|
HC ALLIED HLTH CONF PARTICIPATION
|
Facility
IP
|
$47.00
|
|
| Hospital Charge Code |
912900111
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$11.28 |
| Max. Negotiated Rate |
$39.95 |
| Rate for Payer: Cash Price |
$21.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$18.80
|
| Rate for Payer: Galaxy Health WC |
$39.95
|
| Rate for Payer: Global Benefits Group Commercial |
$28.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$31.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$17.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.28
|
| Rate for Payer: Multiplan Commercial |
$37.60
|
| Rate for Payer: Networks By Design Commercial |
$30.55
|
| Rate for Payer: Prime Health Services Commercial |
$39.95
|
|
|
HC ALLIED HLTH CONF PARTICIPATION
|
Facility
OP
|
$47.00
|
|
| Hospital Charge Code |
912900111
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$11.28 |
| Max. Negotiated Rate |
$39.95 |
| Rate for Payer: Aetna of CA HMO/PPO |
$30.83
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$39.95
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$25.85
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$25.85
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$28.00
|
| Rate for Payer: BCBS Transplant Transplant |
$28.20
|
| Rate for Payer: Blue Shield of California Commercial |
$34.64
|
| Rate for Payer: Blue Shield of California EPN |
$27.45
|
| Rate for Payer: Cash Price |
$21.15
|
| Rate for Payer: Cigna of CA HMO |
$30.08
|
| Rate for Payer: Cigna of CA PPO |
$34.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$39.95
|
| Rate for Payer: Dignity Health Media |
$39.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$39.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$18.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$18.80
|
| Rate for Payer: Galaxy Health WC |
$39.95
|
| Rate for Payer: Global Benefits Group Commercial |
$28.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$35.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$31.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$17.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.28
|
| Rate for Payer: Multiplan Commercial |
$37.60
|
| Rate for Payer: Networks By Design Commercial |
$30.55
|
| Rate for Payer: Prime Health Services Commercial |
$39.95
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$28.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$28.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$28.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$23.50
|
| Rate for Payer: United Healthcare All Other HMO |
$23.50
|
| Rate for Payer: United Healthcare HMO Rider |
$23.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$23.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$39.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$39.95
|
| Rate for Payer: Vantage Medical Group Senior |
$39.95
|
|
|
HC ALLIED HLTH GROUP TEACHING
|
Facility
IP
|
$47.00
|
|
| Hospital Charge Code |
912900003
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$11.28 |
| Max. Negotiated Rate |
$39.95 |
| Rate for Payer: Cash Price |
$21.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$18.80
|
| Rate for Payer: Galaxy Health WC |
$39.95
|
| Rate for Payer: Global Benefits Group Commercial |
$28.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$31.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$17.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.28
|
| Rate for Payer: Multiplan Commercial |
$37.60
|
| Rate for Payer: Networks By Design Commercial |
$30.55
|
| Rate for Payer: Prime Health Services Commercial |
$39.95
|
|
|
HC ALLIED HLTH GROUP TEACHING
|
Facility
OP
|
$47.00
|
|
| Hospital Charge Code |
912900003
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$11.28 |
| Max. Negotiated Rate |
$39.95 |
| Rate for Payer: Aetna of CA HMO/PPO |
$30.83
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$39.95
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$25.85
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$25.85
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$28.00
|
| Rate for Payer: BCBS Transplant Transplant |
$28.20
|
| Rate for Payer: Blue Shield of California Commercial |
$34.64
|
| Rate for Payer: Blue Shield of California EPN |
$27.45
|
| Rate for Payer: Cash Price |
$21.15
|
| Rate for Payer: Cigna of CA HMO |
$30.08
|
| Rate for Payer: Cigna of CA PPO |
$34.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$39.95
|
| Rate for Payer: Dignity Health Media |
$39.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$39.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$18.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$18.80
|
| Rate for Payer: Galaxy Health WC |
$39.95
|
| Rate for Payer: Global Benefits Group Commercial |
$28.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$35.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$31.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$17.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.28
|
| Rate for Payer: Multiplan Commercial |
$37.60
|
| Rate for Payer: Networks By Design Commercial |
$30.55
|
| Rate for Payer: Prime Health Services Commercial |
$39.95
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$28.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$28.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$28.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$23.50
|
| Rate for Payer: United Healthcare All Other HMO |
$23.50
|
| Rate for Payer: United Healthcare HMO Rider |
$23.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$23.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$39.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$39.95
|
| Rate for Payer: Vantage Medical Group Senior |
$39.95
|
|
|
HC ALLIED HLTH PHONE CONF 15 MINS
|
Facility
OP
|
$23.00
|
|
| Hospital Charge Code |
912900007
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5.52 |
| Max. Negotiated Rate |
$19.55 |
| Rate for Payer: Aetna of CA HMO/PPO |
$15.09
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$19.55
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$12.65
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$12.65
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13.70
|
| Rate for Payer: BCBS Transplant Transplant |
$13.80
|
| Rate for Payer: Blue Shield of California Commercial |
$16.95
|
| Rate for Payer: Blue Shield of California EPN |
$13.43
|
| Rate for Payer: Cash Price |
$10.35
|
| Rate for Payer: Cigna of CA HMO |
$14.72
|
| Rate for Payer: Cigna of CA PPO |
$17.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.55
|
| Rate for Payer: Dignity Health Media |
$19.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$19.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$9.20
|
| Rate for Payer: Galaxy Health WC |
$19.55
|
| Rate for Payer: Global Benefits Group Commercial |
$13.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$17.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.52
|
| Rate for Payer: Multiplan Commercial |
$18.40
|
| Rate for Payer: Networks By Design Commercial |
$14.95
|
| Rate for Payer: Prime Health Services Commercial |
$19.55
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$13.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$13.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$13.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$11.50
|
| Rate for Payer: United Healthcare All Other HMO |
$11.50
|
| Rate for Payer: United Healthcare HMO Rider |
$11.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.55
|
| Rate for Payer: Vantage Medical Group Senior |
$19.55
|
|
|
HC ALLIED HLTH PHONE CONF 15 MINS
|
Facility
IP
|
$23.00
|
|
| Hospital Charge Code |
912900007
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5.52 |
| Max. Negotiated Rate |
$19.55 |
| Rate for Payer: Cash Price |
$10.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.20
|
| Rate for Payer: Galaxy Health WC |
$19.55
|
| Rate for Payer: Global Benefits Group Commercial |
$13.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.52
|
| Rate for Payer: Multiplan Commercial |
$18.40
|
| Rate for Payer: Networks By Design Commercial |
$14.95
|
| Rate for Payer: Prime Health Services Commercial |
$19.55
|
|
|
HC ALPHA 1 ANTITRYPSN
|
Facility
OP
|
$52.00
|
|
|
Service Code
|
CPT 82103
|
| Hospital Charge Code |
900910838
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.89 |
| Max. Negotiated Rate |
$122.48 |
| Rate for Payer: Aetna of CA HMO/PPO |
$111.72
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$20.16
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$14.78
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$13.44
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$122.48
|
| Rate for Payer: BCBS Transplant 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: Cigna of CA HMO |
$33.28
|
| Rate for Payer: Cigna of CA PPO |
$38.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20.16
|
| Rate for Payer: Dignity Health Media |
$13.44
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$18.14
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$13.44
|
| Rate for Payer: EPIC Health Plan Transplant |
$13.44
|
| 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 Transplant Other |
$39.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$22.04
|
| Rate for Payer: Heritage Provider Network Transplant |
$22.04
|
| Rate for Payer: IEHP Medi-Cal |
$21.77
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$21.77
|
| Rate for Payer: IEHP Medicare Advantage |
$13.44
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$34.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$22.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.48
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16.93
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18.01
|
| 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: Redlands Yucaipa Medical Group Commercial/Senior |
$31.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$31.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$31.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.89
|
| Rate for Payer: United Healthcare All Other HMO |
$10.89
|
| Rate for Payer: United Healthcare HMO Rider |
$10.89
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.89
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20.16
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.78
|
| Rate for Payer: Vantage Medical Group Senior |
$13.44
|
|
|
HC ALPHA-FETOPROTEIN BLOOD
|
Facility
OP
|
$60.00
|
|
|
Service Code
|
CPT 82105
|
| Hospital Charge Code |
900910947
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.58 |
| Max. Negotiated Rate |
$161.50 |
| Rate for Payer: Aetna of CA HMO/PPO |
$139.53
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$25.16
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$18.45
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$16.77
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$153.07
|
| Rate for Payer: BCBS Transplant Transplant |
$36.00
|
| Rate for Payer: Blue Shield of California Commercial |
$38.76
|
| Rate for Payer: Blue Shield of California EPN |
$30.72
|
| Rate for Payer: Cash Price |
$27.00
|
| Rate for Payer: Cash Price |
$27.00
|
| Rate for Payer: Cigna of CA HMO |
$38.40
|
| Rate for Payer: Cigna of CA PPO |
$44.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$25.16
|
| Rate for Payer: Dignity Health Media |
$16.77
|
| Rate for Payer: Dignity Health Medi-Cal |
$18.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$22.64
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$16.77
|
| Rate for Payer: EPIC Health Plan Transplant |
$16.77
|
| Rate for Payer: Galaxy Health WC |
$51.00
|
| Rate for Payer: Global Benefits Group Commercial |
$36.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$45.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$27.50
|
| Rate for Payer: Heritage Provider Network Transplant |
$27.50
|
| Rate for Payer: IEHP Medi-Cal |
$27.17
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$27.17
|
| Rate for Payer: IEHP Medicare Advantage |
$16.77
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$40.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$161.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$21.13
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$22.47
|
| Rate for Payer: Multiplan Commercial |
$48.00
|
| Rate for Payer: Networks By Design Commercial |
$39.00
|
| Rate for Payer: Prime Health Services Commercial |
$51.00
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$36.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$36.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$36.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$13.58
|
| Rate for Payer: United Healthcare All Other HMO |
$13.58
|
| Rate for Payer: United Healthcare HMO Rider |
$13.58
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$13.58
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$25.16
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$18.45
|
| Rate for Payer: Vantage Medical Group Senior |
$16.77
|
|
|
HC ALT
|
Facility
OP
|
$15.00
|
|
|
Service Code
|
CPT 84460
|
| Hospital Charge Code |
900910233
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.60 |
| Max. Negotiated Rate |
$47.73 |
| Rate for Payer: Aetna of CA HMO/PPO |
$43.94
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$7.95
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$5.83
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$5.30
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$47.73
|
| Rate for Payer: BCBS Transplant Transplant |
$9.00
|
| Rate for Payer: Blue Shield of California Commercial |
$9.69
|
| Rate for Payer: Blue Shield of California EPN |
$7.68
|
| Rate for Payer: Cash Price |
$6.75
|
| Rate for Payer: Cash Price |
$6.75
|
| Rate for Payer: Cigna of CA HMO |
$9.60
|
| Rate for Payer: Cigna of CA PPO |
$11.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.95
|
| Rate for Payer: Dignity Health Media |
$5.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.83
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.16
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$5.30
|
| Rate for Payer: EPIC Health Plan Transplant |
$5.30
|
| Rate for Payer: Galaxy Health WC |
$12.75
|
| Rate for Payer: Global Benefits Group Commercial |
$9.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$11.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$8.69
|
| Rate for Payer: Heritage Provider Network Transplant |
$8.69
|
| Rate for Payer: IEHP Medi-Cal |
$8.59
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$8.59
|
| Rate for Payer: IEHP Medicare Advantage |
$5.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.70
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.68
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$7.10
|
| Rate for Payer: Multiplan Commercial |
$12.00
|
| Rate for Payer: Networks By Design Commercial |
$9.75
|
| Rate for Payer: Prime Health Services Commercial |
$12.75
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$9.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.29
|
| Rate for Payer: United Healthcare All Other HMO |
$4.29
|
| Rate for Payer: United Healthcare HMO Rider |
$4.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.29
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.83
|
| Rate for Payer: Vantage Medical Group Senior |
$5.30
|
|
|
HC ALT SINGLE
|
Facility
OP
|
$15.00
|
|
|
Service Code
|
CPT 84460
|
| Hospital Charge Code |
900910510
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.60 |
| Max. Negotiated Rate |
$47.73 |
| Rate for Payer: Aetna of CA HMO/PPO |
$43.94
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$7.95
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$5.83
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$5.30
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$47.73
|
| Rate for Payer: BCBS Transplant Transplant |
$9.00
|
| Rate for Payer: Blue Shield of California Commercial |
$9.69
|
| Rate for Payer: Blue Shield of California EPN |
$7.68
|
| Rate for Payer: Cash Price |
$6.75
|
| Rate for Payer: Cash Price |
$6.75
|
| Rate for Payer: Cigna of CA HMO |
$9.60
|
| Rate for Payer: Cigna of CA PPO |
$11.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.95
|
| Rate for Payer: Dignity Health Media |
$5.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.83
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.16
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$5.30
|
| Rate for Payer: EPIC Health Plan Transplant |
$5.30
|
| Rate for Payer: Galaxy Health WC |
$12.75
|
| Rate for Payer: Global Benefits Group Commercial |
$9.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$11.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$8.69
|
| Rate for Payer: Heritage Provider Network Transplant |
$8.69
|
| Rate for Payer: IEHP Medi-Cal |
$8.59
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$8.59
|
| Rate for Payer: IEHP Medicare Advantage |
$5.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.70
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.68
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$7.10
|
| Rate for Payer: Multiplan Commercial |
$12.00
|
| Rate for Payer: Networks By Design Commercial |
$9.75
|
| Rate for Payer: Prime Health Services Commercial |
$12.75
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$9.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.29
|
| Rate for Payer: United Healthcare All Other HMO |
$4.29
|
| Rate for Payer: United Healthcare HMO Rider |
$4.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.29
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.83
|
| Rate for Payer: Vantage Medical Group Senior |
$5.30
|
|
|
HC AMIKACIN
|
Facility
OP
|
$50.00
|
|
|
Service Code
|
CPT 80150
|
| Hospital Charge Code |
900910405
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.00 |
| Max. Negotiated Rate |
$137.53 |
| Rate for Payer: Aetna of CA HMO/PPO |
$125.35
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$22.62
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$16.59
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$15.08
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$137.53
|
| Rate for Payer: BCBS Transplant Transplant |
$30.00
|
| Rate for Payer: Blue Shield of California Commercial |
$32.30
|
| Rate for Payer: Blue Shield of California EPN |
$25.60
|
| Rate for Payer: Cash Price |
$22.50
|
| Rate for Payer: Cash Price |
$22.50
|
| Rate for Payer: Cigna of CA HMO |
$32.00
|
| Rate for Payer: Cigna of CA PPO |
$37.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$22.62
|
| Rate for Payer: Dignity Health Media |
$15.08
|
| Rate for Payer: Dignity Health Medi-Cal |
$16.59
|
| Rate for Payer: EPIC Health Plan Commercial |
$20.36
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$15.08
|
| Rate for Payer: EPIC Health Plan Transplant |
$15.08
|
| Rate for Payer: Galaxy Health WC |
$42.50
|
| Rate for Payer: Global Benefits Group Commercial |
$30.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$37.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$24.73
|
| Rate for Payer: Heritage Provider Network Transplant |
$24.73
|
| Rate for Payer: IEHP Medi-Cal |
$24.43
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$24.43
|
| Rate for Payer: IEHP Medicare Advantage |
$15.08
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$33.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$25.46
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$19.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$20.21
|
| Rate for Payer: Multiplan Commercial |
$40.00
|
| Rate for Payer: Networks By Design Commercial |
$32.50
|
| Rate for Payer: Prime Health Services Commercial |
$42.50
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$30.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$30.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$30.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$12.21
|
| Rate for Payer: United Healthcare All Other HMO |
$12.21
|
| Rate for Payer: United Healthcare HMO Rider |
$12.21
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$12.21
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$22.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$16.59
|
| Rate for Payer: Vantage Medical Group Senior |
$15.08
|
|
|
HC AMMONIA
|
Facility
OP
|
$56.00
|
|
|
Service Code
|
CPT 82140
|
| Hospital Charge Code |
900910276
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.80 |
| Max. Negotiated Rate |
$132.98 |
| Rate for Payer: Aetna of CA HMO/PPO |
$121.18
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$21.86
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$16.03
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$14.57
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$132.98
|
| Rate for Payer: BCBS Transplant Transplant |
$33.60
|
| Rate for Payer: Blue Shield of California Commercial |
$36.18
|
| Rate for Payer: Blue Shield of California EPN |
$28.67
|
| Rate for Payer: Cash Price |
$25.20
|
| Rate for Payer: Cash Price |
$25.20
|
| Rate for Payer: Cigna of CA HMO |
$35.84
|
| Rate for Payer: Cigna of CA PPO |
$41.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21.86
|
| Rate for Payer: Dignity Health Media |
$14.57
|
| Rate for Payer: Dignity Health Medi-Cal |
$16.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.67
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$14.57
|
| Rate for Payer: EPIC Health Plan Transplant |
$14.57
|
| Rate for Payer: Galaxy Health WC |
$47.60
|
| Rate for Payer: Global Benefits Group Commercial |
$33.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$42.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$23.89
|
| Rate for Payer: Heritage Provider Network Transplant |
$23.89
|
| Rate for Payer: IEHP Medi-Cal |
$23.60
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$23.60
|
| Rate for Payer: IEHP Medicare Advantage |
$14.57
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$37.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$24.60
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18.36
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$19.52
|
| Rate for Payer: Multiplan Commercial |
$44.80
|
| Rate for Payer: Networks By Design Commercial |
$36.40
|
| Rate for Payer: Prime Health Services Commercial |
$47.60
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$33.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$33.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$33.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$11.80
|
| Rate for Payer: United Healthcare All Other HMO |
$11.80
|
| Rate for Payer: United Healthcare HMO Rider |
$11.80
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.80
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21.86
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$16.03
|
| Rate for Payer: Vantage Medical Group Senior |
$14.57
|
|
|
HC AMNIOCENTESIS DIAGNOSTIC
|
Facility
IP
|
$1,511.00
|
|
|
Service Code
|
CPT 59000
|
| Hospital Charge Code |
910400080
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$362.64 |
| Max. Negotiated Rate |
$1,284.35 |
| Rate for Payer: Cash Price |
$679.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$604.40
|
| Rate for Payer: Galaxy Health WC |
$1,284.35
|
| Rate for Payer: Global Benefits Group Commercial |
$906.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,007.84
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$575.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$362.64
|
| Rate for Payer: Multiplan Commercial |
$1,208.80
|
| Rate for Payer: Networks By Design Commercial |
$982.15
|
| Rate for Payer: Prime Health Services Commercial |
$1,284.35
|
|
|
HC AMNIOCENTESIS DIAGNOSTIC
|
Facility
OP
|
$1,511.00
|
|
|
Service Code
|
CPT 59000
|
| Hospital Charge Code |
910400080
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$108.79 |
| Max. Negotiated Rate |
$4,984.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,506.64
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1,104.87
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1,004.43
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,984.00
|
| Rate for Payer: BCBS Transplant Transplant |
$906.60
|
| Rate for Payer: Blue Shield of California Commercial |
$1,113.61
|
| Rate for Payer: Blue Shield of California EPN |
$882.42
|
| Rate for Payer: Cash Price |
$679.95
|
| Rate for Payer: Cash Price |
$679.95
|
| Rate for Payer: Cigna of CA HMO |
$967.04
|
| Rate for Payer: Cigna of CA PPO |
$1,118.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,506.64
|
| Rate for Payer: Dignity Health Media |
$1,004.43
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,104.87
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,355.98
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,004.43
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,004.43
|
| Rate for Payer: Galaxy Health WC |
$1,284.35
|
| Rate for Payer: Global Benefits Group Commercial |
$906.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,133.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,647.27
|
| Rate for Payer: Heritage Provider Network Transplant |
$1,647.27
|
| Rate for Payer: IEHP Medi-Cal |
$1,627.18
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$1,627.18
|
| Rate for Payer: IEHP Medicare Advantage |
$1,004.43
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,007.84
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$108.79
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,004.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$362.64
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,265.58
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,345.94
|
| Rate for Payer: Multiplan Commercial |
$1,208.80
|
| Rate for Payer: Networks By Design Commercial |
$982.15
|
| Rate for Payer: Prime Health Services Commercial |
$1,284.35
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$906.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$906.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$906.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$755.50
|
| Rate for Payer: United Healthcare All Other HMO |
$755.50
|
| Rate for Payer: United Healthcare HMO Rider |
$755.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$755.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,506.64
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,104.87
|
| Rate for Payer: Vantage Medical Group Senior |
$1,004.43
|
|
|
HC AMNIOCENTESIS DIAGNOSTIC ADDL FETUS
|
Facility
IP
|
$1,511.00
|
|
|
Service Code
|
CPT 59000
|
| Hospital Charge Code |
910400081
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$362.64 |
| Max. Negotiated Rate |
$1,284.35 |
| Rate for Payer: Cash Price |
$679.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$604.40
|
| Rate for Payer: Galaxy Health WC |
$1,284.35
|
| Rate for Payer: Global Benefits Group Commercial |
$906.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,007.84
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$575.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$362.64
|
| Rate for Payer: Multiplan Commercial |
$1,208.80
|
| Rate for Payer: Networks By Design Commercial |
$982.15
|
| Rate for Payer: Prime Health Services Commercial |
$1,284.35
|
|
|
HC AMNIOCENTESIS DIAGNOSTIC ADDL FETUS
|
Facility
OP
|
$1,511.00
|
|
|
Service Code
|
CPT 59000
|
| Hospital Charge Code |
910400081
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$108.79 |
| Max. Negotiated Rate |
$4,984.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,506.64
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1,104.87
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1,004.43
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,984.00
|
| Rate for Payer: BCBS Transplant Transplant |
$906.60
|
| Rate for Payer: Blue Shield of California Commercial |
$1,113.61
|
| Rate for Payer: Blue Shield of California EPN |
$882.42
|
| Rate for Payer: Cash Price |
$679.95
|
| Rate for Payer: Cash Price |
$679.95
|
| Rate for Payer: Cigna of CA HMO |
$967.04
|
| Rate for Payer: Cigna of CA PPO |
$1,118.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,506.64
|
| Rate for Payer: Dignity Health Media |
$1,004.43
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,104.87
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,355.98
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,004.43
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,004.43
|
| Rate for Payer: Galaxy Health WC |
$1,284.35
|
| Rate for Payer: Global Benefits Group Commercial |
$906.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,133.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,647.27
|
| Rate for Payer: Heritage Provider Network Transplant |
$1,647.27
|
| Rate for Payer: IEHP Medi-Cal |
$1,627.18
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$1,627.18
|
| Rate for Payer: IEHP Medicare Advantage |
$1,004.43
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,007.84
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$108.79
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,004.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$362.64
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,265.58
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,345.94
|
| Rate for Payer: Multiplan Commercial |
$1,208.80
|
| Rate for Payer: Networks By Design Commercial |
$982.15
|
| Rate for Payer: Prime Health Services Commercial |
$1,284.35
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$906.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$906.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$906.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$755.50
|
| Rate for Payer: United Healthcare All Other HMO |
$755.50
|
| Rate for Payer: United Healthcare HMO Rider |
$755.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$755.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,506.64
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,104.87
|
| Rate for Payer: Vantage Medical Group Senior |
$1,004.43
|
|
|
HC AMNIOCENTESIS THERAPEUTIC
|
Facility
OP
|
$3,381.00
|
|
|
Service Code
|
CPT 59001
|
| Hospital Charge Code |
910400082
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$288.23 |
| Max. Negotiated Rate |
$4,984.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$601.23
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$440.90
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$400.82
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,984.00
|
| Rate for Payer: BCBS Transplant Transplant |
$2,028.60
|
| Rate for Payer: Blue Shield of California Commercial |
$2,491.80
|
| Rate for Payer: Blue Shield of California EPN |
$1,974.50
|
| Rate for Payer: Cash Price |
$1,521.45
|
| Rate for Payer: Cash Price |
$1,521.45
|
| Rate for Payer: Cigna of CA HMO |
$2,163.84
|
| Rate for Payer: Cigna of CA PPO |
$2,501.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$601.23
|
| Rate for Payer: Dignity Health Media |
$400.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$440.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$541.11
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$400.82
|
| Rate for Payer: EPIC Health Plan Transplant |
$400.82
|
| Rate for Payer: Galaxy Health WC |
$2,873.85
|
| Rate for Payer: Global Benefits Group Commercial |
$2,028.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$2,535.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$657.34
|
| Rate for Payer: Heritage Provider Network Transplant |
$657.34
|
| Rate for Payer: IEHP Medi-Cal |
$649.33
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$649.33
|
| Rate for Payer: IEHP Medicare Advantage |
$400.82
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,255.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$288.23
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$400.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$811.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$505.03
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$537.10
|
| Rate for Payer: Multiplan Commercial |
$2,704.80
|
| Rate for Payer: Networks By Design Commercial |
$2,197.65
|
| Rate for Payer: Prime Health Services Commercial |
$2,873.85
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$2,028.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,028.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,028.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,690.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,690.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,690.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,690.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$601.23
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$440.90
|
| Rate for Payer: Vantage Medical Group Senior |
$400.82
|
|
|
HC AMNIOCENTESIS THERAPEUTIC
|
Facility
OP
|
$3,381.00
|
|
|
Service Code
|
CPT 59001
|
| Hospital Charge Code |
910400082
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$288.23 |
| Max. Negotiated Rate |
$4,984.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$601.23
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$440.90
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$400.82
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,984.00
|
| Rate for Payer: BCBS Transplant Transplant |
$2,028.60
|
| Rate for Payer: Blue Shield of California Commercial |
$2,491.80
|
| Rate for Payer: Blue Shield of California EPN |
$1,974.50
|
| Rate for Payer: Cash Price |
$1,521.45
|
| Rate for Payer: Cash Price |
$1,521.45
|
| Rate for Payer: Cash Price |
$1,521.45
|
| Rate for Payer: Cigna of CA HMO |
$2,163.84
|
| Rate for Payer: Cigna of CA PPO |
$2,501.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$601.23
|
| Rate for Payer: Dignity Health Media |
$400.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$440.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$541.11
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$400.82
|
| Rate for Payer: EPIC Health Plan Transplant |
$400.82
|
| Rate for Payer: Galaxy Health WC |
$2,873.85
|
| Rate for Payer: Global Benefits Group Commercial |
$2,028.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$2,535.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$657.34
|
| Rate for Payer: Heritage Provider Network Transplant |
$657.34
|
| Rate for Payer: IEHP Medi-Cal |
$649.33
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$649.33
|
| Rate for Payer: IEHP Medicare Advantage |
$400.82
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,255.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$288.23
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$400.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$811.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$505.03
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$537.10
|
| Rate for Payer: Multiplan Commercial |
$2,704.80
|
| Rate for Payer: Networks By Design Commercial |
$2,197.65
|
| Rate for Payer: Prime Health Services Commercial |
$2,873.85
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$2,028.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,028.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,028.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,036.00
|
| Rate for Payer: United Healthcare All Other HMO |
$799.00
|
| Rate for Payer: United Healthcare HMO Rider |
$605.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$552.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$601.23
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$440.90
|
| Rate for Payer: Vantage Medical Group Senior |
$400.82
|
|
|
HC AMNIOCENTESIS THERAPEUTIC
|
Facility
IP
|
$3,381.00
|
|
|
Service Code
|
CPT 59001
|
| Hospital Charge Code |
910400082
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$811.44 |
| Max. Negotiated Rate |
$2,873.85 |
| Rate for Payer: Cash Price |
$1,521.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,352.40
|
| Rate for Payer: Galaxy Health WC |
$2,873.85
|
| Rate for Payer: Global Benefits Group Commercial |
$2,028.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,255.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,288.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$811.44
|
| Rate for Payer: Multiplan Commercial |
$2,704.80
|
| Rate for Payer: Networks By Design Commercial |
$2,197.65
|
| Rate for Payer: Prime Health Services Commercial |
$2,873.85
|
|
|
HC AMNIOCENTESIS THERAPEUTIC
|
Facility
IP
|
$3,381.00
|
|
|
Service Code
|
CPT 59001
|
| Hospital Charge Code |
910400082
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$811.44 |
| Max. Negotiated Rate |
$2,873.85 |
| Rate for Payer: Cash Price |
$1,521.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,352.40
|
| Rate for Payer: Galaxy Health WC |
$2,873.85
|
| Rate for Payer: Global Benefits Group Commercial |
$2,028.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,255.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,288.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$811.44
|
| Rate for Payer: Multiplan Commercial |
$2,704.80
|
| Rate for Payer: Networks By Design Commercial |
$2,197.65
|
| Rate for Payer: Prime Health Services Commercial |
$2,873.85
|
|
|
HC AMNIOCENTESIS THERAPEUTIC ADDL FETUS
|
Facility
IP
|
$3,381.00
|
|
|
Service Code
|
CPT 59001
|
| Hospital Charge Code |
910400083
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$811.44 |
| Max. Negotiated Rate |
$2,873.85 |
| Rate for Payer: Cash Price |
$1,521.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,352.40
|
| Rate for Payer: Galaxy Health WC |
$2,873.85
|
| Rate for Payer: Global Benefits Group Commercial |
$2,028.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,255.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,288.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$811.44
|
| Rate for Payer: Multiplan Commercial |
$2,704.80
|
| Rate for Payer: Networks By Design Commercial |
$2,197.65
|
| Rate for Payer: Prime Health Services Commercial |
$2,873.85
|
|
|
HC AMNIOCENTESIS THERAPEUTIC ADDL FETUS
|
Facility
OP
|
$3,381.00
|
|
|
Service Code
|
CPT 59001
|
| Hospital Charge Code |
910400083
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$288.23 |
| Max. Negotiated Rate |
$4,984.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$601.23
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$440.90
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$400.82
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,984.00
|
| Rate for Payer: BCBS Transplant Transplant |
$2,028.60
|
| Rate for Payer: Blue Shield of California Commercial |
$2,491.80
|
| Rate for Payer: Blue Shield of California EPN |
$1,974.50
|
| Rate for Payer: Cash Price |
$1,521.45
|
| Rate for Payer: Cash Price |
$1,521.45
|
| Rate for Payer: Cigna of CA HMO |
$2,163.84
|
| Rate for Payer: Cigna of CA PPO |
$2,501.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$601.23
|
| Rate for Payer: Dignity Health Media |
$400.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$440.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$541.11
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$400.82
|
| Rate for Payer: EPIC Health Plan Transplant |
$400.82
|
| Rate for Payer: Galaxy Health WC |
$2,873.85
|
| Rate for Payer: Global Benefits Group Commercial |
$2,028.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$2,535.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$657.34
|
| Rate for Payer: Heritage Provider Network Transplant |
$657.34
|
| Rate for Payer: IEHP Medi-Cal |
$649.33
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$649.33
|
| Rate for Payer: IEHP Medicare Advantage |
$400.82
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,255.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$288.23
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$400.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$811.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$505.03
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$537.10
|
| Rate for Payer: Multiplan Commercial |
$2,704.80
|
| Rate for Payer: Networks By Design Commercial |
$2,197.65
|
| Rate for Payer: Prime Health Services Commercial |
$2,873.85
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$2,028.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,028.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,028.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,690.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,690.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,690.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,690.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$601.23
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$440.90
|
| Rate for Payer: Vantage Medical Group Senior |
$400.82
|
|
|
HC AMNIOTIC FLUID SCA
|
Facility
OP
|
$26.00
|
|
|
Service Code
|
CPT 82143
|
| Hospital Charge Code |
900910277
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.24 |
| Max. Negotiated Rate |
$62.71 |
| Rate for Payer: Aetna of CA HMO/PPO |
$57.15
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$14.02
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$10.28
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$9.35
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$62.71
|
| Rate for Payer: BCBS Transplant Transplant |
$15.60
|
| Rate for Payer: Blue Shield of California Commercial |
$16.80
|
| Rate for Payer: Blue Shield of California EPN |
$13.31
|
| Rate for Payer: Cash Price |
$11.70
|
| Rate for Payer: Cash Price |
$11.70
|
| Rate for Payer: Cigna of CA HMO |
$16.64
|
| Rate for Payer: Cigna of CA PPO |
$19.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$14.02
|
| Rate for Payer: Dignity Health Media |
$9.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$10.28
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.62
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$9.35
|
| Rate for Payer: EPIC Health Plan Transplant |
$9.35
|
| Rate for Payer: Galaxy Health WC |
$22.10
|
| Rate for Payer: Global Benefits Group Commercial |
$15.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$19.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$15.33
|
| Rate for Payer: Heritage Provider Network Transplant |
$15.33
|
| Rate for Payer: IEHP Medi-Cal |
$15.15
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$15.15
|
| Rate for Payer: IEHP Medicare Advantage |
$9.35
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11.78
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$12.53
|
| Rate for Payer: Multiplan Commercial |
$20.80
|
| Rate for Payer: Networks By Design Commercial |
$16.90
|
| Rate for Payer: Prime Health Services Commercial |
$22.10
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$15.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$15.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.58
|
| Rate for Payer: United Healthcare All Other HMO |
$7.58
|
| Rate for Payer: United Healthcare HMO Rider |
$7.58
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.58
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$14.02
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.28
|
| Rate for Payer: Vantage Medical Group Senior |
$9.35
|
|
|
HC AMP FING/THUMB PRI/SEC SING
|
Facility
IP
|
$11,187.00
|
|
|
Service Code
|
CPT 26951
|
| Hospital Charge Code |
900501081
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,684.88 |
| Max. Negotiated Rate |
$9,508.95 |
| Rate for Payer: Cash Price |
$5,034.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,474.80
|
| Rate for Payer: Galaxy Health WC |
$9,508.95
|
| Rate for Payer: Global Benefits Group Commercial |
$6,712.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,461.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,262.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,684.88
|
| Rate for Payer: Multiplan Commercial |
$8,949.60
|
| Rate for Payer: Networks By Design Commercial |
$7,271.55
|
| Rate for Payer: Prime Health Services Commercial |
$9,508.95
|
|
|
HC AMP FING/THUMB PRI/SEC SING
|
Facility
OP
|
$11,187.00
|
|
|
Service Code
|
CPT 26951
|
| Hospital Charge Code |
900501081
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$936.00 |
| Max. Negotiated Rate |
$9,508.95 |
| Rate for Payer: Aetna of CA HMO/PPO |
$7,385.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$6,066.32
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4,448.63
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$4,044.21
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,938.00
|
| Rate for Payer: BCBS Transplant Transplant |
$6,712.20
|
| Rate for Payer: Cash Price |
$5,034.15
|
| Rate for Payer: Cash Price |
$5,034.15
|
| Rate for Payer: Cash Price |
$5,034.15
|
| Rate for Payer: Cigna of CA PPO |
$8,278.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,066.32
|
| Rate for Payer: Dignity Health Media |
$4,044.21
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,448.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,459.68
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4,044.21
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,044.21
|
| Rate for Payer: Galaxy Health WC |
$9,508.95
|
| Rate for Payer: Global Benefits Group Commercial |
$6,712.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$8,390.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,632.50
|
| Rate for Payer: Heritage Provider Network Transplant |
$6,632.50
|
| Rate for Payer: IEHP Medi-Cal |
$936.00
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$4,044.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,461.73
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,044.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,684.88
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,095.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,419.24
|
| Rate for Payer: Multiplan Commercial |
$8,949.60
|
| Rate for Payer: Networks By Design Commercial |
$7,271.55
|
| Rate for Payer: Prime Health Services Commercial |
$9,508.95
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$6,712.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,712.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,593.50
|
| Rate for Payer: United Healthcare All Other HMO |
$5,593.50
|
| Rate for Payer: United Healthcare HMO Rider |
$5,593.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,593.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,066.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,448.63
|
| Rate for Payer: Vantage Medical Group Senior |
$4,044.21
|
|
