HC CORONARY THROMBECTOMY
|
Facility
OP
|
$8,187.00
|
|
Service Code
|
CPT 92973
|
Hospital Charge Code |
906812217
|
Hospital Revenue Code
|
481
|
Min. Negotiated Rate |
$278.75 |
Max. Negotiated Rate |
$8,241.00 |
Rate for Payer: Aetna of CA HMO/PPO |
$1,192.65
|
Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$6,958.95
|
Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4,502.85
|
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$4,502.85
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,241.00
|
Rate for Payer: BCBS Transplant Transplant |
$4,912.20
|
Rate for Payer: Blue Shield of California Commercial |
$6,668.88
|
Rate for Payer: Blue Shield of California EPN |
$4,340.48
|
Rate for Payer: Cash Price |
$3,684.15
|
Rate for Payer: Cash Price |
$3,684.15
|
Rate for Payer: Cash Price |
$3,684.15
|
Rate for Payer: Cigna of CA PPO |
$6,058.38
|
Rate for Payer: Dignity Health Commercial/Exchange |
$6,958.95
|
Rate for Payer: Dignity Health Media |
$6,958.95
|
Rate for Payer: Dignity Health Medi-Cal |
$6,958.95
|
Rate for Payer: EPIC Health Plan Commercial |
$3,274.80
|
Rate for Payer: EPIC Health Plan Transplant |
$3,274.80
|
Rate for Payer: Galaxy Health WC |
$6,958.95
|
Rate for Payer: Global Benefits Group Commercial |
$4,912.20
|
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$6,140.25
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,460.73
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$278.75
|
Rate for Payer: LLUH Dept of Risk Management WC |
$1,964.88
|
Rate for Payer: Multiplan Commercial |
$6,549.60
|
Rate for Payer: Networks By Design Commercial |
$5,321.55
|
Rate for Payer: Prime Health Services Commercial |
$6,958.95
|
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$4,912.20
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,912.20
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,912.20
|
Rate for Payer: United Healthcare All Other Commercial |
$1,834.00
|
Rate for Payer: United Healthcare All Other HMO |
$1,517.00
|
Rate for Payer: United Healthcare HMO Rider |
$1,041.00
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$951.00
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,958.95
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$6,958.95
|
Rate for Payer: Vantage Medical Group Senior |
$6,958.95
|
|
HC CORPORA CAVERNOSA-GLANS PENIS
|
Facility
IP
|
$9,009.00
|
|
Service Code
|
CPT 54435
|
Hospital Charge Code |
900501751
|
Hospital Revenue Code
|
450
|
Min. Negotiated Rate |
$2,162.16 |
Max. Negotiated Rate |
$7,657.65 |
Rate for Payer: Cash Price |
$4,054.05
|
Rate for Payer: EPIC Health Plan Commercial |
$3,603.60
|
Rate for Payer: Galaxy Health WC |
$7,657.65
|
Rate for Payer: Global Benefits Group Commercial |
$5,405.40
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,009.00
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,432.43
|
Rate for Payer: LLUH Dept of Risk Management WC |
$2,162.16
|
Rate for Payer: Multiplan Commercial |
$7,207.20
|
Rate for Payer: Networks By Design Commercial |
$5,855.85
|
Rate for Payer: Prime Health Services Commercial |
$7,657.65
|
|
HC CORPORA CAVERNOSA-GLANS PENIS
|
Facility
OP
|
$9,009.00
|
|
Service Code
|
CPT 54435
|
Hospital Charge Code |
900501751
|
Hospital Revenue Code
|
450
|
Min. Negotiated Rate |
$164.10 |
Max. Negotiated Rate |
$12,491.00 |
Rate for Payer: Aetna of CA HMO/PPO |
$12,491.00
|
Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$6,533.58
|
Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4,791.29
|
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$4,355.72
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,049.00
|
Rate for Payer: BCBS Transplant Transplant |
$5,405.40
|
Rate for Payer: Cash Price |
$4,054.05
|
Rate for Payer: Cash Price |
$4,054.05
|
Rate for Payer: Cash Price |
$4,054.05
|
Rate for Payer: Cigna of CA PPO |
$6,666.66
|
Rate for Payer: Dignity Health Commercial/Exchange |
$6,533.58
|
Rate for Payer: Dignity Health Media |
$4,355.72
|
Rate for Payer: Dignity Health Medi-Cal |
$4,791.29
|
Rate for Payer: EPIC Health Plan Commercial |
$5,880.22
|
Rate for Payer: EPIC Health Plan Medicare/Senior |
$4,355.72
|
Rate for Payer: EPIC Health Plan Transplant |
$4,355.72
|
Rate for Payer: Galaxy Health WC |
$7,657.65
|
Rate for Payer: Global Benefits Group Commercial |
$5,405.40
|
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$6,756.75
|
Rate for Payer: Heritage Provider Network Commercial |
$7,143.38
|
Rate for Payer: Heritage Provider Network Transplant |
$7,143.38
|
Rate for Payer: IEHP Medi-Cal |
$936.00
|
Rate for Payer: IEHP Medi-Cal Transplant |
$936.00
|
Rate for Payer: IEHP Medicare Advantage |
$4,355.72
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,009.00
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$164.10
|
Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,355.72
|
Rate for Payer: LLUH Dept of Risk Management WC |
$2,162.16
|
Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,488.21
|
Rate for Payer: Molina Healthcare of CA Medicare |
$5,836.66
|
Rate for Payer: Multiplan Commercial |
$7,207.20
|
Rate for Payer: Networks By Design Commercial |
$5,855.85
|
Rate for Payer: Prime Health Services Commercial |
$7,657.65
|
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$5,405.40
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,405.40
|
Rate for Payer: United Healthcare All Other Commercial |
$4,504.50
|
Rate for Payer: United Healthcare All Other HMO |
$4,504.50
|
Rate for Payer: United Healthcare HMO Rider |
$4,504.50
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$4,504.50
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,533.58
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$4,791.29
|
Rate for Payer: Vantage Medical Group Senior |
$4,355.72
|
|
HC CORPORA CAVERNOSOGRAPHY
|
Facility
IP
|
$808.00
|
|
Service Code
|
CPT 74445
|
Hospital Charge Code |
909080040
|
Hospital Revenue Code
|
320
|
Min. Negotiated Rate |
$193.92 |
Max. Negotiated Rate |
$686.80 |
Rate for Payer: Cash Price |
$363.60
|
Rate for Payer: EPIC Health Plan Commercial |
$323.20
|
Rate for Payer: Galaxy Health WC |
$686.80
|
Rate for Payer: Global Benefits Group Commercial |
$484.80
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$538.94
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$307.85
|
Rate for Payer: LLUH Dept of Risk Management WC |
$193.92
|
Rate for Payer: Multiplan Commercial |
$646.40
|
Rate for Payer: Networks By Design Commercial |
$525.20
|
Rate for Payer: Prime Health Services Commercial |
$686.80
|
|
HC CORPORA CAVERNOSOGRAPHY
|
Facility
OP
|
$808.00
|
|
Service Code
|
CPT 74445
|
Hospital Charge Code |
909080040
|
Hospital Revenue Code
|
320
|
Min. Negotiated Rate |
$98.63 |
Max. Negotiated Rate |
$1,120.07 |
Rate for Payer: Aetna of CA HMO/PPO |
$1,120.07
|
Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$206.04
|
Rate for Payer: AlphaCare Medical Group Medi-Cal |
$151.10
|
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$137.36
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$296.25
|
Rate for Payer: BCBS Transplant Transplant |
$484.80
|
Rate for Payer: Blue Shield of California Commercial |
$477.53
|
Rate for Payer: Blue Shield of California EPN |
$378.95
|
Rate for Payer: Cash Price |
$363.60
|
Rate for Payer: Cash Price |
$363.60
|
Rate for Payer: Cigna of CA HMO |
$517.12
|
Rate for Payer: Cigna of CA PPO |
$597.92
|
Rate for Payer: Dignity Health Commercial/Exchange |
$206.04
|
Rate for Payer: Dignity Health Media |
$137.36
|
Rate for Payer: Dignity Health Medi-Cal |
$151.10
|
Rate for Payer: EPIC Health Plan Commercial |
$185.44
|
Rate for Payer: EPIC Health Plan Medicare/Senior |
$137.36
|
Rate for Payer: EPIC Health Plan Transplant |
$137.36
|
Rate for Payer: Galaxy Health WC |
$686.80
|
Rate for Payer: Global Benefits Group Commercial |
$484.80
|
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$606.00
|
Rate for Payer: Heritage Provider Network Commercial |
$225.27
|
Rate for Payer: Heritage Provider Network Transplant |
$225.27
|
Rate for Payer: IEHP Medi-Cal |
$222.52
|
Rate for Payer: IEHP Medi-Cal Transplant |
$222.52
|
Rate for Payer: IEHP Medicare Advantage |
$137.36
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$538.94
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$98.63
|
Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$137.36
|
Rate for Payer: LLUH Dept of Risk Management WC |
$193.92
|
Rate for Payer: Molina Healthcare of CA Medi-Cal |
$173.07
|
Rate for Payer: Molina Healthcare of CA Medicare |
$184.06
|
Rate for Payer: Multiplan Commercial |
$646.40
|
Rate for Payer: Networks By Design Commercial |
$525.20
|
Rate for Payer: Prime Health Services Commercial |
$686.80
|
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$484.80
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$484.80
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$484.80
|
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 |
$206.04
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$151.10
|
Rate for Payer: Vantage Medical Group Senior |
$137.36
|
|
HC CORTISOL
|
Facility
OP
|
$54.00
|
|
Service Code
|
CPT 82533
|
Hospital Charge Code |
900912125
|
Hospital Revenue Code
|
301
|
Min. Negotiated Rate |
$12.96 |
Max. Negotiated Rate |
$148.89 |
Rate for Payer: Aetna of CA HMO/PPO |
$135.64
|
Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$24.45
|
Rate for Payer: AlphaCare Medical Group Medi-Cal |
$17.93
|
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$16.30
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$148.89
|
Rate for Payer: BCBS Transplant Transplant |
$32.40
|
Rate for Payer: Blue Shield of California Commercial |
$34.88
|
Rate for Payer: Blue Shield of California EPN |
$27.65
|
Rate for Payer: Cash Price |
$24.30
|
Rate for Payer: Cash Price |
$24.30
|
Rate for Payer: Cigna of CA HMO |
$34.56
|
Rate for Payer: Cigna of CA PPO |
$39.96
|
Rate for Payer: Dignity Health Commercial/Exchange |
$24.45
|
Rate for Payer: Dignity Health Media |
$16.30
|
Rate for Payer: Dignity Health Medi-Cal |
$17.93
|
Rate for Payer: EPIC Health Plan Commercial |
$22.00
|
Rate for Payer: EPIC Health Plan Medicare/Senior |
$16.30
|
Rate for Payer: EPIC Health Plan Transplant |
$16.30
|
Rate for Payer: Galaxy Health WC |
$45.90
|
Rate for Payer: Global Benefits Group Commercial |
$32.40
|
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$40.50
|
Rate for Payer: Heritage Provider Network Commercial |
$26.73
|
Rate for Payer: Heritage Provider Network Transplant |
$26.73
|
Rate for Payer: IEHP Medi-Cal |
$26.41
|
Rate for Payer: IEHP Medi-Cal Transplant |
$26.41
|
Rate for Payer: IEHP Medicare Advantage |
$16.30
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$36.02
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$27.53
|
Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16.30
|
Rate for Payer: LLUH Dept of Risk Management WC |
$12.96
|
Rate for Payer: Molina Healthcare of CA Medi-Cal |
$20.54
|
Rate for Payer: Molina Healthcare of CA Medicare |
$21.84
|
Rate for Payer: Multiplan Commercial |
$43.20
|
Rate for Payer: Networks By Design Commercial |
$35.10
|
Rate for Payer: Prime Health Services Commercial |
$45.90
|
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$32.40
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$32.40
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$32.40
|
Rate for Payer: United Healthcare All Other Commercial |
$13.20
|
Rate for Payer: United Healthcare All Other HMO |
$13.20
|
Rate for Payer: United Healthcare HMO Rider |
$13.20
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$13.20
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$24.45
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$17.93
|
Rate for Payer: Vantage Medical Group Senior |
$16.30
|
|
HC COVID19 CONVALESCENT PLASMA
|
Facility
IP
|
$862.00
|
|
Service Code
|
CPT C9507
|
Hospital Charge Code |
900909507
|
Hospital Revenue Code
|
390
|
Min. Negotiated Rate |
$206.88 |
Max. Negotiated Rate |
$732.70 |
Rate for Payer: Cash Price |
$387.90
|
Rate for Payer: EPIC Health Plan Commercial |
$344.80
|
Rate for Payer: Galaxy Health WC |
$732.70
|
Rate for Payer: Global Benefits Group Commercial |
$517.20
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$574.95
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$328.42
|
Rate for Payer: LLUH Dept of Risk Management WC |
$206.88
|
Rate for Payer: Multiplan Commercial |
$689.60
|
Rate for Payer: Networks By Design Commercial |
$560.30
|
Rate for Payer: Prime Health Services Commercial |
$732.70
|
|
HC COVID19 CONVALESCENT PLASMA
|
Facility
OP
|
$862.00
|
|
Service Code
|
CPT C9507
|
Hospital Charge Code |
900909507
|
Hospital Revenue Code
|
390
|
Min. Negotiated Rate |
$206.88 |
Max. Negotiated Rate |
$5,217.63 |
Rate for Payer: Aetna of CA HMO/PPO |
$5,217.63
|
Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$964.10
|
Rate for Payer: AlphaCare Medical Group Medi-Cal |
$707.00
|
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$642.73
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$513.58
|
Rate for Payer: BCBS Transplant Transplant |
$517.20
|
Rate for Payer: Blue Shield of California Commercial |
$635.29
|
Rate for Payer: Blue Shield of California EPN |
$503.41
|
Rate for Payer: Cash Price |
$387.90
|
Rate for Payer: Cash Price |
$387.90
|
Rate for Payer: Cash Price |
$387.90
|
Rate for Payer: Cigna of CA HMO |
$551.68
|
Rate for Payer: Cigna of CA PPO |
$637.88
|
Rate for Payer: Dignity Health Commercial/Exchange |
$964.10
|
Rate for Payer: Dignity Health Media |
$642.73
|
Rate for Payer: Dignity Health Medi-Cal |
$707.00
|
Rate for Payer: EPIC Health Plan Commercial |
$867.69
|
Rate for Payer: EPIC Health Plan Medicare/Senior |
$642.73
|
Rate for Payer: EPIC Health Plan Transplant |
$642.73
|
Rate for Payer: Galaxy Health WC |
$732.70
|
Rate for Payer: Global Benefits Group Commercial |
$517.20
|
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$646.50
|
Rate for Payer: Heritage Provider Network Commercial |
$1,054.08
|
Rate for Payer: Heritage Provider Network Transplant |
$1,054.08
|
Rate for Payer: IEHP Medi-Cal |
$1,041.22
|
Rate for Payer: IEHP Medi-Cal Transplant |
$1,041.22
|
Rate for Payer: IEHP Medicare Advantage |
$642.73
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$574.95
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,434.42
|
Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$642.73
|
Rate for Payer: LLUH Dept of Risk Management WC |
$206.88
|
Rate for Payer: Molina Healthcare of CA Medi-Cal |
$809.84
|
Rate for Payer: Molina Healthcare of CA Medicare |
$861.26
|
Rate for Payer: Multiplan Commercial |
$689.60
|
Rate for Payer: Networks By Design Commercial |
$560.30
|
Rate for Payer: Prime Health Services Commercial |
$732.70
|
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$517.20
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$517.20
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$517.20
|
Rate for Payer: United Healthcare All Other Commercial |
$431.00
|
Rate for Payer: United Healthcare All Other HMO |
$631.00
|
Rate for Payer: United Healthcare HMO Rider |
$630.00
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$575.00
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$964.10
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$707.00
|
Rate for Payer: Vantage Medical Group Senior |
$642.73
|
|
HC COVID 19 IGM IGG
|
Facility
OP
|
$67.00
|
|
Service Code
|
CPT 86318
|
Hospital Charge Code |
900912259
|
Hospital Revenue Code
|
309
|
Min. Negotiated Rate |
$14.65 |
Max. Negotiated Rate |
$118.12 |
Rate for Payer: Aetna of CA HMO/PPO |
$107.69
|
Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$27.14
|
Rate for Payer: AlphaCare Medical Group Medi-Cal |
$19.90
|
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$18.09
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$118.12
|
Rate for Payer: BCBS Transplant Transplant |
$40.20
|
Rate for Payer: Blue Shield of California Commercial |
$43.28
|
Rate for Payer: Blue Shield of California EPN |
$34.30
|
Rate for Payer: Cash Price |
$30.15
|
Rate for Payer: Cash Price |
$30.15
|
Rate for Payer: Cigna of CA HMO |
$42.88
|
Rate for Payer: Cigna of CA PPO |
$49.58
|
Rate for Payer: Dignity Health Commercial/Exchange |
$27.14
|
Rate for Payer: Dignity Health Media |
$18.09
|
Rate for Payer: Dignity Health Medi-Cal |
$19.90
|
Rate for Payer: EPIC Health Plan Commercial |
$24.42
|
Rate for Payer: EPIC Health Plan Medicare/Senior |
$18.09
|
Rate for Payer: EPIC Health Plan Transplant |
$18.09
|
Rate for Payer: Galaxy Health WC |
$56.95
|
Rate for Payer: Global Benefits Group Commercial |
$40.20
|
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$50.25
|
Rate for Payer: Heritage Provider Network Commercial |
$29.67
|
Rate for Payer: Heritage Provider Network Transplant |
$29.67
|
Rate for Payer: IEHP Medi-Cal |
$29.31
|
Rate for Payer: IEHP Medi-Cal Transplant |
$29.31
|
Rate for Payer: IEHP Medicare Advantage |
$18.09
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$44.69
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$26.79
|
Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18.09
|
Rate for Payer: LLUH Dept of Risk Management WC |
$16.08
|
Rate for Payer: Molina Healthcare of CA Medi-Cal |
$22.79
|
Rate for Payer: Molina Healthcare of CA Medicare |
$24.24
|
Rate for Payer: Multiplan Commercial |
$53.60
|
Rate for Payer: Networks By Design Commercial |
$43.55
|
Rate for Payer: Prime Health Services Commercial |
$56.95
|
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$40.20
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$40.20
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$40.20
|
Rate for Payer: United Healthcare All Other Commercial |
$14.65
|
Rate for Payer: United Healthcare All Other HMO |
$14.65
|
Rate for Payer: United Healthcare HMO Rider |
$14.65
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$14.65
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$27.14
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$19.90
|
Rate for Payer: Vantage Medical Group Senior |
$18.09
|
|
HC CPAP/BIPAP/NIPPV - DAILY
|
Facility
OP
|
$5,035.00
|
|
Service Code
|
CPT 94660
|
Hospital Charge Code |
900800110
|
Hospital Revenue Code
|
410
|
Min. Negotiated Rate |
$77.52 |
Max. Negotiated Rate |
$4,279.75 |
Rate for Payer: Aetna of CA HMO/PPO |
$237.00
|
Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$399.74
|
Rate for Payer: AlphaCare Medical Group Medi-Cal |
$293.14
|
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$266.49
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$421.00
|
Rate for Payer: BCBS Transplant Transplant |
$3,021.00
|
Rate for Payer: Blue Shield of California Commercial |
$407.00
|
Rate for Payer: Blue Shield of California EPN |
$293.00
|
Rate for Payer: Cash Price |
$2,265.75
|
Rate for Payer: Cash Price |
$2,265.75
|
Rate for Payer: Cash Price |
$2,265.75
|
Rate for Payer: Cash Price |
$2,265.75
|
Rate for Payer: Cigna of CA HMO |
$3,222.40
|
Rate for Payer: Cigna of CA PPO |
$3,725.90
|
Rate for Payer: Dignity Health Commercial/Exchange |
$399.74
|
Rate for Payer: Dignity Health Media |
$266.49
|
Rate for Payer: Dignity Health Medi-Cal |
$293.14
|
Rate for Payer: EPIC Health Plan Commercial |
$359.76
|
Rate for Payer: EPIC Health Plan Medicare/Senior |
$266.49
|
Rate for Payer: EPIC Health Plan Transplant |
$266.49
|
Rate for Payer: Galaxy Health WC |
$4,279.75
|
Rate for Payer: Global Benefits Group Commercial |
$3,021.00
|
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$3,776.25
|
Rate for Payer: Heritage Provider Network Commercial |
$437.04
|
Rate for Payer: Heritage Provider Network Transplant |
$437.04
|
Rate for Payer: IEHP Medi-Cal |
$431.71
|
Rate for Payer: IEHP Medi-Cal Transplant |
$431.71
|
Rate for Payer: IEHP Medicare Advantage |
$266.49
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,358.34
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$77.52
|
Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$266.49
|
Rate for Payer: LLUH Dept of Risk Management WC |
$1,208.40
|
Rate for Payer: Molina Healthcare of CA Medi-Cal |
$335.78
|
Rate for Payer: Molina Healthcare of CA Medicare |
$357.10
|
Rate for Payer: Multiplan Commercial |
$4,028.00
|
Rate for Payer: Networks By Design Commercial |
$3,272.75
|
Rate for Payer: Prime Health Services Commercial |
$4,279.75
|
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$3,021.00
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,021.00
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,021.00
|
Rate for Payer: United Healthcare All Other Commercial |
$509.00
|
Rate for Payer: United Healthcare All Other HMO |
$478.00
|
Rate for Payer: United Healthcare HMO Rider |
$428.00
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$391.00
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$399.74
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$293.14
|
Rate for Payer: Vantage Medical Group Senior |
$266.49
|
|
HC CPAP/BIPAP/NIPPV - DAILY
|
Facility
IP
|
$5,035.00
|
|
Service Code
|
CPT 94660
|
Hospital Charge Code |
900800110
|
Hospital Revenue Code
|
410
|
Min. Negotiated Rate |
$1,208.40 |
Max. Negotiated Rate |
$4,279.75 |
Rate for Payer: Cash Price |
$2,265.75
|
Rate for Payer: EPIC Health Plan Commercial |
$2,014.00
|
Rate for Payer: Galaxy Health WC |
$4,279.75
|
Rate for Payer: Global Benefits Group Commercial |
$3,021.00
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,358.34
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,918.34
|
Rate for Payer: LLUH Dept of Risk Management WC |
$1,208.40
|
Rate for Payer: Multiplan Commercial |
$4,028.00
|
Rate for Payer: Networks By Design Commercial |
$3,272.75
|
Rate for Payer: Prime Health Services Commercial |
$4,279.75
|
|
HC C-REACTIVE PROTEIN
|
Facility
OP
|
$18.00
|
|
Service Code
|
CPT 86140
|
Hospital Charge Code |
900910887
|
Hospital Revenue Code
|
302
|
Min. Negotiated Rate |
$4.19 |
Max. Negotiated Rate |
$47.17 |
Rate for Payer: Aetna of CA HMO/PPO |
$43.03
|
Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$7.77
|
Rate for Payer: AlphaCare Medical Group Medi-Cal |
$5.70
|
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$5.18
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$47.17
|
Rate for Payer: BCBS Transplant Transplant |
$10.80
|
Rate for Payer: Blue Shield of California Commercial |
$11.63
|
Rate for Payer: Blue Shield of California EPN |
$9.22
|
Rate for Payer: Cash Price |
$8.10
|
Rate for Payer: Cash Price |
$8.10
|
Rate for Payer: Cigna of CA HMO |
$11.52
|
Rate for Payer: Cigna of CA PPO |
$13.32
|
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 |
$15.30
|
Rate for Payer: Global Benefits Group Commercial |
$10.80
|
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$13.50
|
Rate for Payer: Heritage Provider Network Commercial |
$8.50
|
Rate for Payer: Heritage Provider Network Transplant |
$8.50
|
Rate for Payer: IEHP Medi-Cal |
$8.39
|
Rate for Payer: IEHP Medi-Cal Transplant |
$8.39
|
Rate for Payer: IEHP Medicare Advantage |
$5.18
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12.01
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.74
|
Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.18
|
Rate for Payer: LLUH Dept of Risk Management WC |
$4.32
|
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 |
$14.40
|
Rate for Payer: Networks By Design Commercial |
$11.70
|
Rate for Payer: Prime Health Services Commercial |
$15.30
|
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$10.80
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10.80
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$10.80
|
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 C-REACTIVE PROTEIN HI SENSITIVITY
|
Facility
OP
|
$36.00
|
|
Service Code
|
CPT 86141
|
Hospital Charge Code |
900912102
|
Hospital Revenue Code
|
302
|
Min. Negotiated Rate |
$8.64 |
Max. Negotiated Rate |
$118.06 |
Rate for Payer: Aetna of CA HMO/PPO |
$107.69
|
Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$19.42
|
Rate for Payer: AlphaCare Medical Group Medi-Cal |
$14.24
|
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$12.95
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$118.06
|
Rate for Payer: BCBS Transplant 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 |
$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 |
$30.60
|
Rate for Payer: Global Benefits Group Commercial |
$21.60
|
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$27.00
|
Rate for Payer: Heritage Provider Network Commercial |
$21.24
|
Rate for Payer: Heritage Provider Network Transplant |
$21.24
|
Rate for Payer: IEHP Medi-Cal |
$20.98
|
Rate for Payer: IEHP Medi-Cal Transplant |
$20.98
|
Rate for Payer: IEHP Medicare Advantage |
$12.95
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$24.01
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$21.01
|
Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12.95
|
Rate for Payer: LLUH Dept of Risk Management WC |
$8.64
|
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 |
$28.80
|
Rate for Payer: Networks By Design Commercial |
$23.40
|
Rate for Payer: Prime Health Services Commercial |
$30.60
|
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$21.60
|
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 |
$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 CREATINE KINASE
|
Facility
OP
|
$24.00
|
|
Service Code
|
CPT 82550
|
Hospital Charge Code |
900910222
|
Hospital Revenue Code
|
301
|
Min. Negotiated Rate |
$5.27 |
Max. Negotiated Rate |
$59.83 |
Rate for Payer: Aetna of CA HMO/PPO |
$54.16
|
Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$9.76
|
Rate for Payer: AlphaCare Medical Group Medi-Cal |
$7.16
|
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$6.51
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$59.83
|
Rate for Payer: BCBS Transplant Transplant |
$14.40
|
Rate for Payer: Blue Shield of California Commercial |
$15.50
|
Rate for Payer: Blue Shield of California EPN |
$12.29
|
Rate for Payer: Cash Price |
$10.80
|
Rate for Payer: Cash Price |
$10.80
|
Rate for Payer: Cigna of CA HMO |
$15.36
|
Rate for Payer: Cigna of CA PPO |
$17.76
|
Rate for Payer: Dignity Health Commercial/Exchange |
$9.76
|
Rate for Payer: Dignity Health Media |
$6.51
|
Rate for Payer: Dignity Health Medi-Cal |
$7.16
|
Rate for Payer: EPIC Health Plan Commercial |
$8.79
|
Rate for Payer: EPIC Health Plan Medicare/Senior |
$6.51
|
Rate for Payer: EPIC Health Plan Transplant |
$6.51
|
Rate for Payer: Galaxy Health WC |
$20.40
|
Rate for Payer: Global Benefits Group Commercial |
$14.40
|
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$18.00
|
Rate for Payer: Heritage Provider Network Commercial |
$10.68
|
Rate for Payer: Heritage Provider Network Transplant |
$10.68
|
Rate for Payer: IEHP Medi-Cal |
$10.55
|
Rate for Payer: IEHP Medi-Cal Transplant |
$10.55
|
Rate for Payer: IEHP Medicare Advantage |
$6.51
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16.01
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.00
|
Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6.51
|
Rate for Payer: LLUH Dept of Risk Management WC |
$5.76
|
Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8.20
|
Rate for Payer: Molina Healthcare of CA Medicare |
$8.72
|
Rate for Payer: Multiplan Commercial |
$19.20
|
Rate for Payer: Networks By Design Commercial |
$15.60
|
Rate for Payer: Prime Health Services Commercial |
$20.40
|
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$14.40
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$14.40
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$14.40
|
Rate for Payer: United Healthcare All Other Commercial |
$5.27
|
Rate for Payer: United Healthcare All Other HMO |
$5.27
|
Rate for Payer: United Healthcare HMO Rider |
$5.27
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$5.27
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$9.76
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$7.16
|
Rate for Payer: Vantage Medical Group Senior |
$6.51
|
|
HC CREATININE
|
Facility
OP
|
$15.00
|
|
Service Code
|
CPT 82565
|
Hospital Charge Code |
900910247
|
Hospital Revenue Code
|
301
|
Min. Negotiated Rate |
$3.60 |
Max. Negotiated Rate |
$46.68 |
Rate for Payer: Aetna of CA HMO/PPO |
$42.69
|
Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$7.68
|
Rate for Payer: AlphaCare Medical Group Medi-Cal |
$5.63
|
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$5.12
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$46.68
|
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 |
$7.68
|
Rate for Payer: Dignity Health Media |
$5.12
|
Rate for Payer: Dignity Health Medi-Cal |
$5.63
|
Rate for Payer: EPIC Health Plan Commercial |
$6.91
|
Rate for Payer: EPIC Health Plan Medicare/Senior |
$5.12
|
Rate for Payer: EPIC Health Plan Transplant |
$5.12
|
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 |
$8.40
|
Rate for Payer: Heritage Provider Network Transplant |
$8.40
|
Rate for Payer: IEHP Medi-Cal |
$8.29
|
Rate for Payer: IEHP Medi-Cal Transplant |
$8.29
|
Rate for Payer: IEHP Medicare Advantage |
$5.12
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.00
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.19
|
Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.12
|
Rate for Payer: LLUH Dept of Risk Management WC |
$3.60
|
Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.45
|
Rate for Payer: Molina Healthcare of CA Medicare |
$6.86
|
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 |
$4.15
|
Rate for Payer: United Healthcare All Other HMO |
$4.15
|
Rate for Payer: United Healthcare HMO Rider |
$4.15
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$4.15
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.68
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$5.63
|
Rate for Payer: Vantage Medical Group Senior |
$5.12
|
|
HC CREATININE BODY FLUID
|
Facility
OP
|
$15.00
|
|
Service Code
|
CPT 82570
|
Hospital Charge Code |
900910377
|
Hospital Revenue Code
|
301
|
Min. Negotiated Rate |
$3.60 |
Max. Negotiated Rate |
$47.17 |
Rate for Payer: Aetna of CA HMO/PPO |
$43.03
|
Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$7.77
|
Rate for Payer: AlphaCare Medical Group Medi-Cal |
$5.70
|
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$5.18
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$47.17
|
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 |
$7.77
|
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 |
$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 |
$8.50
|
Rate for Payer: Heritage Provider Network Transplant |
$8.50
|
Rate for Payer: IEHP Medi-Cal |
$8.39
|
Rate for Payer: IEHP Medi-Cal Transplant |
$8.39
|
Rate for Payer: IEHP Medicare Advantage |
$5.18
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.00
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.74
|
Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.18
|
Rate for Payer: LLUH Dept of Risk Management WC |
$3.60
|
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 |
$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 |
$4.19
|
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 CREATININE CLEARAN
|
Facility
OP
|
$36.00
|
|
Service Code
|
CPT 82575
|
Hospital Charge Code |
900910260
|
Hospital Revenue Code
|
301
|
Min. Negotiated Rate |
$7.66 |
Max. Negotiated Rate |
$86.06 |
Rate for Payer: Aetna of CA HMO/PPO |
$78.63
|
Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$14.19
|
Rate for Payer: AlphaCare Medical Group Medi-Cal |
$10.41
|
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$9.46
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$86.06
|
Rate for Payer: BCBS Transplant 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 |
$14.19
|
Rate for Payer: Dignity Health Media |
$9.46
|
Rate for Payer: Dignity Health Medi-Cal |
$10.41
|
Rate for Payer: EPIC Health Plan Commercial |
$12.77
|
Rate for Payer: EPIC Health Plan Medicare/Senior |
$9.46
|
Rate for Payer: EPIC Health Plan Transplant |
$9.46
|
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 Transplant Other |
$27.00
|
Rate for Payer: Heritage Provider Network Commercial |
$15.51
|
Rate for Payer: Heritage Provider Network Transplant |
$15.51
|
Rate for Payer: IEHP Medi-Cal |
$15.33
|
Rate for Payer: IEHP Medi-Cal Transplant |
$15.33
|
Rate for Payer: IEHP Medicare Advantage |
$9.46
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$24.01
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$15.96
|
Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.46
|
Rate for Payer: LLUH Dept of Risk Management WC |
$8.64
|
Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11.92
|
Rate for Payer: Molina Healthcare of CA Medicare |
$12.68
|
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: Redlands Yucaipa Medical Group Commercial/Senior |
$21.60
|
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 |
$7.66
|
Rate for Payer: United Healthcare All Other HMO |
$7.66
|
Rate for Payer: United Healthcare HMO Rider |
$7.66
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$7.66
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$14.19
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$10.41
|
Rate for Payer: Vantage Medical Group Senior |
$9.46
|
|
HC CREATININE INDIVIDUAL
|
Facility
OP
|
$15.00
|
|
Service Code
|
CPT 82565
|
Hospital Charge Code |
900910493
|
Hospital Revenue Code
|
301
|
Min. Negotiated Rate |
$3.60 |
Max. Negotiated Rate |
$46.68 |
Rate for Payer: Aetna of CA HMO/PPO |
$42.69
|
Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$7.68
|
Rate for Payer: AlphaCare Medical Group Medi-Cal |
$5.63
|
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$5.12
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$46.68
|
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 |
$7.68
|
Rate for Payer: Dignity Health Media |
$5.12
|
Rate for Payer: Dignity Health Medi-Cal |
$5.63
|
Rate for Payer: EPIC Health Plan Commercial |
$6.91
|
Rate for Payer: EPIC Health Plan Medicare/Senior |
$5.12
|
Rate for Payer: EPIC Health Plan Transplant |
$5.12
|
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 |
$8.40
|
Rate for Payer: Heritage Provider Network Transplant |
$8.40
|
Rate for Payer: IEHP Medi-Cal |
$8.29
|
Rate for Payer: IEHP Medi-Cal Transplant |
$8.29
|
Rate for Payer: IEHP Medicare Advantage |
$5.12
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.00
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.19
|
Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.12
|
Rate for Payer: LLUH Dept of Risk Management WC |
$3.60
|
Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.45
|
Rate for Payer: Molina Healthcare of CA Medicare |
$6.86
|
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 |
$4.15
|
Rate for Payer: United Healthcare All Other HMO |
$4.15
|
Rate for Payer: United Healthcare HMO Rider |
$4.15
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$4.15
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.68
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$5.63
|
Rate for Payer: Vantage Medical Group Senior |
$5.12
|
|
HC CRITICAL CARE ADDL 30 MIN
|
Facility
IP
|
$6,354.00
|
|
Service Code
|
CPT 99292
|
Hospital Charge Code |
900501641
|
Hospital Revenue Code
|
450
|
Min. Negotiated Rate |
$1,524.96 |
Max. Negotiated Rate |
$5,400.90 |
Rate for Payer: Cash Price |
$2,859.30
|
Rate for Payer: EPIC Health Plan Commercial |
$2,541.60
|
Rate for Payer: Galaxy Health WC |
$5,400.90
|
Rate for Payer: Global Benefits Group Commercial |
$3,812.40
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,238.12
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,420.87
|
Rate for Payer: LLUH Dept of Risk Management WC |
$1,524.96
|
Rate for Payer: Multiplan Commercial |
$5,083.20
|
Rate for Payer: Networks By Design Commercial |
$4,130.10
|
Rate for Payer: Prime Health Services Commercial |
$5,400.90
|
|
HC CRITICAL CARE ADDL 30 MIN
|
Facility
OP
|
$6,354.00
|
|
Service Code
|
CPT 99292
|
Hospital Charge Code |
900501641
|
Hospital Revenue Code
|
450
|
Min. Negotiated Rate |
$111.91 |
Max. Negotiated Rate |
$5,400.90 |
Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$5,400.90
|
Rate for Payer: AlphaCare Medical Group Medi-Cal |
$3,494.70
|
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$3,494.70
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,299.00
|
Rate for Payer: BCBS Transplant Transplant |
$3,812.40
|
Rate for Payer: Cash Price |
$2,859.30
|
Rate for Payer: Cash Price |
$2,859.30
|
Rate for Payer: Cash Price |
$2,859.30
|
Rate for Payer: Cigna of CA PPO |
$4,701.96
|
Rate for Payer: Dignity Health Commercial/Exchange |
$5,400.90
|
Rate for Payer: Dignity Health Media |
$5,400.90
|
Rate for Payer: Dignity Health Medi-Cal |
$5,400.90
|
Rate for Payer: EPIC Health Plan Commercial |
$2,541.60
|
Rate for Payer: EPIC Health Plan Transplant |
$2,541.60
|
Rate for Payer: Galaxy Health WC |
$5,400.90
|
Rate for Payer: Global Benefits Group Commercial |
$3,812.40
|
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$4,765.50
|
Rate for Payer: IEHP Medi-Cal |
$936.00
|
Rate for Payer: IEHP Medi-Cal Transplant |
$936.00
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,238.12
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$111.91
|
Rate for Payer: LLUH Dept of Risk Management WC |
$1,524.96
|
Rate for Payer: Multiplan Commercial |
$5,083.20
|
Rate for Payer: Networks By Design Commercial |
$4,130.10
|
Rate for Payer: Prime Health Services Commercial |
$5,400.90
|
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$3,812.40
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,812.40
|
Rate for Payer: United Healthcare All Other Commercial |
$3,177.00
|
Rate for Payer: United Healthcare All Other HMO |
$3,177.00
|
Rate for Payer: United Healthcare HMO Rider |
$3,177.00
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$3,177.00
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,400.90
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$5,400.90
|
Rate for Payer: Vantage Medical Group Senior |
$5,400.90
|
|
HC CRITICAL CARE E&M 30-74 MIN
|
Facility
IP
|
$12,719.00
|
|
Service Code
|
CPT 99291
|
Hospital Charge Code |
900509291
|
Hospital Revenue Code
|
450
|
Min. Negotiated Rate |
$3,052.56 |
Max. Negotiated Rate |
$10,811.15 |
Rate for Payer: Cash Price |
$5,723.55
|
Rate for Payer: EPIC Health Plan Commercial |
$5,087.60
|
Rate for Payer: Galaxy Health WC |
$10,811.15
|
Rate for Payer: Global Benefits Group Commercial |
$7,631.40
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,483.57
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,845.94
|
Rate for Payer: LLUH Dept of Risk Management WC |
$3,052.56
|
Rate for Payer: Multiplan Commercial |
$10,175.20
|
Rate for Payer: Networks By Design Commercial |
$8,267.35
|
Rate for Payer: Prime Health Services Commercial |
$10,811.15
|
|
HC CRITICAL CARE E&M 30-74 MIN
|
Facility
OP
|
$12,719.00
|
|
Service Code
|
CPT 99291
|
Hospital Charge Code |
900509291
|
Hospital Revenue Code
|
450
|
Min. Negotiated Rate |
$231.04 |
Max. Negotiated Rate |
$10,811.15 |
Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,663.06
|
Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1,219.58
|
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1,108.71
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,299.00
|
Rate for Payer: BCBS Transplant Transplant |
$7,631.40
|
Rate for Payer: Cash Price |
$5,723.55
|
Rate for Payer: Cash Price |
$5,723.55
|
Rate for Payer: Cash Price |
$5,723.55
|
Rate for Payer: Cigna of CA PPO |
$9,412.06
|
Rate for Payer: Dignity Health Commercial/Exchange |
$1,663.06
|
Rate for Payer: Dignity Health Media |
$1,108.71
|
Rate for Payer: Dignity Health Medi-Cal |
$1,219.58
|
Rate for Payer: EPIC Health Plan Commercial |
$1,496.76
|
Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,108.71
|
Rate for Payer: EPIC Health Plan Transplant |
$1,108.71
|
Rate for Payer: Galaxy Health WC |
$10,811.15
|
Rate for Payer: Global Benefits Group Commercial |
$7,631.40
|
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$9,539.25
|
Rate for Payer: Heritage Provider Network Commercial |
$1,818.28
|
Rate for Payer: Heritage Provider Network Transplant |
$1,818.28
|
Rate for Payer: IEHP Medi-Cal |
$936.00
|
Rate for Payer: IEHP Medi-Cal Transplant |
$936.00
|
Rate for Payer: IEHP Medicare Advantage |
$1,108.71
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,483.57
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$231.04
|
Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,108.71
|
Rate for Payer: LLUH Dept of Risk Management WC |
$3,052.56
|
Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,396.97
|
Rate for Payer: Molina Healthcare of CA Medicare |
$1,485.67
|
Rate for Payer: Multiplan Commercial |
$10,175.20
|
Rate for Payer: Networks By Design Commercial |
$8,267.35
|
Rate for Payer: Prime Health Services Commercial |
$10,811.15
|
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$7,631.40
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,631.40
|
Rate for Payer: United Healthcare All Other Commercial |
$7,631.00
|
Rate for Payer: United Healthcare All Other HMO |
$7,690.00
|
Rate for Payer: United Healthcare HMO Rider |
$7,039.00
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$6,435.00
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,663.06
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$1,219.58
|
Rate for Payer: Vantage Medical Group Senior |
$1,108.71
|
|
HC CRPRA CVRNSA-CRPS SPNGSM SHNT, UNI OR BI
|
Facility
OP
|
$9,452.00
|
|
Service Code
|
CPT 54430
|
Hospital Charge Code |
900504430
|
Hospital Revenue Code
|
450
|
Min. Negotiated Rate |
$929.48 |
Max. Negotiated Rate |
$8,034.20 |
Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$8,034.20
|
Rate for Payer: AlphaCare Medical Group Medi-Cal |
$5,198.60
|
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$5,198.60
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,938.00
|
Rate for Payer: BCBS Transplant Transplant |
$5,671.20
|
Rate for Payer: Cash Price |
$4,253.40
|
Rate for Payer: Cash Price |
$4,253.40
|
Rate for Payer: Cash Price |
$4,253.40
|
Rate for Payer: Cigna of CA PPO |
$6,994.48
|
Rate for Payer: Dignity Health Commercial/Exchange |
$8,034.20
|
Rate for Payer: Dignity Health Media |
$8,034.20
|
Rate for Payer: Dignity Health Medi-Cal |
$8,034.20
|
Rate for Payer: EPIC Health Plan Commercial |
$3,780.80
|
Rate for Payer: EPIC Health Plan Transplant |
$3,780.80
|
Rate for Payer: Galaxy Health WC |
$8,034.20
|
Rate for Payer: Global Benefits Group Commercial |
$5,671.20
|
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$7,089.00
|
Rate for Payer: IEHP Medi-Cal |
$936.00
|
Rate for Payer: IEHP Medi-Cal Transplant |
$936.00
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,304.48
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$929.48
|
Rate for Payer: LLUH Dept of Risk Management WC |
$2,268.48
|
Rate for Payer: Multiplan Commercial |
$7,561.60
|
Rate for Payer: Networks By Design Commercial |
$6,143.80
|
Rate for Payer: Prime Health Services Commercial |
$8,034.20
|
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$5,671.20
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,671.20
|
Rate for Payer: United Healthcare All Other Commercial |
$4,726.00
|
Rate for Payer: United Healthcare All Other HMO |
$4,726.00
|
Rate for Payer: United Healthcare HMO Rider |
$4,726.00
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$4,726.00
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$8,034.20
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$8,034.20
|
Rate for Payer: Vantage Medical Group Senior |
$8,034.20
|
|
HC CRPRA CVRNSA-CRPS SPNGSM SHNT, UNI OR BI
|
Facility
IP
|
$9,452.00
|
|
Service Code
|
CPT 54430
|
Hospital Charge Code |
900504430
|
Hospital Revenue Code
|
450
|
Min. Negotiated Rate |
$2,268.48 |
Max. Negotiated Rate |
$8,034.20 |
Rate for Payer: Cash Price |
$4,253.40
|
Rate for Payer: EPIC Health Plan Commercial |
$3,780.80
|
Rate for Payer: Galaxy Health WC |
$8,034.20
|
Rate for Payer: Global Benefits Group Commercial |
$5,671.20
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,304.48
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,601.21
|
Rate for Payer: LLUH Dept of Risk Management WC |
$2,268.48
|
Rate for Payer: Multiplan Commercial |
$7,561.60
|
Rate for Payer: Networks By Design Commercial |
$6,143.80
|
Rate for Payer: Prime Health Services Commercial |
$8,034.20
|
|
HC CRYABLATION BONE
|
Facility
OP
|
$19,181.00
|
|
Service Code
|
CPT 20999
|
Hospital Charge Code |
909020151
|
Hospital Revenue Code
|
361
|
Min. Negotiated Rate |
$294.64 |
Max. Negotiated Rate |
$16,303.85 |
Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$441.96
|
Rate for Payer: AlphaCare Medical Group Medi-Cal |
$324.10
|
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$294.64
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,428.04
|
Rate for Payer: BCBS Transplant Transplant |
$11,508.60
|
Rate for Payer: Blue Shield of California Commercial |
$4,128.35
|
Rate for Payer: Blue Shield of California EPN |
$2,686.96
|
Rate for Payer: Cash Price |
$8,631.45
|
Rate for Payer: Cash Price |
$8,631.45
|
Rate for Payer: Cigna of CA PPO |
$14,193.94
|
Rate for Payer: Dignity Health Commercial/Exchange |
$441.96
|
Rate for Payer: Dignity Health Media |
$294.64
|
Rate for Payer: Dignity Health Medi-Cal |
$324.10
|
Rate for Payer: EPIC Health Plan Commercial |
$397.76
|
Rate for Payer: EPIC Health Plan Medicare/Senior |
$294.64
|
Rate for Payer: EPIC Health Plan Transplant |
$294.64
|
Rate for Payer: Galaxy Health WC |
$16,303.85
|
Rate for Payer: Global Benefits Group Commercial |
$11,508.60
|
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$14,385.75
|
Rate for Payer: Heritage Provider Network Commercial |
$483.21
|
Rate for Payer: Heritage Provider Network Transplant |
$483.21
|
Rate for Payer: IEHP Medi-Cal |
$477.32
|
Rate for Payer: IEHP Medi-Cal Transplant |
$477.32
|
Rate for Payer: IEHP Medicare Advantage |
$294.64
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12,793.73
|
Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$294.64
|
Rate for Payer: LLUH Dept of Risk Management WC |
$4,603.44
|
Rate for Payer: Molina Healthcare of CA Medi-Cal |
$371.25
|
Rate for Payer: Molina Healthcare of CA Medicare |
$394.82
|
Rate for Payer: Multiplan Commercial |
$15,344.80
|
Rate for Payer: Networks By Design Commercial |
$12,467.65
|
Rate for Payer: Prime Health Services Commercial |
$16,303.85
|
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$11,508.60
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$11,508.60
|
Rate for Payer: United Healthcare All Other Commercial |
$1,834.00
|
Rate for Payer: United Healthcare All Other HMO |
$1,517.00
|
Rate for Payer: United Healthcare HMO Rider |
$1,041.00
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$951.00
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$441.96
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$324.10
|
Rate for Payer: Vantage Medical Group Senior |
$294.64
|
|