|
HC CULTURE FOR VIROLOGY
|
Facility
|
OP
|
$90.00
|
|
|
Service Code
|
CPT 87252
|
| Hospital Charge Code |
900911528
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.00 |
| Max. Negotiated Rate |
$257.48 |
| Rate for Payer: Adventist Health Commercial |
$18.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$59.03
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$39.10
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$28.68
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$26.07
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$257.48
|
| Rate for Payer: Blue Shield of California Commercial |
$60.21
|
| Rate for Payer: Blue Shield of California EPN |
$39.78
|
| Rate for Payer: Cash Price |
$40.50
|
| Rate for Payer: Cash Price |
$40.50
|
| Rate for Payer: Cigna of CA HMO |
$57.60
|
| Rate for Payer: Cigna of CA PPO |
$66.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$39.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$28.68
|
| Rate for Payer: Dignity Health Medicare Advantage |
$26.07
|
| Rate for Payer: EPIC Health Plan Commercial |
$35.19
|
| Rate for Payer: EPIC Health Plan Senior |
$26.07
|
| Rate for Payer: Galaxy Health WC |
$76.50
|
| Rate for Payer: Global Benefits Group Commercial |
$54.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$42.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$35.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$26.07
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$60.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$40.45
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$26.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$21.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$32.85
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$34.93
|
| Rate for Payer: Multiplan Commercial |
$72.00
|
| Rate for Payer: Networks By Design Commercial |
$58.50
|
| Rate for Payer: Prime Health Services Commercial |
$76.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$54.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$54.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$21.11
|
| Rate for Payer: United Healthcare All Other HMO |
$21.11
|
| Rate for Payer: United Healthcare HMO Rider |
$21.11
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$21.11
|
| Rate for Payer: Upland Medical Group Pediatric |
$26.07
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$39.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$28.68
|
| Rate for Payer: Vantage Medical Group Senior |
$26.07
|
|
|
HC CULTURE FOR VIROLOGY
|
Facility
|
IP
|
$165.00
|
|
|
Service Code
|
CPT 87252
|
| Hospital Charge Code |
900911528
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$33.00 |
| Max. Negotiated Rate |
$140.25 |
| Rate for Payer: Adventist Health Commercial |
$33.00
|
| Rate for Payer: Cash Price |
$74.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$66.00
|
| Rate for Payer: EPIC Health Plan Senior |
$66.00
|
| Rate for Payer: Galaxy Health WC |
$140.25
|
| Rate for Payer: Global Benefits Group Commercial |
$99.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$110.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$62.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$102.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$39.60
|
| Rate for Payer: Multiplan Commercial |
$132.00
|
| Rate for Payer: Networks By Design Commercial |
$107.25
|
| Rate for Payer: Prime Health Services Commercial |
$140.25
|
|
|
HC CULTURE FUNGUS (BLOOD)
|
Facility
|
OP
|
$53.00
|
|
|
Service Code
|
CPT 87103
|
| Hospital Charge Code |
900912430
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$10.60 |
| Max. Negotiated Rate |
$89.04 |
| Rate for Payer: Adventist Health Commercial |
$10.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$34.76
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$30.69
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$22.51
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$20.46
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$89.04
|
| Rate for Payer: Blue Shield of California Commercial |
$35.46
|
| Rate for Payer: Blue Shield of California EPN |
$23.43
|
| Rate for Payer: Cash Price |
$23.85
|
| Rate for Payer: Cash Price |
$23.85
|
| Rate for Payer: Cigna of CA HMO |
$33.92
|
| Rate for Payer: Cigna of CA PPO |
$39.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$30.69
|
| Rate for Payer: Dignity Health Medi-Cal |
$22.51
|
| Rate for Payer: Dignity Health Medicare Advantage |
$20.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$27.62
|
| Rate for Payer: EPIC Health Plan Senior |
$20.46
|
| Rate for Payer: Galaxy Health WC |
$45.05
|
| Rate for Payer: Global Benefits Group Commercial |
$31.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$33.55
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$13.46
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$20.46
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$35.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$15.22
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$20.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.72
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$25.78
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$27.42
|
| Rate for Payer: Multiplan Commercial |
$42.40
|
| Rate for Payer: Networks By Design Commercial |
$34.45
|
| Rate for Payer: Prime Health Services Commercial |
$45.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$31.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$31.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$16.57
|
| Rate for Payer: United Healthcare All Other HMO |
$16.57
|
| Rate for Payer: United Healthcare HMO Rider |
$16.57
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16.57
|
| Rate for Payer: Upland Medical Group Pediatric |
$20.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$30.69
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$22.51
|
| Rate for Payer: Vantage Medical Group Senior |
$20.46
|
|
|
HC CULTURE FUNGUS (BLOOD)
|
Facility
|
IP
|
$264.00
|
|
|
Service Code
|
CPT 87103
|
| Hospital Charge Code |
900912430
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$52.80 |
| Max. Negotiated Rate |
$224.40 |
| Rate for Payer: Adventist Health Commercial |
$52.80
|
| Rate for Payer: Cash Price |
$118.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$105.60
|
| Rate for Payer: EPIC Health Plan Senior |
$105.60
|
| Rate for Payer: Galaxy Health WC |
$224.40
|
| Rate for Payer: Global Benefits Group Commercial |
$158.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$176.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$100.58
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$163.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$63.36
|
| Rate for Payer: Multiplan Commercial |
$211.20
|
| Rate for Payer: Networks By Design Commercial |
$171.60
|
| Rate for Payer: Prime Health Services Commercial |
$224.40
|
|
|
HC CULTURE FUNGUS OTHER
|
Facility
|
OP
|
$84.00
|
|
|
Service Code
|
CPT 87102
|
| Hospital Charge Code |
900911523
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.81 |
| Max. Negotiated Rate |
$82.99 |
| Rate for Payer: Adventist Health Commercial |
$16.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$55.10
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.41
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$82.99
|
| Rate for Payer: Blue Shield of California Commercial |
$56.20
|
| Rate for Payer: Blue Shield of California EPN |
$37.13
|
| Rate for Payer: Cash Price |
$37.80
|
| Rate for Payer: Cash Price |
$37.80
|
| Rate for Payer: Cigna of CA HMO |
$53.76
|
| Rate for Payer: Cigna of CA PPO |
$62.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.25
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8.41
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.35
|
| Rate for Payer: EPIC Health Plan Senior |
$8.41
|
| Rate for Payer: Galaxy Health WC |
$71.40
|
| Rate for Payer: Global Benefits Group Commercial |
$50.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$13.79
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$12.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.41
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$56.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11.27
|
| Rate for Payer: Multiplan Commercial |
$67.20
|
| Rate for Payer: Networks By Design Commercial |
$54.60
|
| Rate for Payer: Prime Health Services Commercial |
$71.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$50.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$50.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.81
|
| Rate for Payer: United Healthcare All Other HMO |
$6.81
|
| Rate for Payer: United Healthcare HMO Rider |
$6.81
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.81
|
| Rate for Payer: Upland Medical Group Pediatric |
$8.41
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.25
|
| Rate for Payer: Vantage Medical Group Senior |
$8.41
|
|
|
HC CULTURE FUNGUS OTHER
|
Facility
|
IP
|
$353.00
|
|
|
Service Code
|
CPT 87102
|
| Hospital Charge Code |
900911523
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$70.60 |
| Max. Negotiated Rate |
$300.05 |
| Rate for Payer: Adventist Health Commercial |
$70.60
|
| Rate for Payer: Cash Price |
$158.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$141.20
|
| Rate for Payer: EPIC Health Plan Senior |
$141.20
|
| Rate for Payer: Galaxy Health WC |
$300.05
|
| Rate for Payer: Global Benefits Group Commercial |
$211.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$235.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$134.49
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$218.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$84.72
|
| Rate for Payer: Multiplan Commercial |
$282.40
|
| Rate for Payer: Networks By Design Commercial |
$229.45
|
| Rate for Payer: Prime Health Services Commercial |
$300.05
|
|
|
HC CULTURE FUNGUS(SKIN,HAIR,NAIL)
|
Facility
|
OP
|
$82.00
|
|
|
Service Code
|
CPT 87101
|
| Hospital Charge Code |
900912429
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.25 |
| Max. Negotiated Rate |
$76.14 |
| Rate for Payer: Adventist Health Commercial |
$16.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$53.78
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11.56
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.48
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7.71
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$76.14
|
| Rate for Payer: Blue Shield of California Commercial |
$54.86
|
| Rate for Payer: Blue Shield of California EPN |
$36.24
|
| Rate for Payer: Cash Price |
$36.90
|
| Rate for Payer: Cash Price |
$36.90
|
| Rate for Payer: Cigna of CA HMO |
$52.48
|
| Rate for Payer: Cigna of CA PPO |
$60.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11.56
|
| Rate for Payer: Dignity Health Medi-Cal |
$8.48
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7.71
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.41
|
| Rate for Payer: EPIC Health Plan Senior |
$7.71
|
| Rate for Payer: Galaxy Health WC |
$69.70
|
| Rate for Payer: Global Benefits Group Commercial |
$49.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$12.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$11.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7.71
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$54.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13.02
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9.71
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10.33
|
| Rate for Payer: Multiplan Commercial |
$65.60
|
| Rate for Payer: Networks By Design Commercial |
$53.30
|
| Rate for Payer: Prime Health Services Commercial |
$69.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$49.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$49.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.25
|
| Rate for Payer: United Healthcare All Other HMO |
$6.25
|
| Rate for Payer: United Healthcare HMO Rider |
$6.25
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.25
|
| Rate for Payer: Upland Medical Group Pediatric |
$7.71
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11.56
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.48
|
| Rate for Payer: Vantage Medical Group Senior |
$7.71
|
|
|
HC CULTURE FUNGUS(SKIN,HAIR,NAIL)
|
Facility
|
IP
|
$395.00
|
|
|
Service Code
|
CPT 87101
|
| Hospital Charge Code |
900912429
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$79.00 |
| Max. Negotiated Rate |
$335.75 |
| Rate for Payer: Adventist Health Commercial |
$79.00
|
| Rate for Payer: Cash Price |
$177.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$158.00
|
| Rate for Payer: EPIC Health Plan Senior |
$158.00
|
| Rate for Payer: Galaxy Health WC |
$335.75
|
| Rate for Payer: Global Benefits Group Commercial |
$237.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$263.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$150.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$244.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$94.80
|
| Rate for Payer: Multiplan Commercial |
$316.00
|
| Rate for Payer: Networks By Design Commercial |
$256.75
|
| Rate for Payer: Prime Health Services Commercial |
$335.75
|
|
|
HC CULTURE GASTRIC ASPIRATE
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
900911506
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$78.00 |
| Max. Negotiated Rate |
$331.50 |
| Rate for Payer: Adventist Health Commercial |
$78.00
|
| Rate for Payer: Cash Price |
$175.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$156.00
|
| Rate for Payer: EPIC Health Plan Senior |
$156.00
|
| Rate for Payer: Galaxy Health WC |
$331.50
|
| Rate for Payer: Global Benefits Group Commercial |
$234.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$260.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$148.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$241.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$93.60
|
| Rate for Payer: Multiplan Commercial |
$312.00
|
| Rate for Payer: Networks By Design Commercial |
$253.50
|
| Rate for Payer: Prime Health Services Commercial |
$331.50
|
|
|
HC CULTURE GASTRIC ASPIRATE
|
Facility
|
OP
|
$84.00
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
900911506
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.98 |
| Max. Negotiated Rate |
$225.00 |
| Rate for Payer: Adventist Health Commercial |
$16.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$55.10
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9.48
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.62
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$84.98
|
| Rate for Payer: Blue Shield of California Commercial |
$56.20
|
| Rate for Payer: Blue Shield of California EPN |
$37.13
|
| Rate for Payer: Cash Price |
$37.80
|
| Rate for Payer: Cash Price |
$37.80
|
| Rate for Payer: Cash Price |
$37.80
|
| Rate for Payer: Cigna of CA HMO |
$53.76
|
| Rate for Payer: Cigna of CA PPO |
$62.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.48
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.64
|
| Rate for Payer: EPIC Health Plan Senior |
$8.62
|
| Rate for Payer: Galaxy Health WC |
$71.40
|
| Rate for Payer: Global Benefits Group Commercial |
$50.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$14.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$12.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.62
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$56.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14.27
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11.55
|
| Rate for Payer: Multiplan Commercial |
$67.20
|
| Rate for Payer: Networks By Design Commercial |
$54.60
|
| Rate for Payer: Prime Health Services Commercial |
$71.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$50.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$225.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.98
|
| Rate for Payer: United Healthcare All Other HMO |
$6.98
|
| Rate for Payer: United Healthcare HMO Rider |
$6.98
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.98
|
| Rate for Payer: Upland Medical Group Pediatric |
$8.62
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.48
|
| Rate for Payer: Vantage Medical Group Senior |
$8.62
|
|
|
HC CULTURE G.C.
|
Facility
|
OP
|
$82.00
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
900911631
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.98 |
| Max. Negotiated Rate |
$225.00 |
| Rate for Payer: Adventist Health Commercial |
$16.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$53.78
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9.48
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.62
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$84.98
|
| Rate for Payer: Blue Shield of California Commercial |
$54.86
|
| Rate for Payer: Blue Shield of California EPN |
$36.24
|
| Rate for Payer: Cash Price |
$36.90
|
| Rate for Payer: Cash Price |
$36.90
|
| Rate for Payer: Cash Price |
$36.90
|
| Rate for Payer: Cigna of CA HMO |
$52.48
|
| Rate for Payer: Cigna of CA PPO |
$60.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.48
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.64
|
| Rate for Payer: EPIC Health Plan Senior |
$8.62
|
| Rate for Payer: Galaxy Health WC |
$69.70
|
| Rate for Payer: Global Benefits Group Commercial |
$49.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$14.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$12.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.62
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$54.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14.27
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11.55
|
| Rate for Payer: Multiplan Commercial |
$65.60
|
| Rate for Payer: Networks By Design Commercial |
$53.30
|
| Rate for Payer: Prime Health Services Commercial |
$69.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$49.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$225.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.98
|
| Rate for Payer: United Healthcare All Other HMO |
$6.98
|
| Rate for Payer: United Healthcare HMO Rider |
$6.98
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.98
|
| Rate for Payer: Upland Medical Group Pediatric |
$8.62
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.48
|
| Rate for Payer: Vantage Medical Group Senior |
$8.62
|
|
|
HC CULTURE G.C.
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
900911631
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$78.00 |
| Max. Negotiated Rate |
$331.50 |
| Rate for Payer: Adventist Health Commercial |
$78.00
|
| Rate for Payer: Cash Price |
$175.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$156.00
|
| Rate for Payer: EPIC Health Plan Senior |
$156.00
|
| Rate for Payer: Galaxy Health WC |
$331.50
|
| Rate for Payer: Global Benefits Group Commercial |
$234.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$260.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$148.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$241.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$93.60
|
| Rate for Payer: Multiplan Commercial |
$312.00
|
| Rate for Payer: Networks By Design Commercial |
$253.50
|
| Rate for Payer: Prime Health Services Commercial |
$331.50
|
|
|
HC CULTURE GRAM NEGATIVE ID
|
Facility
|
IP
|
$200.00
|
|
|
Service Code
|
CPT 87077
|
| Hospital Charge Code |
900912411
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$40.00 |
| Max. Negotiated Rate |
$170.00 |
| Rate for Payer: Adventist Health Commercial |
$40.00
|
| Rate for Payer: Cash Price |
$90.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$80.00
|
| Rate for Payer: EPIC Health Plan Senior |
$80.00
|
| Rate for Payer: Galaxy Health WC |
$170.00
|
| Rate for Payer: Global Benefits Group Commercial |
$120.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$133.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$76.20
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$123.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$48.00
|
| Rate for Payer: Multiplan Commercial |
$160.00
|
| Rate for Payer: Networks By Design Commercial |
$130.00
|
| Rate for Payer: Prime Health Services Commercial |
$170.00
|
|
|
HC CULTURE GRAM NEGATIVE ID
|
Facility
|
OP
|
$72.00
|
|
|
Service Code
|
CPT 87077
|
| Hospital Charge Code |
900912411
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.54 |
| Max. Negotiated Rate |
$225.00 |
| Rate for Payer: Adventist Health Commercial |
$14.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$47.22
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.12
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.89
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.08
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$79.73
|
| Rate for Payer: Blue Shield of California Commercial |
$48.17
|
| Rate for Payer: Blue Shield of California EPN |
$31.82
|
| Rate for Payer: Cash Price |
$32.40
|
| Rate for Payer: Cash Price |
$32.40
|
| Rate for Payer: Cash Price |
$32.40
|
| Rate for Payer: Cigna of CA HMO |
$46.08
|
| Rate for Payer: Cigna of CA PPO |
$53.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$8.89
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.91
|
| Rate for Payer: EPIC Health Plan Senior |
$8.08
|
| Rate for Payer: Galaxy Health WC |
$61.20
|
| Rate for Payer: Global Benefits Group Commercial |
$43.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$13.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$11.17
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.08
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$48.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$17.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10.83
|
| Rate for Payer: Multiplan Commercial |
$57.60
|
| Rate for Payer: Networks By Design Commercial |
$46.80
|
| Rate for Payer: Prime Health Services Commercial |
$61.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$43.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$225.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.54
|
| Rate for Payer: United Healthcare All Other HMO |
$6.54
|
| Rate for Payer: United Healthcare HMO Rider |
$6.54
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.54
|
| Rate for Payer: Upland Medical Group Pediatric |
$8.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.89
|
| Rate for Payer: Vantage Medical Group Senior |
$8.08
|
|
|
HC CULTURE GRAM POSITIVE ID
|
Facility
|
OP
|
$72.00
|
|
|
Service Code
|
CPT 87077
|
| Hospital Charge Code |
900912410
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.54 |
| Max. Negotiated Rate |
$225.00 |
| Rate for Payer: Adventist Health Commercial |
$14.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$47.22
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.12
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.89
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.08
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$79.73
|
| Rate for Payer: Blue Shield of California Commercial |
$48.17
|
| Rate for Payer: Blue Shield of California EPN |
$31.82
|
| Rate for Payer: Cash Price |
$32.40
|
| Rate for Payer: Cash Price |
$32.40
|
| Rate for Payer: Cash Price |
$32.40
|
| Rate for Payer: Cigna of CA HMO |
$46.08
|
| Rate for Payer: Cigna of CA PPO |
$53.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$8.89
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.91
|
| Rate for Payer: EPIC Health Plan Senior |
$8.08
|
| Rate for Payer: Galaxy Health WC |
$61.20
|
| Rate for Payer: Global Benefits Group Commercial |
$43.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$13.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$11.17
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.08
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$48.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$17.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10.83
|
| Rate for Payer: Multiplan Commercial |
$57.60
|
| Rate for Payer: Networks By Design Commercial |
$46.80
|
| Rate for Payer: Prime Health Services Commercial |
$61.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$43.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$225.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.54
|
| Rate for Payer: United Healthcare All Other HMO |
$6.54
|
| Rate for Payer: United Healthcare HMO Rider |
$6.54
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.54
|
| Rate for Payer: Upland Medical Group Pediatric |
$8.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.89
|
| Rate for Payer: Vantage Medical Group Senior |
$8.08
|
|
|
HC CULTURE GRAM POSITIVE ID
|
Facility
|
IP
|
$165.00
|
|
|
Service Code
|
CPT 87077
|
| Hospital Charge Code |
900912410
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$33.00 |
| Max. Negotiated Rate |
$140.25 |
| Rate for Payer: Adventist Health Commercial |
$33.00
|
| Rate for Payer: Cash Price |
$74.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$66.00
|
| Rate for Payer: EPIC Health Plan Senior |
$66.00
|
| Rate for Payer: Galaxy Health WC |
$140.25
|
| Rate for Payer: Global Benefits Group Commercial |
$99.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$110.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$62.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$102.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$39.60
|
| Rate for Payer: Multiplan Commercial |
$132.00
|
| Rate for Payer: Networks By Design Commercial |
$107.25
|
| Rate for Payer: Prime Health Services Commercial |
$140.25
|
|
|
HC CULTURE GROUP B STREP
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
900912406
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$78.00 |
| Max. Negotiated Rate |
$331.50 |
| Rate for Payer: Adventist Health Commercial |
$78.00
|
| Rate for Payer: Cash Price |
$175.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$156.00
|
| Rate for Payer: EPIC Health Plan Senior |
$156.00
|
| Rate for Payer: Galaxy Health WC |
$331.50
|
| Rate for Payer: Global Benefits Group Commercial |
$234.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$260.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$148.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$241.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$93.60
|
| Rate for Payer: Multiplan Commercial |
$312.00
|
| Rate for Payer: Networks By Design Commercial |
$253.50
|
| Rate for Payer: Prime Health Services Commercial |
$331.50
|
|
|
HC CULTURE GROUP B STREP
|
Facility
|
OP
|
$84.00
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
900912406
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.98 |
| Max. Negotiated Rate |
$225.00 |
| Rate for Payer: Adventist Health Commercial |
$16.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$55.10
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9.48
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.62
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$84.98
|
| Rate for Payer: Blue Shield of California Commercial |
$56.20
|
| Rate for Payer: Blue Shield of California EPN |
$37.13
|
| Rate for Payer: Cash Price |
$37.80
|
| Rate for Payer: Cash Price |
$37.80
|
| Rate for Payer: Cash Price |
$37.80
|
| Rate for Payer: Cigna of CA HMO |
$53.76
|
| Rate for Payer: Cigna of CA PPO |
$62.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.48
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.64
|
| Rate for Payer: EPIC Health Plan Senior |
$8.62
|
| Rate for Payer: Galaxy Health WC |
$71.40
|
| Rate for Payer: Global Benefits Group Commercial |
$50.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$14.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$12.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.62
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$56.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14.27
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11.55
|
| Rate for Payer: Multiplan Commercial |
$67.20
|
| Rate for Payer: Networks By Design Commercial |
$54.60
|
| Rate for Payer: Prime Health Services Commercial |
$71.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$50.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$225.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.98
|
| Rate for Payer: United Healthcare All Other HMO |
$6.98
|
| Rate for Payer: United Healthcare HMO Rider |
$6.98
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.98
|
| Rate for Payer: Upland Medical Group Pediatric |
$8.62
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.48
|
| Rate for Payer: Vantage Medical Group Senior |
$8.62
|
|
|
HC CULTURE,INVASIVE LOWER RESP
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
900912408
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$78.00 |
| Max. Negotiated Rate |
$331.50 |
| Rate for Payer: Adventist Health Commercial |
$78.00
|
| Rate for Payer: Cash Price |
$175.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$156.00
|
| Rate for Payer: EPIC Health Plan Senior |
$156.00
|
| Rate for Payer: Galaxy Health WC |
$331.50
|
| Rate for Payer: Global Benefits Group Commercial |
$234.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$260.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$148.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$241.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$93.60
|
| Rate for Payer: Multiplan Commercial |
$312.00
|
| Rate for Payer: Networks By Design Commercial |
$253.50
|
| Rate for Payer: Prime Health Services Commercial |
$331.50
|
|
|
HC CULTURE,INVASIVE LOWER RESP
|
Facility
|
OP
|
$84.00
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
900912408
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.98 |
| Max. Negotiated Rate |
$225.00 |
| Rate for Payer: Adventist Health Commercial |
$16.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$55.10
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9.48
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.62
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$84.98
|
| Rate for Payer: Blue Shield of California Commercial |
$56.20
|
| Rate for Payer: Blue Shield of California EPN |
$37.13
|
| Rate for Payer: Cash Price |
$37.80
|
| Rate for Payer: Cash Price |
$37.80
|
| Rate for Payer: Cash Price |
$37.80
|
| Rate for Payer: Cigna of CA HMO |
$53.76
|
| Rate for Payer: Cigna of CA PPO |
$62.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.48
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.64
|
| Rate for Payer: EPIC Health Plan Senior |
$8.62
|
| Rate for Payer: Galaxy Health WC |
$71.40
|
| Rate for Payer: Global Benefits Group Commercial |
$50.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$14.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$12.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.62
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$56.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14.27
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11.55
|
| Rate for Payer: Multiplan Commercial |
$67.20
|
| Rate for Payer: Networks By Design Commercial |
$54.60
|
| Rate for Payer: Prime Health Services Commercial |
$71.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$50.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$225.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.98
|
| Rate for Payer: United Healthcare All Other HMO |
$6.98
|
| Rate for Payer: United Healthcare HMO Rider |
$6.98
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.98
|
| Rate for Payer: Upland Medical Group Pediatric |
$8.62
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.48
|
| Rate for Payer: Vantage Medical Group Senior |
$8.62
|
|
|
HC CULTURE JEJUNUM AEROBIC
|
Facility
|
OP
|
$39.00
|
|
|
Service Code
|
CPT 87071
|
| Hospital Charge Code |
900911507
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$7.80 |
| Max. Negotiated Rate |
$46.55 |
| Rate for Payer: Adventist Health Commercial |
$7.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$25.58
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$14.84
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10.88
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9.89
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$46.55
|
| Rate for Payer: Blue Shield of California Commercial |
$26.09
|
| Rate for Payer: Blue Shield of California EPN |
$17.24
|
| Rate for Payer: Cash Price |
$17.55
|
| Rate for Payer: Cash Price |
$17.55
|
| Rate for Payer: Cigna of CA HMO |
$24.96
|
| Rate for Payer: Cigna of CA PPO |
$28.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$14.84
|
| Rate for Payer: Dignity Health Medi-Cal |
$10.88
|
| Rate for Payer: Dignity Health Medicare Advantage |
$9.89
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.35
|
| Rate for Payer: EPIC Health Plan Senior |
$9.89
|
| Rate for Payer: Galaxy Health WC |
$33.15
|
| Rate for Payer: Global Benefits Group Commercial |
$23.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$16.22
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$8.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$9.89
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$26.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.92
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$12.46
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$13.25
|
| Rate for Payer: Multiplan Commercial |
$31.20
|
| Rate for Payer: Networks By Design Commercial |
$25.35
|
| Rate for Payer: Prime Health Services Commercial |
$33.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$23.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$23.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$8.01
|
| Rate for Payer: United Healthcare All Other HMO |
$8.01
|
| Rate for Payer: United Healthcare HMO Rider |
$8.01
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8.01
|
| Rate for Payer: Upland Medical Group Pediatric |
$9.89
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$14.84
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.88
|
| Rate for Payer: Vantage Medical Group Senior |
$9.89
|
|
|
HC CULTURE JEJUNUM AEROBIC
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
CPT 87071
|
| Hospital Charge Code |
900911507
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$78.00 |
| Max. Negotiated Rate |
$331.50 |
| Rate for Payer: Adventist Health Commercial |
$78.00
|
| Rate for Payer: Cash Price |
$175.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$156.00
|
| Rate for Payer: EPIC Health Plan Senior |
$156.00
|
| Rate for Payer: Galaxy Health WC |
$331.50
|
| Rate for Payer: Global Benefits Group Commercial |
$234.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$260.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$148.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$241.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$93.60
|
| Rate for Payer: Multiplan Commercial |
$312.00
|
| Rate for Payer: Networks By Design Commercial |
$253.50
|
| Rate for Payer: Prime Health Services Commercial |
$331.50
|
|
|
HC CULTURE JEJUNUM ANAEROBIC
|
Facility
|
IP
|
$429.00
|
|
|
Service Code
|
CPT 87073
|
| Hospital Charge Code |
900911508
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$85.80 |
| Max. Negotiated Rate |
$364.65 |
| Rate for Payer: Adventist Health Commercial |
$85.80
|
| Rate for Payer: Cash Price |
$193.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$171.60
|
| Rate for Payer: EPIC Health Plan Senior |
$171.60
|
| Rate for Payer: Galaxy Health WC |
$364.65
|
| Rate for Payer: Global Benefits Group Commercial |
$257.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$286.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$163.45
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$265.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$102.96
|
| Rate for Payer: Multiplan Commercial |
$343.20
|
| Rate for Payer: Networks By Design Commercial |
$278.85
|
| Rate for Payer: Prime Health Services Commercial |
$364.65
|
|
|
HC CULTURE JEJUNUM ANAEROBIC
|
Facility
|
OP
|
$39.00
|
|
|
Service Code
|
CPT 87073
|
| Hospital Charge Code |
900911508
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$7.80 |
| Max. Negotiated Rate |
$46.55 |
| Rate for Payer: Adventist Health Commercial |
$7.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$25.58
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$14.49
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10.63
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9.66
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$46.55
|
| Rate for Payer: Blue Shield of California Commercial |
$26.09
|
| Rate for Payer: Blue Shield of California EPN |
$17.24
|
| Rate for Payer: Cash Price |
$17.55
|
| Rate for Payer: Cash Price |
$17.55
|
| Rate for Payer: Cigna of CA HMO |
$24.96
|
| Rate for Payer: Cigna of CA PPO |
$28.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$14.49
|
| Rate for Payer: Dignity Health Medi-Cal |
$10.63
|
| Rate for Payer: Dignity Health Medicare Advantage |
$9.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.04
|
| Rate for Payer: EPIC Health Plan Senior |
$9.66
|
| Rate for Payer: Galaxy Health WC |
$33.15
|
| Rate for Payer: Global Benefits Group Commercial |
$23.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$15.84
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$8.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$9.66
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$26.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.92
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$12.17
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$12.94
|
| Rate for Payer: Multiplan Commercial |
$31.20
|
| Rate for Payer: Networks By Design Commercial |
$25.35
|
| Rate for Payer: Prime Health Services Commercial |
$33.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$23.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$23.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.82
|
| Rate for Payer: United Healthcare All Other HMO |
$7.82
|
| Rate for Payer: United Healthcare HMO Rider |
$7.82
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.82
|
| Rate for Payer: Upland Medical Group Pediatric |
$9.66
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$14.49
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.63
|
| Rate for Payer: Vantage Medical Group Senior |
$9.66
|
|
|
HC CULTURE LEGIONELLA
|
Facility
|
OP
|
$84.00
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
900911524
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.98 |
| Max. Negotiated Rate |
$225.00 |
| Rate for Payer: Adventist Health Commercial |
$16.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$55.10
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9.48
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.62
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$84.98
|
| Rate for Payer: Blue Shield of California Commercial |
$56.20
|
| Rate for Payer: Blue Shield of California EPN |
$37.13
|
| Rate for Payer: Cash Price |
$37.80
|
| Rate for Payer: Cash Price |
$37.80
|
| Rate for Payer: Cash Price |
$37.80
|
| Rate for Payer: Cigna of CA HMO |
$53.76
|
| Rate for Payer: Cigna of CA PPO |
$62.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.48
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.64
|
| Rate for Payer: EPIC Health Plan Senior |
$8.62
|
| Rate for Payer: Galaxy Health WC |
$71.40
|
| Rate for Payer: Global Benefits Group Commercial |
$50.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$14.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$12.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.62
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$56.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14.27
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11.55
|
| Rate for Payer: Multiplan Commercial |
$67.20
|
| Rate for Payer: Networks By Design Commercial |
$54.60
|
| Rate for Payer: Prime Health Services Commercial |
$71.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$50.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$225.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.98
|
| Rate for Payer: United Healthcare All Other HMO |
$6.98
|
| Rate for Payer: United Healthcare HMO Rider |
$6.98
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.98
|
| Rate for Payer: Upland Medical Group Pediatric |
$8.62
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.48
|
| Rate for Payer: Vantage Medical Group Senior |
$8.62
|
|
