|
HC CHROM AMNIO 6-12 COLN 1 KARYO
|
Facility
|
IP
|
$181.00
|
|
|
Service Code
|
CPT 88269
|
| Hospital Charge Code |
910408269
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$36.20 |
| Max. Negotiated Rate |
$153.85 |
| Rate for Payer: Adventist Health Commercial |
$36.20
|
| Rate for Payer: Cash Price |
$81.45
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$126.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$72.40
|
| Rate for Payer: EPIC Health Plan Senior |
$72.40
|
| Rate for Payer: Galaxy Health WC |
$153.85
|
| Rate for Payer: Global Benefits Group Commercial |
$108.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$114.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$106.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$43.44
|
| Rate for Payer: Multiplan Commercial |
$144.80
|
| Rate for Payer: Networks By Design Commercial |
$117.65
|
| Rate for Payer: Prime Health Services Commercial |
$153.85
|
|
|
HC CHROM ANALYSIS ADDL KARYO
|
Facility
|
IP
|
$181.00
|
|
|
Service Code
|
CPT 88280
|
| Hospital Charge Code |
910408280
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$36.20 |
| Max. Negotiated Rate |
$153.85 |
| Rate for Payer: Adventist Health Commercial |
$36.20
|
| Rate for Payer: Cash Price |
$81.45
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$126.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$72.40
|
| Rate for Payer: EPIC Health Plan Senior |
$72.40
|
| Rate for Payer: Galaxy Health WC |
$153.85
|
| Rate for Payer: Global Benefits Group Commercial |
$108.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$114.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$106.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$43.44
|
| Rate for Payer: Multiplan Commercial |
$144.80
|
| Rate for Payer: Networks By Design Commercial |
$117.65
|
| Rate for Payer: Prime Health Services Commercial |
$153.85
|
|
|
HC CHROM ANALYSIS ADDL KARYO
|
Facility
|
OP
|
$181.00
|
|
|
Service Code
|
CPT 88280
|
| Hospital Charge Code |
910408280
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$27.11 |
| Max. Negotiated Rate |
$259.05 |
| Rate for Payer: Adventist Health Commercial |
$36.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$208.71
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$50.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$36.82
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$33.47
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$259.05
|
| Rate for Payer: Blue Shield of California Commercial |
$126.16
|
| Rate for Payer: Blue Shield of California Commercial |
$83.44
|
| Rate for Payer: Cash Price |
$81.45
|
| Rate for Payer: Cash Price |
$81.45
|
| Rate for Payer: Cigna of CA HMO |
$115.84
|
| Rate for Payer: Cigna of CA PPO |
$133.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$50.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$36.82
|
| Rate for Payer: Dignity Health Medicare Advantage |
$33.47
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$126.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$55.23
|
| Rate for Payer: EPIC Health Plan Senior |
$36.82
|
| Rate for Payer: Galaxy Health WC |
$153.85
|
| Rate for Payer: Global Benefits Group Commercial |
$108.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$54.89
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$32.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$33.47
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$114.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$36.42
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$46.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$43.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$42.17
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$44.85
|
| Rate for Payer: Multiplan Commercial |
$144.80
|
| Rate for Payer: Networks By Design Commercial |
$117.65
|
| Rate for Payer: Prime Health Services Commercial |
$153.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$108.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$108.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$27.11
|
| Rate for Payer: United Healthcare All Other HMO |
$27.11
|
| Rate for Payer: United Healthcare HMO Rider |
$27.11
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$27.11
|
| Rate for Payer: Upland Medical Group Pediatric |
$33.47
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$50.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$36.82
|
| Rate for Payer: Vantage Medical Group Senior |
$33.47
|
|
|
HC CHROM ANALYSIS AMNIO/CVS
|
Facility
|
OP
|
$301.00
|
|
|
Service Code
|
CPT 88267
|
| Hospital Charge Code |
910408267
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$60.20 |
| Max. Negotiated Rate |
$1,855.50 |
| Rate for Payer: Adventist Health Commercial |
$60.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,494.93
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$282.86
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$207.43
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$188.57
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,855.50
|
| Rate for Payer: Blue Shield of California Commercial |
$138.76
|
| Rate for Payer: Blue Shield of California Commercial |
$209.80
|
| Rate for Payer: Cash Price |
$135.45
|
| Rate for Payer: Cash Price |
$135.45
|
| Rate for Payer: Cigna of CA HMO |
$192.64
|
| Rate for Payer: Cigna of CA PPO |
$222.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$282.86
|
| Rate for Payer: Dignity Health Medi-Cal |
$207.43
|
| Rate for Payer: Dignity Health Medicare Advantage |
$188.57
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$210.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$311.14
|
| Rate for Payer: EPIC Health Plan Senior |
$207.43
|
| Rate for Payer: Galaxy Health WC |
$255.85
|
| Rate for Payer: Global Benefits Group Commercial |
$180.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$309.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$268.46
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$188.57
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$191.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$303.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$264.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$72.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$237.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$252.68
|
| Rate for Payer: Multiplan Commercial |
$240.80
|
| Rate for Payer: Networks By Design Commercial |
$195.65
|
| Rate for Payer: Prime Health Services Commercial |
$255.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$180.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$180.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$152.74
|
| Rate for Payer: United Healthcare All Other HMO |
$152.74
|
| Rate for Payer: United Healthcare HMO Rider |
$152.74
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$152.74
|
| Rate for Payer: Upland Medical Group Pediatric |
$188.57
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$282.86
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$207.43
|
| Rate for Payer: Vantage Medical Group Senior |
$188.57
|
|
|
HC CHROM ANALYSIS AMNIO/CVS
|
Facility
|
IP
|
$301.00
|
|
|
Service Code
|
CPT 88267
|
| Hospital Charge Code |
910408267
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$60.20 |
| Max. Negotiated Rate |
$255.85 |
| Rate for Payer: Adventist Health Commercial |
$60.20
|
| Rate for Payer: Cash Price |
$135.45
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$210.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$120.40
|
| Rate for Payer: EPIC Health Plan Senior |
$120.40
|
| Rate for Payer: Galaxy Health WC |
$255.85
|
| Rate for Payer: Global Benefits Group Commercial |
$180.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$191.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$177.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$72.24
|
| Rate for Payer: Multiplan Commercial |
$240.80
|
| Rate for Payer: Networks By Design Commercial |
$195.65
|
| Rate for Payer: Prime Health Services Commercial |
$255.85
|
|
|
HC CHROM ANLZ 15-20 CELLS 2 KARYO
|
Facility
|
IP
|
$564.00
|
|
|
Service Code
|
CPT 88262
|
| Hospital Charge Code |
900918020
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$112.80 |
| Max. Negotiated Rate |
$479.40 |
| Rate for Payer: Adventist Health Commercial |
$112.80
|
| Rate for Payer: Cash Price |
$253.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$394.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$225.60
|
| Rate for Payer: EPIC Health Plan Senior |
$225.60
|
| Rate for Payer: Galaxy Health WC |
$479.40
|
| Rate for Payer: Global Benefits Group Commercial |
$338.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$358.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$332.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$135.36
|
| Rate for Payer: Multiplan Commercial |
$451.20
|
| Rate for Payer: Networks By Design Commercial |
$366.60
|
| Rate for Payer: Prime Health Services Commercial |
$479.40
|
|
|
HC CHROM ANLZ 15-20 CELLS 2 KARYO
|
Facility
|
OP
|
$400.00
|
|
|
Service Code
|
CPT 88262
|
| Hospital Charge Code |
900918020
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$80.00 |
| Max. Negotiated Rate |
$1,286.45 |
| Rate for Payer: Adventist Health Commercial |
$80.00
|
| Rate for Payer: Adventist Health Commercial |
$112.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,036.50
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,036.50
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$188.24
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$188.24
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$138.04
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$138.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$125.49
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$125.49
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,286.45
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,286.45
|
| Rate for Payer: Blue Shield of California Commercial |
$260.00
|
| Rate for Payer: Blue Shield of California Commercial |
$184.40
|
| Rate for Payer: Blue Shield of California Commercial |
$393.11
|
| Rate for Payer: Blue Shield of California Commercial |
$278.80
|
| Rate for Payer: Cash Price |
$253.80
|
| Rate for Payer: Cash Price |
$253.80
|
| Rate for Payer: Cash Price |
$180.00
|
| Rate for Payer: Cash Price |
$180.00
|
| Rate for Payer: Cigna of CA HMO |
$360.96
|
| Rate for Payer: Cigna of CA HMO |
$256.00
|
| Rate for Payer: Cigna of CA PPO |
$296.00
|
| Rate for Payer: Cigna of CA PPO |
$417.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$188.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$188.24
|
| Rate for Payer: Dignity Health Medi-Cal |
$138.04
|
| Rate for Payer: Dignity Health Medi-Cal |
$138.04
|
| Rate for Payer: Dignity Health Medicare Advantage |
$125.49
|
| Rate for Payer: Dignity Health Medicare Advantage |
$125.49
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$280.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$394.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$207.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$207.06
|
| Rate for Payer: EPIC Health Plan Senior |
$138.04
|
| Rate for Payer: EPIC Health Plan Senior |
$138.04
|
| Rate for Payer: Galaxy Health WC |
$340.00
|
| Rate for Payer: Galaxy Health WC |
$479.40
|
| Rate for Payer: Global Benefits Group Commercial |
$240.00
|
| Rate for Payer: Global Benefits Group Commercial |
$338.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$205.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$205.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$181.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$181.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$125.49
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$125.49
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$254.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$358.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$204.84
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$204.84
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$175.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$175.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$96.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$135.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$158.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$158.12
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$168.16
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$168.16
|
| Rate for Payer: Multiplan Commercial |
$451.20
|
| Rate for Payer: Multiplan Commercial |
$320.00
|
| Rate for Payer: Networks By Design Commercial |
$366.60
|
| Rate for Payer: Networks By Design Commercial |
$260.00
|
| Rate for Payer: Prime Health Services Commercial |
$340.00
|
| Rate for Payer: Prime Health Services Commercial |
$479.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$240.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$338.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$240.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$338.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$101.65
|
| Rate for Payer: United Healthcare All Other Commercial |
$101.65
|
| Rate for Payer: United Healthcare All Other HMO |
$101.65
|
| Rate for Payer: United Healthcare All Other HMO |
$101.65
|
| Rate for Payer: United Healthcare HMO Rider |
$101.65
|
| Rate for Payer: United Healthcare HMO Rider |
$101.65
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$101.65
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$101.65
|
| Rate for Payer: Upland Medical Group Pediatric |
$125.49
|
| Rate for Payer: Upland Medical Group Pediatric |
$125.49
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$188.24
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$188.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$138.04
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$138.04
|
| Rate for Payer: Vantage Medical Group Senior |
$125.49
|
| Rate for Payer: Vantage Medical Group Senior |
$125.49
|
|
|
HC CHROM ANLZ 20-25 CELLS
|
Facility
|
OP
|
$400.00
|
|
|
Service Code
|
CPT 88264
|
| Hospital Charge Code |
900918016
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$80.00 |
| Max. Negotiated Rate |
$1,280.75 |
| Rate for Payer: Adventist Health Commercial |
$80.00
|
| Rate for Payer: Adventist Health Commercial |
$112.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,036.50
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,036.50
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$216.91
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$216.91
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$159.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$159.07
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$144.61
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$144.61
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,280.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,280.75
|
| Rate for Payer: Blue Shield of California Commercial |
$260.00
|
| Rate for Payer: Blue Shield of California Commercial |
$184.40
|
| Rate for Payer: Blue Shield of California Commercial |
$393.11
|
| Rate for Payer: Blue Shield of California Commercial |
$278.80
|
| Rate for Payer: Cash Price |
$253.80
|
| Rate for Payer: Cash Price |
$253.80
|
| Rate for Payer: Cash Price |
$180.00
|
| Rate for Payer: Cash Price |
$180.00
|
| Rate for Payer: Cigna of CA HMO |
$360.96
|
| Rate for Payer: Cigna of CA HMO |
$256.00
|
| Rate for Payer: Cigna of CA PPO |
$296.00
|
| Rate for Payer: Cigna of CA PPO |
$417.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$216.91
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$216.91
|
| Rate for Payer: Dignity Health Medi-Cal |
$159.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$159.07
|
| Rate for Payer: Dignity Health Medicare Advantage |
$144.61
|
| Rate for Payer: Dignity Health Medicare Advantage |
$144.61
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$280.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$394.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$238.61
|
| Rate for Payer: EPIC Health Plan Commercial |
$238.61
|
| Rate for Payer: EPIC Health Plan Senior |
$159.07
|
| Rate for Payer: EPIC Health Plan Senior |
$159.07
|
| Rate for Payer: Galaxy Health WC |
$340.00
|
| Rate for Payer: Galaxy Health WC |
$479.40
|
| Rate for Payer: Global Benefits Group Commercial |
$240.00
|
| Rate for Payer: Global Benefits Group Commercial |
$338.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$237.16
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$237.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$194.34
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$194.34
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$144.61
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$144.61
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$254.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$358.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$219.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$219.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$202.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$202.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$96.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$135.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$182.21
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$182.21
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$193.78
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$193.78
|
| Rate for Payer: Multiplan Commercial |
$451.20
|
| Rate for Payer: Multiplan Commercial |
$320.00
|
| Rate for Payer: Networks By Design Commercial |
$366.60
|
| Rate for Payer: Networks By Design Commercial |
$260.00
|
| Rate for Payer: Prime Health Services Commercial |
$340.00
|
| Rate for Payer: Prime Health Services Commercial |
$479.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$240.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$338.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$240.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$338.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$117.14
|
| Rate for Payer: United Healthcare All Other Commercial |
$117.14
|
| Rate for Payer: United Healthcare All Other HMO |
$117.14
|
| Rate for Payer: United Healthcare All Other HMO |
$117.14
|
| Rate for Payer: United Healthcare HMO Rider |
$117.14
|
| Rate for Payer: United Healthcare HMO Rider |
$117.14
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$117.14
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$117.14
|
| Rate for Payer: Upland Medical Group Pediatric |
$144.61
|
| Rate for Payer: Upland Medical Group Pediatric |
$144.61
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$216.91
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$216.91
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$159.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$159.07
|
| Rate for Payer: Vantage Medical Group Senior |
$144.61
|
| Rate for Payer: Vantage Medical Group Senior |
$144.61
|
|
|
HC CHROM ANLZ 20-25 CELLS
|
Facility
|
IP
|
$564.00
|
|
|
Service Code
|
CPT 88264
|
| Hospital Charge Code |
900918016
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$112.80 |
| Max. Negotiated Rate |
$479.40 |
| Rate for Payer: Adventist Health Commercial |
$112.80
|
| Rate for Payer: Cash Price |
$253.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$394.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$225.60
|
| Rate for Payer: EPIC Health Plan Senior |
$225.60
|
| Rate for Payer: Galaxy Health WC |
$479.40
|
| Rate for Payer: Global Benefits Group Commercial |
$338.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$358.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$332.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$135.36
|
| Rate for Payer: Multiplan Commercial |
$451.20
|
| Rate for Payer: Networks By Design Commercial |
$366.60
|
| Rate for Payer: Prime Health Services Commercial |
$479.40
|
|
|
HC CHROM ANLZ 45 CEL MSAIC 2 KRYO
|
Facility
|
OP
|
$208.00
|
|
|
Service Code
|
CPT 88263
|
| Hospital Charge Code |
900918017
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$41.60 |
| Max. Negotiated Rate |
$1,500.82 |
| Rate for Payer: Adventist Health Commercial |
$41.60
|
| Rate for Payer: Adventist Health Commercial |
$58.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$863.95
|
| Rate for Payer: Aetna of CA HMO/PPO |
$863.95
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$225.44
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$225.44
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$165.32
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$165.32
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$150.29
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$150.29
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,500.82
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,500.82
|
| Rate for Payer: Blue Shield of California Commercial |
$134.15
|
| Rate for Payer: Blue Shield of California Commercial |
$144.98
|
| Rate for Payer: Blue Shield of California Commercial |
$202.83
|
| Rate for Payer: Blue Shield of California Commercial |
$95.89
|
| Rate for Payer: Cash Price |
$130.95
|
| Rate for Payer: Cash Price |
$130.95
|
| Rate for Payer: Cash Price |
$93.60
|
| Rate for Payer: Cash Price |
$93.60
|
| Rate for Payer: Cigna of CA HMO |
$186.24
|
| Rate for Payer: Cigna of CA HMO |
$133.12
|
| Rate for Payer: Cigna of CA PPO |
$153.92
|
| Rate for Payer: Cigna of CA PPO |
$215.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$225.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$225.44
|
| Rate for Payer: Dignity Health Medi-Cal |
$165.32
|
| Rate for Payer: Dignity Health Medi-Cal |
$165.32
|
| Rate for Payer: Dignity Health Medicare Advantage |
$150.29
|
| Rate for Payer: Dignity Health Medicare Advantage |
$150.29
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$145.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$203.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$247.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$247.98
|
| Rate for Payer: EPIC Health Plan Senior |
$165.32
|
| Rate for Payer: EPIC Health Plan Senior |
$165.32
|
| Rate for Payer: Galaxy Health WC |
$176.80
|
| Rate for Payer: Galaxy Health WC |
$247.35
|
| Rate for Payer: Global Benefits Group Commercial |
$124.80
|
| Rate for Payer: Global Benefits Group Commercial |
$174.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$246.48
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$246.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$224.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$224.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$150.29
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$150.29
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$132.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$184.78
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$253.82
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$253.82
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$210.41
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$210.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$49.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$69.84
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$189.37
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$189.37
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$201.39
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$201.39
|
| Rate for Payer: Multiplan Commercial |
$232.80
|
| Rate for Payer: Multiplan Commercial |
$166.40
|
| Rate for Payer: Networks By Design Commercial |
$189.15
|
| Rate for Payer: Networks By Design Commercial |
$135.20
|
| Rate for Payer: Prime Health Services Commercial |
$176.80
|
| Rate for Payer: Prime Health Services Commercial |
$247.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$124.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$174.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$124.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$174.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$121.73
|
| Rate for Payer: United Healthcare All Other Commercial |
$121.73
|
| Rate for Payer: United Healthcare All Other HMO |
$121.73
|
| Rate for Payer: United Healthcare All Other HMO |
$121.73
|
| Rate for Payer: United Healthcare HMO Rider |
$121.73
|
| Rate for Payer: United Healthcare HMO Rider |
$121.73
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$121.73
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$121.73
|
| Rate for Payer: Upland Medical Group Pediatric |
$150.29
|
| Rate for Payer: Upland Medical Group Pediatric |
$150.29
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$225.44
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$225.44
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$165.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$165.32
|
| Rate for Payer: Vantage Medical Group Senior |
$150.29
|
| Rate for Payer: Vantage Medical Group Senior |
$150.29
|
|
|
HC CHROM ANLZ 45 CEL MSAIC 2 KRYO
|
Facility
|
IP
|
$291.00
|
|
|
Service Code
|
CPT 88263
|
| Hospital Charge Code |
900918017
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$58.20 |
| Max. Negotiated Rate |
$247.35 |
| Rate for Payer: Adventist Health Commercial |
$58.20
|
| Rate for Payer: Cash Price |
$130.95
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$203.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$116.40
|
| Rate for Payer: EPIC Health Plan Senior |
$116.40
|
| Rate for Payer: Galaxy Health WC |
$247.35
|
| Rate for Payer: Global Benefits Group Commercial |
$174.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$184.78
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$171.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$69.84
|
| Rate for Payer: Multiplan Commercial |
$232.80
|
| Rate for Payer: Networks By Design Commercial |
$189.15
|
| Rate for Payer: Prime Health Services Commercial |
$247.35
|
|
|
HC CHROM ANLZ 5 CELLS 1 KARYO
|
Facility
|
OP
|
$291.00
|
|
|
Service Code
|
CPT 88261
|
| Hospital Charge Code |
900918019
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$58.20 |
| Max. Negotiated Rate |
$1,548.56 |
| Rate for Payer: Adventist Health Commercial |
$58.20
|
| Rate for Payer: Adventist Health Commercial |
$80.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,469.70
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,469.70
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$396.51
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$396.51
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$290.77
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$290.77
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$264.34
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$264.34
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,548.56
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,548.56
|
| Rate for Payer: Blue Shield of California Commercial |
$185.78
|
| Rate for Payer: Blue Shield of California Commercial |
$134.15
|
| Rate for Payer: Blue Shield of California Commercial |
$280.89
|
| Rate for Payer: Blue Shield of California Commercial |
$202.83
|
| Rate for Payer: Cash Price |
$181.35
|
| Rate for Payer: Cash Price |
$181.35
|
| Rate for Payer: Cash Price |
$130.95
|
| Rate for Payer: Cash Price |
$130.95
|
| Rate for Payer: Cigna of CA HMO |
$257.92
|
| Rate for Payer: Cigna of CA HMO |
$186.24
|
| Rate for Payer: Cigna of CA PPO |
$215.34
|
| Rate for Payer: Cigna of CA PPO |
$298.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$396.51
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$396.51
|
| Rate for Payer: Dignity Health Medi-Cal |
$290.77
|
| Rate for Payer: Dignity Health Medi-Cal |
$290.77
|
| Rate for Payer: Dignity Health Medicare Advantage |
$264.34
|
| Rate for Payer: Dignity Health Medicare Advantage |
$264.34
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$203.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$282.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$436.16
|
| Rate for Payer: EPIC Health Plan Commercial |
$436.16
|
| Rate for Payer: EPIC Health Plan Senior |
$290.77
|
| Rate for Payer: EPIC Health Plan Senior |
$290.77
|
| Rate for Payer: Galaxy Health WC |
$247.35
|
| Rate for Payer: Galaxy Health WC |
$342.55
|
| Rate for Payer: Global Benefits Group Commercial |
$174.60
|
| Rate for Payer: Global Benefits Group Commercial |
$241.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$433.52
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$433.52
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$319.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$319.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$264.34
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$264.34
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$184.78
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$255.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$361.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$361.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$370.08
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$370.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$69.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$96.72
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$333.07
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$333.07
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$354.22
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$354.22
|
| Rate for Payer: Multiplan Commercial |
$322.40
|
| Rate for Payer: Multiplan Commercial |
$232.80
|
| Rate for Payer: Networks By Design Commercial |
$261.95
|
| Rate for Payer: Networks By Design Commercial |
$189.15
|
| Rate for Payer: Prime Health Services Commercial |
$247.35
|
| Rate for Payer: Prime Health Services Commercial |
$342.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$174.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$241.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$174.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$241.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$214.12
|
| Rate for Payer: United Healthcare All Other Commercial |
$214.12
|
| Rate for Payer: United Healthcare All Other HMO |
$214.12
|
| Rate for Payer: United Healthcare All Other HMO |
$214.12
|
| Rate for Payer: United Healthcare HMO Rider |
$214.12
|
| Rate for Payer: United Healthcare HMO Rider |
$214.12
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$214.12
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$214.12
|
| Rate for Payer: Upland Medical Group Pediatric |
$264.34
|
| Rate for Payer: Upland Medical Group Pediatric |
$264.34
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$396.51
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$396.51
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$290.77
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$290.77
|
| Rate for Payer: Vantage Medical Group Senior |
$264.34
|
| Rate for Payer: Vantage Medical Group Senior |
$264.34
|
|
|
HC CHROM ANLZ 5 CELLS 1 KARYO
|
Facility
|
IP
|
$403.00
|
|
|
Service Code
|
CPT 88261
|
| Hospital Charge Code |
900918019
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$80.60 |
| Max. Negotiated Rate |
$342.55 |
| Rate for Payer: Adventist Health Commercial |
$80.60
|
| Rate for Payer: Cash Price |
$181.35
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$282.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$161.20
|
| Rate for Payer: EPIC Health Plan Senior |
$161.20
|
| Rate for Payer: Galaxy Health WC |
$342.55
|
| Rate for Payer: Global Benefits Group Commercial |
$241.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$255.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$237.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$96.72
|
| Rate for Payer: Multiplan Commercial |
$322.40
|
| Rate for Payer: Networks By Design Commercial |
$261.95
|
| Rate for Payer: Prime Health Services Commercial |
$342.55
|
|
|
HC CHROM ANLZ ADDL KARYO
|
Facility
|
IP
|
$57.00
|
|
|
Service Code
|
CPT 88280
|
| Hospital Charge Code |
900918018
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$11.40 |
| Max. Negotiated Rate |
$48.45 |
| Rate for Payer: Adventist Health Commercial |
$11.40
|
| Rate for Payer: Cash Price |
$25.65
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$39.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$22.80
|
| Rate for Payer: EPIC Health Plan Senior |
$22.80
|
| Rate for Payer: Galaxy Health WC |
$48.45
|
| Rate for Payer: Global Benefits Group Commercial |
$34.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$36.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$33.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.68
|
| Rate for Payer: Multiplan Commercial |
$45.60
|
| Rate for Payer: Networks By Design Commercial |
$37.05
|
| Rate for Payer: Prime Health Services Commercial |
$48.45
|
|
|
HC CHROM ANLZ ADDL KARYO
|
Facility
|
OP
|
$42.00
|
|
|
Service Code
|
CPT 88280
|
| Hospital Charge Code |
900918018
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$8.40 |
| Max. Negotiated Rate |
$259.05 |
| Rate for Payer: Adventist Health Commercial |
$8.40
|
| Rate for Payer: Adventist Health Commercial |
$11.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$208.71
|
| Rate for Payer: Aetna of CA HMO/PPO |
$208.71
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$50.20
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$50.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$36.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$36.82
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$33.47
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$33.47
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$259.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$259.05
|
| Rate for Payer: Blue Shield of California Commercial |
$26.28
|
| Rate for Payer: Blue Shield of California Commercial |
$19.36
|
| Rate for Payer: Blue Shield of California Commercial |
$39.73
|
| Rate for Payer: Blue Shield of California Commercial |
$29.27
|
| Rate for Payer: Cash Price |
$25.65
|
| Rate for Payer: Cash Price |
$25.65
|
| Rate for Payer: Cash Price |
$18.90
|
| Rate for Payer: Cash Price |
$18.90
|
| Rate for Payer: Cigna of CA HMO |
$36.48
|
| Rate for Payer: Cigna of CA HMO |
$26.88
|
| Rate for Payer: Cigna of CA PPO |
$31.08
|
| Rate for Payer: Cigna of CA PPO |
$42.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$50.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$50.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$36.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$36.82
|
| Rate for Payer: Dignity Health Medicare Advantage |
$33.47
|
| Rate for Payer: Dignity Health Medicare Advantage |
$33.47
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$29.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$39.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$55.23
|
| Rate for Payer: EPIC Health Plan Commercial |
$55.23
|
| Rate for Payer: EPIC Health Plan Senior |
$36.82
|
| Rate for Payer: EPIC Health Plan Senior |
$36.82
|
| Rate for Payer: Galaxy Health WC |
$35.70
|
| Rate for Payer: Galaxy Health WC |
$48.45
|
| Rate for Payer: Global Benefits Group Commercial |
$25.20
|
| Rate for Payer: Global Benefits Group Commercial |
$34.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$54.89
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$54.89
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$32.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$32.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$33.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$33.47
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$26.67
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$36.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$36.42
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$36.42
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$46.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$46.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$42.17
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$42.17
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$44.85
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$44.85
|
| Rate for Payer: Multiplan Commercial |
$45.60
|
| Rate for Payer: Multiplan Commercial |
$33.60
|
| Rate for Payer: Networks By Design Commercial |
$37.05
|
| Rate for Payer: Networks By Design Commercial |
$27.30
|
| Rate for Payer: Prime Health Services Commercial |
$35.70
|
| Rate for Payer: Prime Health Services Commercial |
$48.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$25.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$34.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$25.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$34.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$27.11
|
| Rate for Payer: United Healthcare All Other Commercial |
$27.11
|
| Rate for Payer: United Healthcare All Other HMO |
$27.11
|
| Rate for Payer: United Healthcare All Other HMO |
$27.11
|
| Rate for Payer: United Healthcare HMO Rider |
$27.11
|
| Rate for Payer: United Healthcare HMO Rider |
$27.11
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$27.11
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$27.11
|
| Rate for Payer: Upland Medical Group Pediatric |
$33.47
|
| Rate for Payer: Upland Medical Group Pediatric |
$33.47
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$50.20
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$50.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$36.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$36.82
|
| Rate for Payer: Vantage Medical Group Senior |
$33.47
|
| Rate for Payer: Vantage Medical Group Senior |
$33.47
|
|
|
HC CHROMOSOME ANALYSIS; CNT 15-20
|
Facility
|
IP
|
$625.52
|
|
|
Service Code
|
CPT 88262
|
| Hospital Charge Code |
903800162
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$125.10 |
| Max. Negotiated Rate |
$531.69 |
| Rate for Payer: Adventist Health Commercial |
$125.10
|
| Rate for Payer: Cash Price |
$281.48
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$437.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$250.21
|
| Rate for Payer: EPIC Health Plan Senior |
$250.21
|
| Rate for Payer: Galaxy Health WC |
$531.69
|
| Rate for Payer: Global Benefits Group Commercial |
$375.31
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$397.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$369.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$150.12
|
| Rate for Payer: Multiplan Commercial |
$500.42
|
| Rate for Payer: Networks By Design Commercial |
$406.59
|
| Rate for Payer: Prime Health Services Commercial |
$531.69
|
|
|
HC CHROMOSOME ANALYSIS; CNT 15-20
|
Facility
|
OP
|
$625.52
|
|
|
Service Code
|
CPT 88262
|
| Hospital Charge Code |
903800162
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$101.65 |
| Max. Negotiated Rate |
$1,286.45 |
| Rate for Payer: Adventist Health Commercial |
$125.10
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,036.50
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$188.24
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$138.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$125.49
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,286.45
|
| Rate for Payer: Blue Shield of California Commercial |
$288.36
|
| Rate for Payer: Blue Shield of California Commercial |
$435.99
|
| Rate for Payer: Cash Price |
$281.48
|
| Rate for Payer: Cash Price |
$281.48
|
| Rate for Payer: Cigna of CA HMO |
$400.33
|
| Rate for Payer: Cigna of CA PPO |
$462.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$188.24
|
| Rate for Payer: Dignity Health Medi-Cal |
$138.04
|
| Rate for Payer: Dignity Health Medicare Advantage |
$125.49
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$437.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$207.06
|
| Rate for Payer: EPIC Health Plan Senior |
$138.04
|
| Rate for Payer: Galaxy Health WC |
$531.69
|
| Rate for Payer: Global Benefits Group Commercial |
$375.31
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$205.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$181.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$125.49
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$397.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$204.84
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$175.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$150.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$158.12
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$168.16
|
| Rate for Payer: Multiplan Commercial |
$500.42
|
| Rate for Payer: Networks By Design Commercial |
$406.59
|
| Rate for Payer: Prime Health Services Commercial |
$531.69
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$375.31
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$375.31
|
| Rate for Payer: United Healthcare All Other Commercial |
$101.65
|
| Rate for Payer: United Healthcare All Other HMO |
$101.65
|
| Rate for Payer: United Healthcare HMO Rider |
$101.65
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$101.65
|
| Rate for Payer: Upland Medical Group Pediatric |
$125.49
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$188.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$138.04
|
| Rate for Payer: Vantage Medical Group Senior |
$125.49
|
|
|
HC CHW EDU TRAINING PT SELF MGMT EA 30MN
|
Facility
|
IP
|
$112.00
|
|
|
Service Code
|
CPT 98960 U2
|
| Hospital Charge Code |
900501960
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$22.40 |
| Max. Negotiated Rate |
$95.20 |
| Rate for Payer: Adventist Health Commercial |
$22.40
|
| Rate for Payer: Cash Price |
$50.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$78.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$44.80
|
| Rate for Payer: EPIC Health Plan Senior |
$44.80
|
| Rate for Payer: Galaxy Health WC |
$95.20
|
| Rate for Payer: Global Benefits Group Commercial |
$67.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$71.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$66.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$26.88
|
| Rate for Payer: Multiplan Commercial |
$89.60
|
| Rate for Payer: Networks By Design Commercial |
$72.80
|
| Rate for Payer: Prime Health Services Commercial |
$95.20
|
|
|
HC CHW EDU TRAINING PT SELF MGMT EA 30MN
|
Facility
|
OP
|
$112.00
|
|
|
Service Code
|
CPT 98960 U2
|
| Hospital Charge Code |
900501960
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$26.88 |
| Max. Negotiated Rate |
$824.00 |
| Rate for Payer: Dignity Health Medi-Cal |
$95.20
|
| Rate for Payer: Adventist Health Commercial |
$45.92
|
| Rate for Payer: Aetna of CA HMO/PPO |
$192.02
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$95.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$61.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$84.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$71.87
|
| Rate for Payer: Cash Price |
$50.40
|
| Rate for Payer: Cash Price |
$50.40
|
| Rate for Payer: Cash Price |
$50.40
|
| Rate for Payer: Cigna of CA HMO |
$71.68
|
| Rate for Payer: Cigna of CA PPO |
$82.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$95.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$95.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$78.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$44.80
|
| Rate for Payer: EPIC Health Plan Senior |
$44.80
|
| Rate for Payer: Galaxy Health WC |
$95.20
|
| Rate for Payer: Global Benefits Group Commercial |
$67.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$44.79
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$71.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$50.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$66.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$26.88
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$78.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$78.40
|
| Rate for Payer: Multiplan Commercial |
$89.60
|
| Rate for Payer: Networks By Design Commercial |
$72.80
|
| Rate for Payer: Prime Health Services Commercial |
$95.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$67.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$67.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$634.00
|
| Rate for Payer: United Healthcare All Other HMO |
$824.00
|
| Rate for Payer: United Healthcare HMO Rider |
$623.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$570.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$95.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$95.20
|
| Rate for Payer: Vantage Medical Group Senior |
$95.20
|
|
|
HC CILIARY TRANSSLERAL THERAPY
|
Facility
|
OP
|
$5,636.00
|
|
|
Service Code
|
CPT 66710
|
| Hospital Charge Code |
900566710
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$472.53 |
| Max. Negotiated Rate |
$6,716.00 |
| Rate for Payer: Adventist Health Commercial |
$1,127.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4,586.76
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,363.62
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,057.84
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,716.00
|
| Rate for Payer: Cash Price |
$2,536.20
|
| Rate for Payer: Cash Price |
$2,536.20
|
| Rate for Payer: Cash Price |
$2,536.20
|
| Rate for Payer: Cigna of CA HMO |
$3,607.04
|
| Rate for Payer: Cigna of CA PPO |
$4,170.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,586.76
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,363.62
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,057.84
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,945.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,045.44
|
| Rate for Payer: EPIC Health Plan Senior |
$3,363.62
|
| Rate for Payer: Galaxy Health WC |
$4,790.60
|
| Rate for Payer: Global Benefits Group Commercial |
$3,381.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$5,014.86
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,057.84
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,578.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$472.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,287.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,352.64
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,852.88
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4,097.51
|
| Rate for Payer: Multiplan Commercial |
$4,508.80
|
| Rate for Payer: Multiplan WC |
$4,723.01
|
| Rate for Payer: Networks By Design Commercial |
$3,663.40
|
| Rate for Payer: Prime Health Services Commercial |
$4,790.60
|
| Rate for Payer: Prime Health Services WC |
$4,674.82
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,381.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,818.00
|
| Rate for Payer: United Healthcare All Other HMO |
$2,818.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,818.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,818.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$3,057.84
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4,586.76
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,363.62
|
| Rate for Payer: Vantage Medical Group Senior |
$3,057.84
|
|
|
HC CILIARY TRANSSLERAL THERAPY
|
Facility
|
IP
|
$5,636.00
|
|
|
Service Code
|
CPT 66710
|
| Hospital Charge Code |
900566710
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,127.20 |
| Max. Negotiated Rate |
$4,790.60 |
| Rate for Payer: Adventist Health Commercial |
$1,127.20
|
| Rate for Payer: Cash Price |
$2,536.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,945.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,254.40
|
| Rate for Payer: EPIC Health Plan Senior |
$2,254.40
|
| Rate for Payer: Galaxy Health WC |
$4,790.60
|
| Rate for Payer: Global Benefits Group Commercial |
$3,381.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,578.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,325.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,352.64
|
| Rate for Payer: Multiplan Commercial |
$4,508.80
|
| Rate for Payer: Networks By Design Commercial |
$3,663.40
|
| Rate for Payer: Prime Health Services Commercial |
$4,790.60
|
|
|
HC CINERADIOGRAPHY/VIDEORADIOGRAPHY
|
Facility
|
IP
|
$340.00
|
|
|
Service Code
|
CPT 76120
|
| Hospital Charge Code |
906811120
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$68.00 |
| Max. Negotiated Rate |
$289.00 |
| Rate for Payer: Adventist Health Commercial |
$68.00
|
| Rate for Payer: Cash Price |
$153.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$238.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$136.00
|
| Rate for Payer: EPIC Health Plan Senior |
$136.00
|
| Rate for Payer: Galaxy Health WC |
$289.00
|
| Rate for Payer: Global Benefits Group Commercial |
$204.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$215.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$200.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$81.60
|
| Rate for Payer: Multiplan Commercial |
$272.00
|
| Rate for Payer: Networks By Design Commercial |
$221.00
|
| Rate for Payer: Prime Health Services Commercial |
$289.00
|
|
|
HC CINERADIOGRAPHY/VIDEORADIOGRAPHY
|
Facility
|
OP
|
$340.00
|
|
|
Service Code
|
CPT 76120
|
| Hospital Charge Code |
906811120
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$68.00 |
| Max. Negotiated Rate |
$417.90 |
| Rate for Payer: Adventist Health Commercial |
$68.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$417.90
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$201.69
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$147.91
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$134.46
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$311.52
|
| Rate for Payer: Blue Shield of California Commercial |
$143.14
|
| Rate for Payer: Blue Shield of California Commercial |
$216.92
|
| Rate for Payer: Cash Price |
$153.00
|
| Rate for Payer: Cash Price |
$153.00
|
| Rate for Payer: Cigna of CA HMO |
$217.60
|
| Rate for Payer: Cigna of CA PPO |
$251.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$201.69
|
| Rate for Payer: Dignity Health Medi-Cal |
$147.91
|
| Rate for Payer: Dignity Health Medicare Advantage |
$134.46
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$238.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$221.86
|
| Rate for Payer: EPIC Health Plan Senior |
$147.91
|
| Rate for Payer: Galaxy Health WC |
$289.00
|
| Rate for Payer: Global Benefits Group Commercial |
$204.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$220.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$88.57
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$134.46
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$215.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$100.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$188.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$81.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$169.42
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$180.18
|
| Rate for Payer: Multiplan Commercial |
$272.00
|
| Rate for Payer: Networks By Design Commercial |
$221.00
|
| Rate for Payer: Prime Health Services Commercial |
$289.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$204.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$204.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$225.63
|
| Rate for Payer: United Healthcare All Other HMO |
$225.63
|
| Rate for Payer: United Healthcare HMO Rider |
$225.63
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$225.63
|
| Rate for Payer: Upland Medical Group Pediatric |
$134.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$201.69
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$147.91
|
| Rate for Payer: Vantage Medical Group Senior |
$134.46
|
|
|
HC CIPROFLOXACIN E TEST
|
Facility
|
OP
|
$18.00
|
|
|
Service Code
|
CPT 87181
|
| Hospital Charge Code |
900912443
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$1.95 |
| Max. Negotiated Rate |
$23.28 |
| Rate for Payer: Cash Price |
$38.25
|
| Rate for Payer: Cash Price |
$38.25
|
| Rate for Payer: Cash Price |
$8.10
|
| Rate for Payer: Cash Price |
$8.10
|
| Rate for Payer: Cigna of CA HMO |
$54.40
|
| Rate for Payer: Cigna of CA HMO |
$11.52
|
| Rate for Payer: Cigna of CA PPO |
$13.32
|
| Rate for Payer: Cigna of CA PPO |
$62.90
|
| Rate for Payer: Adventist Health Commercial |
$3.60
|
| Rate for Payer: Adventist Health Commercial |
$17.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$13.56
|
| Rate for Payer: Aetna of CA HMO/PPO |
$13.56
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.12
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.12
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.22
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$23.28
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$23.28
|
| Rate for Payer: Blue Shield of California Commercial |
$39.19
|
| Rate for Payer: Blue Shield of California Commercial |
$12.55
|
| Rate for Payer: Blue Shield of California Commercial |
$59.24
|
| Rate for Payer: Blue Shield of California Commercial |
$8.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.22
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4.75
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$12.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$59.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.84
|
| Rate for Payer: EPIC Health Plan Senior |
$5.22
|
| Rate for Payer: EPIC Health Plan Senior |
$5.22
|
| Rate for Payer: Galaxy Health WC |
$15.30
|
| Rate for Payer: Galaxy Health WC |
$72.25
|
| Rate for Payer: Global Benefits Group Commercial |
$10.80
|
| Rate for Payer: Global Benefits Group Commercial |
$51.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7.79
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7.79
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4.75
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$11.43
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$53.98
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5.99
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5.99
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.37
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.37
|
| Rate for Payer: Multiplan Commercial |
$68.00
|
| Rate for Payer: Multiplan Commercial |
$14.40
|
| Rate for Payer: Networks By Design Commercial |
$55.25
|
| Rate for Payer: Networks By Design Commercial |
$11.70
|
| Rate for Payer: Prime Health Services Commercial |
$15.30
|
| Rate for Payer: Prime Health Services Commercial |
$72.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$51.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$10.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$51.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.85
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.85
|
| Rate for Payer: United Healthcare All Other HMO |
$3.85
|
| Rate for Payer: United Healthcare All Other HMO |
$3.85
|
| Rate for Payer: United Healthcare HMO Rider |
$3.85
|
| Rate for Payer: United Healthcare HMO Rider |
$3.85
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.85
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.85
|
| Rate for Payer: Upland Medical Group Pediatric |
$4.75
|
| Rate for Payer: Upland Medical Group Pediatric |
$4.75
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.22
|
| Rate for Payer: Vantage Medical Group Senior |
$4.75
|
| Rate for Payer: Vantage Medical Group Senior |
$4.75
|
|
|
HC CIPROFLOXACIN E TEST
|
Facility
|
IP
|
$85.00
|
|
|
Service Code
|
CPT 87181
|
| Hospital Charge Code |
900912443
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$17.00 |
| Max. Negotiated Rate |
$72.25 |
| Rate for Payer: Adventist Health Commercial |
$17.00
|
| Rate for Payer: Cash Price |
$38.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$59.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$34.00
|
| Rate for Payer: EPIC Health Plan Senior |
$34.00
|
| Rate for Payer: Galaxy Health WC |
$72.25
|
| Rate for Payer: Global Benefits Group Commercial |
$51.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$53.98
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$50.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.40
|
| Rate for Payer: Multiplan Commercial |
$68.00
|
| Rate for Payer: Networks By Design Commercial |
$55.25
|
| Rate for Payer: Prime Health Services Commercial |
$72.25
|
|
