
$14.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$13.96
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$13.96
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.62
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$21.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14.27
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11.55
|
| Rate for Payer: Multiplan Commercial |
$25.60
|
| Rate for Payer: Networks By Design Commercial |
$20.80
|
| Rate for Payer: Prime Health Services Commercial |
$27.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$19.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$225.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.98
|
| Rate for Payer: United Healthcare All Other HMO |
$6.98
|
| Rate for Payer: United Healthcare HMO Rider |
$6.98
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.98
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.48
|
| Rate for Payer: Vantage Medical Group Senior |
$8.62
|
|
|
HC CULTURE TRACHEAL ASPIRATE
|
Facility
|
OP
|
$32.00
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
900911517
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.98 |
| Max. Negotiated Rate |
$225.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$71.61
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9.48
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.62
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$78.50
|
| Rate for Payer: Blue Distinction Transplant |
$19.20
|
| Rate for Payer: Blue Shield of California Commercial |
$20.67
|
| Rate for Payer: Blue Shield of California EPN |
$16.38
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Cigna of CA HMO |
$20.48
|
| Rate for Payer: Cigna of CA PPO |
$23.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.93
|
| Rate for Payer: Dignity Health Media |
$8.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.64
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$8.62
|
| Rate for Payer: EPIC Health Plan Transplant |
$8.62
|
| Rate for Payer: Galaxy Health WC |
$27.20
|
| Rate for Payer: Global Benefits Group Commercial |
$19.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$24.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$14.14
|
| Rate for Payer: Heritage Provider Network Transplant |
$14.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$13.96
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$13.96
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.62
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$21.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14.27
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11.55
|
| Rate for Payer: Multiplan Commercial |
$25.60
|
| Rate for Payer: Networks By Design Commercial |
$20.80
|
| Rate for Payer: Prime Health Services Commercial |
$27.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$19.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$225.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.98
|
| Rate for Payer: United Healthcare All Other HMO |
$6.98
|
| Rate for Payer: United Healthcare HMO Rider |
$6.98
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.98
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.48
|
| Rate for Payer: Vantage Medical Group Senior |
$8.62
|
|
|
HC CULTURE URINE
|
Facility
|
OP
|
$21.00
|
|
|
Service Code
|
CPT 87088
|
| Hospital Charge Code |
900911530
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.04 |
| Max. Negotiated Rate |
$65.66 |
| Rate for Payer: Aetna of CA HMO/PPO |
$54.51
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.14
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$65.66
|
| Rate for Payer: Blue Distinction Transplant |
$12.60
|
| Rate for Payer: Blue Shield of California Commercial |
$13.57
|
| Rate for Payer: Blue Shield of California EPN |
$10.75
|
| Rate for Payer: Cash Price |
$9.45
|
| Rate for Payer: Cash Price |
$9.45
|
| Rate for Payer: Cigna of CA HMO |
$13.44
|
| Rate for Payer: Cigna of CA PPO |
$15.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.14
|
| Rate for Payer: Dignity Health Media |
$8.09
|
| Rate for Payer: Dignity Health Medi-Cal |
$8.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.92
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$8.09
|
| Rate for Payer: EPIC Health Plan Transplant |
$8.09
|
| Rate for Payer: Galaxy Health WC |
$17.85
|
| Rate for Payer: Global Benefits Group Commercial |
$12.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$15.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$13.27
|
| Rate for Payer: Heritage Provider Network Transplant |
$13.27
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$13.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$13.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$14.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.55
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.04
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.19
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10.84
|
| Rate for Payer: Multiplan Commercial |
$16.80
|
| Rate for Payer: Networks By Design Commercial |
$13.65
|
| Rate for Payer: Prime Health Services Commercial |
$17.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$12.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$12.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.55
|
| Rate for Payer: United Healthcare All Other HMO |
$6.55
|
| Rate for Payer: United Healthcare HMO Rider |
$6.55
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.55
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.14
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.90
|
| Rate for Payer: Vantage Medical Group Senior |
$8.09
|
|
|
HC CULTURE URINE ID
|
Facility
|
OP
|
$27.00
|
|
|
Service Code
|
CPT 87088
|
| Hospital Charge Code |
900911556
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.48 |
| Max. Negotiated Rate |
$65.66 |
| Rate for Payer: Aetna of CA HMO/PPO |
$54.51
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.14
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$65.66
|
| Rate for Payer: Blue Distinction Transplant |
$16.20
|
| Rate for Payer: Blue Shield of California Commercial |
$17.44
|
| Rate for Payer: Blue Shield of California EPN |
$13.82
|
| Rate for Payer: Cash Price |
$12.15
|
| Rate for Payer: Cash Price |
$12.15
|
| Rate for Payer: Cigna of CA HMO |
$17.28
|
| Rate for Payer: Cigna of CA PPO |
$19.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.14
|
| Rate for Payer: Dignity Health Media |
$8.09
|
| Rate for Payer: Dignity Health Medi-Cal |
$8.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.92
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$8.09
|
| Rate for Payer: EPIC Health Plan Transplant |
$8.09
|
| Rate for Payer: Galaxy Health WC |
$22.95
|
| Rate for Payer: Global Benefits Group Commercial |
$16.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$20.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$13.27
|
| Rate for Payer: Heritage Provider Network Transplant |
$13.27
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$13.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$13.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$18.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.55
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.48
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.19
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10.84
|
| Rate for Payer: Multiplan Commercial |
$21.60
|
| Rate for Payer: Networks By Design Commercial |
$17.55
|
| Rate for Payer: Prime Health Services Commercial |
$22.95
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$16.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$16.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.55
|
| Rate for Payer: United Healthcare All Other HMO |
$6.55
|
| Rate for Payer: United Healthcare HMO Rider |
$6.55
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.55
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.14
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.90
|
| Rate for Payer: Vantage Medical Group Senior |
$8.09
|
|
|
HC CULTURE UROGENITAL
|
Facility
|
OP
|
$32.00
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
900911519
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.98 |
| Max. Negotiated Rate |
$225.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$71.61
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9.48
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.62
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$78.50
|
| Rate for Payer: Blue Distinction Transplant |
$19.20
|
| Rate for Payer: Blue Shield of California Commercial |
$20.67
|
| Rate for Payer: Blue Shield of California EPN |
$16.38
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Cigna of CA HMO |
$20.48
|
| Rate for Payer: Cigna of CA PPO |
$23.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.93
|
| Rate for Payer: Dignity Health Media |
$8.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.64
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$8.62
|
| Rate for Payer: EPIC Health Plan Transplant |
$8.62
|
| Rate for Payer: Galaxy Health WC |
$27.20
|
| Rate for Payer: Global Benefits Group Commercial |
$19.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$24.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$14.14
|
| Rate for Payer: Heritage Provider Network Transplant |
$14.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$13.96
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$13.96
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.62
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$21.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14.27
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11.55
|
| Rate for Payer: Multiplan Commercial |
$25.60
|
| Rate for Payer: Networks By Design Commercial |
$20.80
|
| Rate for Payer: Prime Health Services Commercial |
$27.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$19.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$225.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.98
|
| Rate for Payer: United Healthcare All Other HMO |
$6.98
|
| Rate for Payer: United Healthcare HMO Rider |
$6.98
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.98
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.48
|
| Rate for Payer: Vantage Medical Group Senior |
$8.62
|
|
|
HC CULTURE WOUND
|
Facility
|
OP
|
$32.00
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
900911520
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.98 |
| Max. Negotiated Rate |
$225.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$71.61
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9.48
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.62
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$78.50
|
| Rate for Payer: Blue Distinction Transplant |
$19.20
|
| Rate for Payer: Blue Shield of California Commercial |
$20.67
|
| Rate for Payer: Blue Shield of California EPN |
$16.38
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Cigna of CA HMO |
$20.48
|
| Rate for Payer: Cigna of CA PPO |
$23.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.93
|
| Rate for Payer: Dignity Health Media |
$8.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.64
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$8.62
|
| Rate for Payer: EPIC Health Plan Transplant |
$8.62
|
| Rate for Payer: Galaxy Health WC |
$27.20
|
| Rate for Payer: Global Benefits Group Commercial |
$19.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$24.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$14.14
|
| Rate for Payer: Heritage Provider Network Transplant |
$14.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$13.96
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$13.96
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.62
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$21.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14.27
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11.55
|
| Rate for Payer: Multiplan Commercial |
$25.60
|
| Rate for Payer: Networks By Design Commercial |
$20.80
|
| Rate for Payer: Prime Health Services Commercial |
$27.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$19.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$225.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.98
|
| Rate for Payer: United Healthcare All Other HMO |
$6.98
|
| Rate for Payer: United Healthcare HMO Rider |
$6.98
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.98
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.48
|
| Rate for Payer: Vantage Medical Group Senior |
$8.62
|
|
|
HC CULTURE YEAST ID
|
Facility
|
OP
|
$34.00
|
|
|
Service Code
|
CPT 87106
|
| Hospital Charge Code |
900911555
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$8.16 |
| Max. Negotiated Rate |
$94.16 |
| Rate for Payer: Aetna of CA HMO/PPO |
$85.86
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15.48
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10.32
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$94.16
|
| Rate for Payer: Blue Distinction Transplant |
$20.40
|
| Rate for Payer: Blue Shield of California Commercial |
$21.96
|
| Rate for Payer: Blue Shield of California EPN |
$17.41
|
| Rate for Payer: Cash Price |
$15.30
|
| Rate for Payer: Cash Price |
$15.30
|
| Rate for Payer: Cigna of CA HMO |
$21.76
|
| Rate for Payer: Cigna of CA PPO |
$25.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15.48
|
| Rate for Payer: Dignity Health Media |
$10.32
|
| Rate for Payer: Dignity Health Medi-Cal |
$11.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.93
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$10.32
|
| Rate for Payer: EPIC Health Plan Transplant |
$10.32
|
| Rate for Payer: Galaxy Health WC |
$28.90
|
| Rate for Payer: Global Benefits Group Commercial |
$20.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$25.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$16.92
|
| Rate for Payer: Heritage Provider Network Transplant |
$16.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$16.72
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$16.72
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10.32
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$22.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$15.43
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$13.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$13.83
|
| Rate for Payer: Multiplan Commercial |
$27.20
|
| Rate for Payer: Networks By Design Commercial |
$22.10
|
| Rate for Payer: Prime Health Services Commercial |
$28.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$20.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$20.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$8.36
|
| Rate for Payer: United Healthcare All Other HMO |
$8.36
|
| Rate for Payer: United Healthcare HMO Rider |
$8.36
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8.36
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11.35
|
| Rate for Payer: Vantage Medical Group Senior |
$10.32
|
|
|
HC CULTURE YEAST RAPID ID
|
Facility
|
OP
|
$31.00
|
|
|
Service Code
|
CPT 87077
|
| Hospital Charge Code |
900912425
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.54 |
| Max. Negotiated Rate |
$225.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$67.16
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.12
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.89
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.08
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$73.65
|
| Rate for Payer: Blue Distinction Transplant |
$18.60
|
| Rate for Payer: Blue Shield of California Commercial |
$20.03
|
| Rate for Payer: Blue Shield of California EPN |
$15.87
|
| Rate for Payer: Cash Price |
$13.95
|
| Rate for Payer: Cash Price |
$13.95
|
| Rate for Payer: Cash Price |
$13.95
|
| Rate for Payer: Cigna of CA HMO |
$19.84
|
| Rate for Payer: Cigna of CA PPO |
$22.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.12
|
| Rate for Payer: Dignity Health Media |
$8.08
|
| Rate for Payer: Dignity Health Medi-Cal |
$8.89
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.91
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$8.08
|
| Rate for Payer: EPIC Health Plan Transplant |
$8.08
|
| Rate for Payer: Galaxy Health WC |
$26.35
|
| Rate for Payer: Global Benefits Group Commercial |
$18.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$23.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$13.25
|
| Rate for Payer: Heritage Provider Network Transplant |
$13.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$13.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$13.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.08
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12.64
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10.83
|
| Rate for Payer: Multiplan Commercial |
$24.80
|
| Rate for Payer: Networks By Design Commercial |
$20.15
|
| Rate for Payer: Prime Health Services Commercial |
$26.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$18.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$225.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.54
|
| Rate for Payer: United Healthcare All Other HMO |
$6.54
|
| Rate for Payer: United Healthcare HMO Rider |
$6.54
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.54
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.89
|
| Rate for Payer: Vantage Medical Group Senior |
$8.08
|
|
|
HC CULTURE YERSINIA
|
Facility
|
OP
|
$36.00
|
|
|
Service Code
|
CPT 87046
|
| Hospital Charge Code |
900911529
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$4.96 |
| Max. Negotiated Rate |
$78.49 |
| Rate for Payer: Aetna of CA HMO/PPO |
$78.49
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$14.16
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10.38
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9.44
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$21.50
|
| Rate for Payer: Blue Distinction Transplant |
$21.60
|
| Rate for Payer: Blue Shield of California Commercial |
$23.26
|
| Rate for Payer: Blue Shield of California EPN |
$18.43
|
| Rate for Payer: Cash Price |
$16.20
|
| Rate for Payer: Cash Price |
$16.20
|
| Rate for Payer: Cigna of CA HMO |
$23.04
|
| Rate for Payer: Cigna of CA PPO |
$26.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$14.16
|
| Rate for Payer: Dignity Health Media |
$9.44
|
| Rate for Payer: Dignity Health Medi-Cal |
$10.38
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.74
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$9.44
|
| Rate for Payer: EPIC Health Plan Transplant |
$9.44
|
| Rate for Payer: Galaxy Health WC |
$30.60
|
| Rate for Payer: Global Benefits Group Commercial |
$21.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$27.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$15.48
|
| Rate for Payer: Heritage Provider Network Transplant |
$15.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$15.29
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$15.29
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$9.44
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$24.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.96
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.64
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11.89
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$12.65
|
| Rate for Payer: Multiplan Commercial |
$28.80
|
| Rate for Payer: Networks By Design Commercial |
$23.40
|
| Rate for Payer: Prime Health Services Commercial |
$30.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$21.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$21.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.65
|
| Rate for Payer: United Healthcare All Other HMO |
$7.65
|
| Rate for Payer: United Healthcare HMO Rider |
$7.65
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.65
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$14.16
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.38
|
| Rate for Payer: Vantage Medical Group Senior |
$9.44
|
|
|
HC CYCLIC CITRUL PEPT AB
|
Facility
|
OP
|
$39.00
|
|
|
Service Code
|
CPT 86200
|
| Hospital Charge Code |
900913652
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.36 |
| Max. Negotiated Rate |
$115.54 |
| Rate for Payer: Aetna of CA HMO/PPO |
$107.69
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19.42
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.24
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12.95
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$115.54
|
| Rate for Payer: Blue Distinction Transplant |
$23.40
|
| Rate for Payer: Blue Shield of California Commercial |
$25.19
|
| Rate for Payer: Blue Shield of California EPN |
$19.97
|
| Rate for Payer: Cash Price |
$17.55
|
| Rate for Payer: Cash Price |
$17.55
|
| Rate for Payer: Cigna of CA HMO |
$24.96
|
| Rate for Payer: Cigna of CA PPO |
$28.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.42
|
| Rate for Payer: Dignity Health Media |
$12.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$17.48
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$12.95
|
| Rate for Payer: EPIC Health Plan Transplant |
$12.95
|
| Rate for Payer: Galaxy Health WC |
$33.15
|
| Rate for Payer: Global Benefits Group Commercial |
$23.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$29.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$21.24
|
| Rate for Payer: Heritage Provider Network Transplant |
$21.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$20.98
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$20.98
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$12.95
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$26.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13.49
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16.32
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17.35
|
| Rate for Payer: Multiplan Commercial |
$31.20
|
| Rate for Payer: Networks By Design Commercial |
$25.35
|
| Rate for Payer: Prime Health Services Commercial |
$33.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$23.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$23.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.49
|
| Rate for Payer: United Healthcare All Other HMO |
$10.49
|
| Rate for Payer: United Healthcare HMO Rider |
$10.49
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.49
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.42
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.24
|
| Rate for Payer: Vantage Medical Group Senior |
$12.95
|
|
|
HC CYCLOSPORINE A (EMIT)
|
Facility
|
OP
|
$69.00
|
|
|
Service Code
|
CPT 80158
|
| Hospital Charge Code |
900910933
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.62 |
| Max. Negotiated Rate |
$164.74 |
| Rate for Payer: Aetna of CA HMO/PPO |
$150.10
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$27.08
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$18.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$164.74
|
| Rate for Payer: Blue Distinction Transplant |
$41.40
|
| Rate for Payer: Blue Shield of California Commercial |
$44.57
|
| Rate for Payer: Blue Shield of California EPN |
$35.33
|
| Rate for Payer: Cash Price |
$31.05
|
| Rate for Payer: Cash Price |
$31.05
|
| Rate for Payer: Cigna of CA HMO |
$44.16
|
| Rate for Payer: Cigna of CA PPO |
$51.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$27.08
|
| Rate for Payer: Dignity Health Media |
$18.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$19.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$24.37
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$18.05
|
| Rate for Payer: EPIC Health Plan Transplant |
$18.05
|
| Rate for Payer: Galaxy Health WC |
$58.65
|
| Rate for Payer: Global Benefits Group Commercial |
$41.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$51.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$29.60
|
| Rate for Payer: Heritage Provider Network Transplant |
$29.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$29.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$29.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$18.05
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$46.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$30.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.56
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$22.74
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$24.19
|
| Rate for Payer: Multiplan Commercial |
$55.20
|
| Rate for Payer: Networks By Design Commercial |
$44.85
|
| Rate for Payer: Prime Health Services Commercial |
$58.65
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$41.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$41.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.62
|
| Rate for Payer: United Healthcare All Other HMO |
$14.62
|
| Rate for Payer: United Healthcare HMO Rider |
$14.62
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.62
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$27.08
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.86
|
| Rate for Payer: Vantage Medical Group Senior |
$18.05
|
|
|
HC CYLINDER CAST-THIGH TO ANKLE
|
Facility
|
OP
|
$699.00
|
|
|
Service Code
|
CPT 29365
|
| Hospital Charge Code |
950510041
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$167.76 |
| Max. Negotiated Rate |
$4,984.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$503.32
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$369.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$335.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,984.00
|
| Rate for Payer: Blue Distinction Transplant |
$419.40
|
| Rate for Payer: Cash Price |
$314.55
|
| Rate for Payer: Cash Price |
$314.55
|
| Rate for Payer: Cash Price |
$314.55
|
| Rate for Payer: Cigna of CA PPO |
$517.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$503.32
|
| Rate for Payer: Dignity Health Media |
$335.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$369.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$452.99
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$335.55
|
| Rate for Payer: EPIC Health Plan Transplant |
$335.55
|
| Rate for Payer: Galaxy Health WC |
$594.15
|
| Rate for Payer: Global Benefits Group Commercial |
$419.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$524.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$550.30
|
| Rate for Payer: Heritage Provider Network Transplant |
$550.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$335.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$466.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$195.95
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$335.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$167.76
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$422.79
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$449.64
|
| Rate for Payer: Multiplan Commercial |
$559.20
|
| Rate for Payer: Networks By Design Commercial |
$454.35
|
| Rate for Payer: Prime Health Services Commercial |
$594.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$419.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$349.50
|
| Rate for Payer: United Healthcare All Other HMO |
$349.50
|
| Rate for Payer: United Healthcare HMO Rider |
$349.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$349.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$503.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$369.10
|
| Rate for Payer: Vantage Medical Group Senior |
$335.55
|
|
|
HC CYLINDER CAST-THIGH TO ANKLE
|
Facility
|
IP
|
$699.00
|
|
|
Service Code
|
CPT 29365
|
| Hospital Charge Code |
950510041
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$167.76 |
| Max. Negotiated Rate |
$594.15 |
| Rate for Payer: Cash Price |
$314.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$279.60
|
| Rate for Payer: Galaxy Health WC |
$594.15
|
| Rate for Payer: Global Benefits Group Commercial |
$419.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$466.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$266.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$167.76
|
| Rate for Payer: Multiplan Commercial |
$559.20
|
| Rate for Payer: Networks By Design Commercial |
$454.35
|
| Rate for Payer: Prime Health Services Commercial |
$594.15
|
|
|
HC CYSTOGRAM, INJECTION
|
Facility
|
OP
|
$875.00
|
|
|
Service Code
|
CPT 51600
|
| Hospital Charge Code |
909000171
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$210.00 |
| Max. Negotiated Rate |
$5,938.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$299.15
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$743.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$481.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$481.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,938.00
|
| Rate for Payer: Blue Distinction Transplant |
$525.00
|
| Rate for Payer: Blue Shield of California Commercial |
$517.12
|
| Rate for Payer: Blue Shield of California EPN |
$410.38
|
| Rate for Payer: Cash Price |
$393.75
|
| Rate for Payer: Cash Price |
$393.75
|
| Rate for Payer: Cigna of CA HMO |
$560.00
|
| Rate for Payer: Cigna of CA PPO |
$647.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$743.75
|
| Rate for Payer: Dignity Health Media |
$743.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$743.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$350.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$350.00
|
| Rate for Payer: Galaxy Health WC |
$743.75
|
| Rate for Payer: Global Benefits Group Commercial |
$525.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$656.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$583.62
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$488.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$210.00
|
| Rate for Payer: Multiplan Commercial |
$700.00
|
| Rate for Payer: Networks By Design Commercial |
$568.75
|
| Rate for Payer: Prime Health Services Commercial |
$743.75
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$525.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$525.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$437.50
|
| Rate for Payer: United Healthcare All Other HMO |
$437.50
|
| Rate for Payer: United Healthcare HMO Rider |
$437.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$437.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$743.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$743.75
|
| Rate for Payer: Vantage Medical Group Senior |
$743.75
|
|
|
HC CYSTOGRAM, INJECTION
|
Facility
|
IP
|
$875.00
|
|
|
Service Code
|
CPT 51600
|
| Hospital Charge Code |
909000171
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$210.00 |
| Max. Negotiated Rate |
$743.75 |
| Rate for Payer: Cash Price |
$393.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$350.00
|
| Rate for Payer: Galaxy Health WC |
$743.75
|
| Rate for Payer: Global Benefits Group Commercial |
$525.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$583.62
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$333.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$210.00
|
| Rate for Payer: Multiplan Commercial |
$700.00
|
| Rate for Payer: Networks By Design Commercial |
$568.75
|
| Rate for Payer: Prime Health Services Commercial |
$743.75
|
|
|
HC CYSTOGRAPH MIN 3 VIEWS
|
Facility
|
OP
|
$1,477.00
|
|
|
Service Code
|
CPT 74430
|
| Hospital Charge Code |
909001901
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$63.00 |
| Max. Negotiated Rate |
$1,255.45 |
| Rate for Payer: Aetna of CA HMO/PPO |
$288.93
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$720.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$528.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$480.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$274.01
|
| Rate for Payer: Blue Distinction Transplant |
$886.20
|
| Rate for Payer: Blue Shield of California Commercial |
$872.91
|
| Rate for Payer: Blue Shield of California EPN |
$692.71
|
| Rate for Payer: Cash Price |
$664.65
|
| Rate for Payer: Cash Price |
$664.65
|
| Rate for Payer: Cigna of CA HMO |
$945.28
|
| Rate for Payer: Cigna of CA PPO |
$1,092.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$720.75
|
| Rate for Payer: Dignity Health Media |
$480.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$528.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$648.68
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$480.50
|
| Rate for Payer: EPIC Health Plan Transplant |
$480.50
|
| Rate for Payer: Galaxy Health WC |
$1,255.45
|
| Rate for Payer: Global Benefits Group Commercial |
$886.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,107.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$788.02
|
| Rate for Payer: Heritage Provider Network Transplant |
$788.02
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$778.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$778.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$480.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$985.16
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$63.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$480.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$354.48
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$605.43
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$643.87
|
| Rate for Payer: Multiplan Commercial |
$1,181.60
|
| Rate for Payer: Networks By Design Commercial |
$960.05
|
| Rate for Payer: Prime Health Services Commercial |
$1,255.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$886.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$886.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$470.69
|
| Rate for Payer: United Healthcare All Other HMO |
$470.69
|
| Rate for Payer: United Healthcare HMO Rider |
$470.69
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$470.69
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$720.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$528.55
|
| Rate for Payer: Vantage Medical Group Senior |
$480.50
|
|
|
HC CYSTOGRAPH MIN 3 VIEWS
|
Facility
|
IP
|
$1,477.00
|
|
|
Service Code
|
CPT 74430
|
| Hospital Charge Code |
909001901
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$354.48 |
| Max. Negotiated Rate |
$1,255.45 |
| Rate for Payer: Cash Price |
$664.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$590.80
|
| Rate for Payer: Galaxy Health WC |
$1,255.45
|
| Rate for Payer: Global Benefits Group Commercial |
$886.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$985.16
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$562.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$354.48
|
| Rate for Payer: Multiplan Commercial |
$1,181.60
|
| Rate for Payer: Networks By Design Commercial |
$960.05
|
| Rate for Payer: Prime Health Services Commercial |
$1,255.45
|
|
|
HC CYSTOSTOMY TUBE CHG SIMPLE
|
Facility
|
IP
|
$1,558.00
|
|
|
Service Code
|
CPT 51705
|
| Hospital Charge Code |
900501165
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$373.92 |
| Max. Negotiated Rate |
$1,324.30 |
| Rate for Payer: Cash Price |
$701.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$623.20
|
| Rate for Payer: Galaxy Health WC |
$1,324.30
|
| Rate for Payer: Global Benefits Group Commercial |
$934.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,039.19
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$593.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$373.92
|
| Rate for Payer: Multiplan Commercial |
$1,246.40
|
| Rate for Payer: Networks By Design Commercial |
$1,012.70
|
| Rate for Payer: Prime Health Services Commercial |
$1,324.30
|
|
|
HC CYSTOSTOMY TUBE CHG SIMPLE
|
Facility
|
OP
|
$1,558.00
|
|
|
Service Code
|
CPT 51705
|
| Hospital Charge Code |
900501165
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$111.76 |
| Max. Negotiated Rate |
$4,984.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$463.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$339.67
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$308.79
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,984.00
|
| Rate for Payer: Blue Distinction Transplant |
$934.80
|
| Rate for Payer: Cash Price |
$701.10
|
| Rate for Payer: Cash Price |
$701.10
|
| Rate for Payer: Cash Price |
$701.10
|
| Rate for Payer: Cigna of CA PPO |
$1,152.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$463.18
|
| Rate for Payer: Dignity Health Media |
$308.79
|
| Rate for Payer: Dignity Health Medi-Cal |
$339.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$416.87
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$308.79
|
| Rate for Payer: EPIC Health Plan Transplant |
$308.79
|
| Rate for Payer: Galaxy Health WC |
$1,324.30
|
| Rate for Payer: Global Benefits Group Commercial |
$934.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,168.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$506.42
|
| Rate for Payer: Heritage Provider Network Transplant |
$506.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$308.79
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,039.19
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$111.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$308.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$373.92
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$389.08
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$413.78
|
| Rate for Payer: Multiplan Commercial |
$1,246.40
|
| Rate for Payer: Networks By Design Commercial |
$1,012.70
|
| Rate for Payer: Prime Health Services Commercial |
$1,324.30
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$934.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$779.00
|
| Rate for Payer: United Healthcare All Other HMO |
$779.00
|
| Rate for Payer: United Healthcare HMO Rider |
$779.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$779.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$463.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$339.67
|
| Rate for Payer: Vantage Medical Group Senior |
$308.79
|
|
|
HC CYSTOSTOMY W DRAINAGE
|
Facility
|
OP
|
$9,497.00
|
|
|
Service Code
|
CPT 51040
|
| Hospital Charge Code |
900551040
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$848.84 |
| Max. Negotiated Rate |
$12,491.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$12,491.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,817.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,799.36
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,544.87
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,049.00
|
| Rate for Payer: Blue Distinction Transplant |
$5,698.20
|
| Rate for Payer: Cash Price |
$4,273.65
|
| Rate for Payer: Cash Price |
$4,273.65
|
| Rate for Payer: Cash Price |
$4,273.65
|
| Rate for Payer: Cigna of CA PPO |
$7,027.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,817.30
|
| Rate for Payer: Dignity Health Media |
$2,544.87
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,799.36
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,435.57
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,544.87
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,544.87
|
| Rate for Payer: Galaxy Health WC |
$8,072.45
|
| Rate for Payer: Global Benefits Group Commercial |
$5,698.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$7,122.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,173.59
|
| Rate for Payer: Heritage Provider Network Transplant |
$4,173.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,544.87
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,334.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$848.84
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,544.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,279.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,206.54
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,410.13
|
| Rate for Payer: Multiplan Commercial |
$7,597.60
|
| Rate for Payer: Networks By Design Commercial |
$6,173.05
|
| Rate for Payer: Prime Health Services Commercial |
$8,072.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,698.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,748.50
|
| Rate for Payer: United Healthcare All Other HMO |
$4,748.50
|
| Rate for Payer: United Healthcare HMO Rider |
$4,748.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,748.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,817.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,799.36
|
| Rate for Payer: Vantage Medical Group Senior |
$2,544.87
|
|
|
HC CYSTOSTOMY W DRAINAGE
|
Facility
|
IP
|
$9,497.00
|
|
|
Service Code
|
CPT 51040
|
| Hospital Charge Code |
900551040
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,279.28 |
| Max. Negotiated Rate |
$8,072.45 |
| Rate for Payer: Cash Price |
$4,273.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,798.80
|
| Rate for Payer: Galaxy Health WC |
$8,072.45
|
| Rate for Payer: Global Benefits Group Commercial |
$5,698.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,334.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,618.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,279.28
|
| Rate for Payer: Multiplan Commercial |
$7,597.60
|
| Rate for Payer: Networks By Design Commercial |
$6,173.05
|
| Rate for Payer: Prime Health Services Commercial |
$8,072.45
|
|
|
HC CYSTOSTOMY W INSERTION CATH OR STNT
|
Facility
|
IP
|
$2,041.00
|
|
|
Service Code
|
CPT 51045
|
| Hospital Charge Code |
900551045
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$489.84 |
| Max. Negotiated Rate |
$1,734.85 |
| Rate for Payer: Cash Price |
$918.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$816.40
|
| Rate for Payer: Galaxy Health WC |
$1,734.85
|
| Rate for Payer: Global Benefits Group Commercial |
$1,224.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,361.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$777.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$489.84
|
| Rate for Payer: Multiplan Commercial |
$1,632.80
|
| Rate for Payer: Networks By Design Commercial |
$1,326.65
|
| Rate for Payer: Prime Health Services Commercial |
$1,734.85
|
|
