|
HC C-REACTIVE PROTEIN HI SENSITIVITY
|
Facility
|
OP
|
$315.00
|
|
|
Service Code
|
CPT 86141
|
| Hospital Charge Code |
900912102
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.49 |
| Max. Negotiated Rate |
$267.75 |
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.24
|
| Rate for Payer: Vantage Medical Group Senior |
$12.95
|
| Rate for Payer: Vantage Medical Group Senior |
$12.95
|
| Rate for Payer: Adventist Health Commercial |
$63.00
|
| Rate for Payer: Adventist Health Commercial |
$16.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$107.69
|
| Rate for Payer: Aetna of CA HMO/PPO |
$107.69
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19.43
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19.43
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.24
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.24
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12.95
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$133.56
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$133.56
|
| Rate for Payer: Blue Shield of California Commercial |
$37.80
|
| Rate for Payer: Blue Shield of California Commercial |
$145.22
|
| Rate for Payer: Blue Shield of California Commercial |
$57.15
|
| Rate for Payer: Blue Shield of California Commercial |
$219.56
|
| Rate for Payer: Cash Price |
$36.90
|
| Rate for Payer: Cash Price |
$36.90
|
| Rate for Payer: Cash Price |
$141.75
|
| Rate for Payer: Cash Price |
$141.75
|
| Rate for Payer: Cigna of CA HMO |
$52.48
|
| Rate for Payer: Cigna of CA HMO |
$201.60
|
| Rate for Payer: Cigna of CA PPO |
$233.10
|
| Rate for Payer: Cigna of CA PPO |
$60.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.43
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.43
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.24
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.24
|
| Rate for Payer: Dignity Health Medicare Advantage |
$12.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$12.95
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$220.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$57.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$21.37
|
| Rate for Payer: EPIC Health Plan Commercial |
$21.37
|
| Rate for Payer: EPIC Health Plan Senior |
$14.24
|
| Rate for Payer: EPIC Health Plan Senior |
$14.24
|
| Rate for Payer: Galaxy Health WC |
$267.75
|
| Rate for Payer: Galaxy Health WC |
$69.70
|
| Rate for Payer: Global Benefits Group Commercial |
$189.00
|
| Rate for Payer: Global Benefits Group Commercial |
$49.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$21.24
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$21.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$18.58
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$18.58
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$12.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$12.95
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$200.03
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$52.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$21.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$21.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$18.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$18.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$75.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16.32
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17.35
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17.35
|
| Rate for Payer: Multiplan Commercial |
$65.60
|
| Rate for Payer: Multiplan Commercial |
$252.00
|
| Rate for Payer: Networks By Design Commercial |
$53.30
|
| Rate for Payer: Networks By Design Commercial |
$204.75
|
| Rate for Payer: Prime Health Services Commercial |
$267.75
|
| Rate for Payer: Prime Health Services Commercial |
$69.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$189.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$49.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$189.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$49.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.49
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.49
|
| Rate for Payer: United Healthcare All Other HMO |
$10.49
|
| Rate for Payer: United Healthcare All Other HMO |
$10.49
|
| Rate for Payer: United Healthcare HMO Rider |
$10.49
|
| Rate for Payer: United Healthcare HMO Rider |
$10.49
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.49
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.49
|
| Rate for Payer: Upland Medical Group Pediatric |
$12.95
|
| Rate for Payer: Upland Medical Group Pediatric |
$12.95
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.43
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.43
|
|
|
HC C-REACTIVE PROTEIN HI SENSITIVITY
|
Facility
|
IP
|
$315.00
|
|
|
Service Code
|
CPT 86141
|
| Hospital Charge Code |
900912102
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$63.00 |
| Max. Negotiated Rate |
$267.75 |
| Rate for Payer: Adventist Health Commercial |
$63.00
|
| Rate for Payer: Cash Price |
$141.75
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$220.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$126.00
|
| Rate for Payer: EPIC Health Plan Senior |
$126.00
|
| Rate for Payer: Galaxy Health WC |
$267.75
|
| Rate for Payer: Global Benefits Group Commercial |
$189.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$200.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$185.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$75.60
|
| Rate for Payer: Multiplan Commercial |
$252.00
|
| Rate for Payer: Networks By Design Commercial |
$204.75
|
| Rate for Payer: Prime Health Services Commercial |
$267.75
|
|
|
HC CREAM WOUND CARE ATRACTAIN 2OZ
|
Facility
|
IP
|
$27.96
|
|
| Hospital Charge Code |
901606201
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$5.59 |
| Max. Negotiated Rate |
$23.77 |
| Rate for Payer: Galaxy Health WC |
$23.77
|
| Rate for Payer: Adventist Health Commercial |
$5.59
|
| Rate for Payer: Cash Price |
$12.58
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$19.57
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.18
|
| Rate for Payer: EPIC Health Plan Senior |
$11.18
|
| Rate for Payer: Global Benefits Group Commercial |
$16.78
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$17.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$16.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.71
|
| Rate for Payer: Multiplan Commercial |
$22.37
|
| Rate for Payer: Networks By Design Commercial |
$18.17
|
| Rate for Payer: Prime Health Services Commercial |
$23.77
|
|
|
HC CREAM WOUND CARE ATRACTAIN 2OZ
|
Facility
|
OP
|
$27.96
|
|
| Hospital Charge Code |
901606201
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$5.59 |
| Max. Negotiated Rate |
$23.77 |
| Rate for Payer: Adventist Health Commercial |
$5.59
|
| Rate for Payer: Aetna of CA HMO/PPO |
$18.34
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$23.77
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15.38
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$20.97
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$17.94
|
| Rate for Payer: Cash Price |
$12.58
|
| Rate for Payer: Cigna of CA HMO |
$17.89
|
| Rate for Payer: Cigna of CA PPO |
$20.69
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$23.77
|
| Rate for Payer: Dignity Health Medi-Cal |
$23.77
|
| Rate for Payer: Dignity Health Medicare Advantage |
$23.77
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$19.57
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.18
|
| Rate for Payer: EPIC Health Plan Senior |
$11.18
|
| Rate for Payer: Galaxy Health WC |
$23.77
|
| Rate for Payer: Global Benefits Group Commercial |
$16.78
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$17.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$10.15
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$16.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.71
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$19.57
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$19.57
|
| Rate for Payer: Multiplan Commercial |
$22.37
|
| Rate for Payer: Networks By Design Commercial |
$18.17
|
| Rate for Payer: Prime Health Services Commercial |
$23.77
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$16.78
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$16.78
|
| Rate for Payer: United Healthcare All Other Commercial |
$13.98
|
| Rate for Payer: United Healthcare All Other HMO |
$13.98
|
| Rate for Payer: United Healthcare HMO Rider |
$13.98
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$13.98
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$23.77
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$23.77
|
| Rate for Payer: Vantage Medical Group Senior |
$23.77
|
|
|
HC CREATINE KINASE
|
Facility
|
IP
|
$153.00
|
|
|
Service Code
|
CPT 82550
|
| Hospital Charge Code |
900910222
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$30.60 |
| Max. Negotiated Rate |
$130.05 |
| Rate for Payer: Adventist Health Commercial |
$30.60
|
| Rate for Payer: Cash Price |
$68.85
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$107.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$61.20
|
| Rate for Payer: EPIC Health Plan Senior |
$61.20
|
| Rate for Payer: Galaxy Health WC |
$130.05
|
| Rate for Payer: Global Benefits Group Commercial |
$91.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$97.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$90.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$36.72
|
| Rate for Payer: Multiplan Commercial |
$122.40
|
| Rate for Payer: Networks By Design Commercial |
$99.45
|
| Rate for Payer: Prime Health Services Commercial |
$130.05
|
|
|
HC CREATINE KINASE
|
Facility
|
OP
|
$153.00
|
|
|
Service Code
|
CPT 82550
|
| Hospital Charge Code |
900910222
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.27 |
| Max. Negotiated Rate |
$130.05 |
| Rate for Payer: Adventist Health Commercial |
$30.60
|
| Rate for Payer: Adventist Health Commercial |
$8.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$54.16
|
| Rate for Payer: Aetna of CA HMO/PPO |
$54.16
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$9.77
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$9.77
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.16
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6.51
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6.51
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$67.68
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$67.68
|
| Rate for Payer: Blue Shield of California Commercial |
$19.82
|
| Rate for Payer: Blue Shield of California Commercial |
$106.64
|
| Rate for Payer: Blue Shield of California Commercial |
$29.97
|
| Rate for Payer: Blue Shield of California Commercial |
$70.53
|
| Rate for Payer: Cash Price |
$19.35
|
| Rate for Payer: Cash Price |
$19.35
|
| Rate for Payer: Cash Price |
$68.85
|
| Rate for Payer: Cash Price |
$68.85
|
| Rate for Payer: Cigna of CA HMO |
$27.52
|
| Rate for Payer: Cigna of CA HMO |
$97.92
|
| Rate for Payer: Cigna of CA PPO |
$113.22
|
| Rate for Payer: Cigna of CA PPO |
$31.82
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9.77
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9.77
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.16
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.16
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6.51
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6.51
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$107.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$30.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.74
|
| Rate for Payer: EPIC Health Plan Senior |
$7.16
|
| Rate for Payer: EPIC Health Plan Senior |
$7.16
|
| Rate for Payer: Galaxy Health WC |
$130.05
|
| Rate for Payer: Galaxy Health WC |
$36.55
|
| Rate for Payer: Global Benefits Group Commercial |
$91.80
|
| Rate for Payer: Global Benefits Group Commercial |
$25.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$10.68
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$10.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$9.73
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$9.73
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6.51
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$97.16
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$27.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$11.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$11.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$36.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8.72
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8.72
|
| Rate for Payer: Multiplan Commercial |
$34.40
|
| Rate for Payer: Multiplan Commercial |
$122.40
|
| Rate for Payer: Networks By Design Commercial |
$27.95
|
| Rate for Payer: Networks By Design Commercial |
$99.45
|
| Rate for Payer: Prime Health Services Commercial |
$130.05
|
| Rate for Payer: Prime Health Services Commercial |
$36.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$91.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$25.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$91.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$25.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.27
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.27
|
| Rate for Payer: United Healthcare All Other HMO |
$5.27
|
| Rate for Payer: United Healthcare All Other HMO |
$5.27
|
| Rate for Payer: United Healthcare HMO Rider |
$5.27
|
| Rate for Payer: United Healthcare HMO Rider |
$5.27
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.27
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.27
|
| Rate for Payer: Upland Medical Group Pediatric |
$6.51
|
| Rate for Payer: Upland Medical Group Pediatric |
$6.51
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$9.77
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$9.77
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.16
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.16
|
| Rate for Payer: Vantage Medical Group Senior |
$6.51
|
| Rate for Payer: Vantage Medical Group Senior |
$6.51
|
|
|
HC CREATININE
|
Facility
|
OP
|
$34.00
|
|
|
Service Code
|
CPT 82565
|
| Hospital Charge Code |
900910247
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.15 |
| Max. Negotiated Rate |
$52.81 |
| Rate for Payer: Adventist Health Commercial |
$6.80
|
| Rate for Payer: Adventist Health Commercial |
$19.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$42.69
|
| Rate for Payer: Aetna of CA HMO/PPO |
$42.69
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.68
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.63
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.63
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$52.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$52.81
|
| Rate for Payer: Blue Shield of California Commercial |
$45.18
|
| Rate for Payer: Blue Shield of California Commercial |
$15.67
|
| Rate for Payer: Blue Shield of California Commercial |
$68.31
|
| Rate for Payer: Blue Shield of California Commercial |
$23.70
|
| Rate for Payer: Cash Price |
$44.10
|
| Rate for Payer: Cash Price |
$44.10
|
| Rate for Payer: Cash Price |
$15.30
|
| Rate for Payer: Cash Price |
$15.30
|
| Rate for Payer: Cigna of CA HMO |
$62.72
|
| Rate for Payer: Cigna of CA HMO |
$21.76
|
| Rate for Payer: Cigna of CA PPO |
$25.16
|
| Rate for Payer: Cigna of CA PPO |
$72.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.63
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.63
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.12
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$23.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$68.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.45
|
| Rate for Payer: EPIC Health Plan Senior |
$5.63
|
| Rate for Payer: EPIC Health Plan Senior |
$5.63
|
| Rate for Payer: Galaxy Health WC |
$28.90
|
| Rate for Payer: Galaxy Health WC |
$83.30
|
| Rate for Payer: Global Benefits Group Commercial |
$20.40
|
| Rate for Payer: Global Benefits Group Commercial |
$58.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$8.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$8.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$7.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$7.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.12
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$21.59
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$62.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23.52
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.45
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.45
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.86
|
| Rate for Payer: Multiplan Commercial |
$78.40
|
| Rate for Payer: Multiplan Commercial |
$27.20
|
| Rate for Payer: Networks By Design Commercial |
$63.70
|
| Rate for Payer: Networks By Design Commercial |
$22.10
|
| Rate for Payer: Prime Health Services Commercial |
$28.90
|
| Rate for Payer: Prime Health Services Commercial |
$83.30
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$20.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$58.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$20.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$58.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.15
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.15
|
| Rate for Payer: United Healthcare All Other HMO |
$4.15
|
| Rate for Payer: United Healthcare All Other HMO |
$4.15
|
| Rate for Payer: United Healthcare HMO Rider |
$4.15
|
| Rate for Payer: United Healthcare HMO Rider |
$4.15
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.15
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.15
|
| Rate for Payer: Upland Medical Group Pediatric |
$5.12
|
| Rate for Payer: Upland Medical Group Pediatric |
$5.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.68
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.63
|
| Rate for Payer: Vantage Medical Group Senior |
$5.12
|
| Rate for Payer: Vantage Medical Group Senior |
$5.12
|
|
|
HC CREATININE
|
Facility
|
IP
|
$98.00
|
|
|
Service Code
|
CPT 82565
|
| Hospital Charge Code |
900910247
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$19.60 |
| Max. Negotiated Rate |
$83.30 |
| Rate for Payer: Adventist Health Commercial |
$19.60
|
| Rate for Payer: Cash Price |
$44.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$68.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$39.20
|
| Rate for Payer: EPIC Health Plan Senior |
$39.20
|
| Rate for Payer: Galaxy Health WC |
$83.30
|
| Rate for Payer: Global Benefits Group Commercial |
$58.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$62.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$57.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23.52
|
| Rate for Payer: Multiplan Commercial |
$78.40
|
| Rate for Payer: Networks By Design Commercial |
$63.70
|
| Rate for Payer: Prime Health Services Commercial |
$83.30
|
|
|
HC CREATININE BODY FLUID
|
Facility
|
OP
|
$127.00
|
|
|
Service Code
|
CPT 82570
|
| Hospital Charge Code |
900910377
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.19 |
| Max. Negotiated Rate |
$107.95 |
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.70
|
| Rate for Payer: Vantage Medical Group Senior |
$5.18
|
| Rate for Payer: Vantage Medical Group Senior |
$5.18
|
| Rate for Payer: Adventist Health Commercial |
$25.40
|
| Rate for Payer: Adventist Health Commercial |
$10.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$43.03
|
| Rate for Payer: Aetna of CA HMO/PPO |
$43.03
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.77
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.77
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.18
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$53.37
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$53.37
|
| Rate for Payer: Blue Shield of California Commercial |
$23.05
|
| Rate for Payer: Blue Shield of California Commercial |
$58.55
|
| Rate for Payer: Blue Shield of California Commercial |
$34.85
|
| Rate for Payer: Blue Shield of California Commercial |
$88.52
|
| Rate for Payer: Cash Price |
$22.50
|
| Rate for Payer: Cash Price |
$22.50
|
| Rate for Payer: Cash Price |
$57.15
|
| Rate for Payer: Cash Price |
$57.15
|
| Rate for Payer: Cigna of CA HMO |
$32.00
|
| Rate for Payer: Cigna of CA HMO |
$81.28
|
| Rate for Payer: Cigna of CA PPO |
$93.98
|
| Rate for Payer: Cigna of CA PPO |
$37.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.77
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.77
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.18
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.18
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$88.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$35.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.55
|
| Rate for Payer: EPIC Health Plan Senior |
$5.70
|
| Rate for Payer: EPIC Health Plan Senior |
$5.70
|
| Rate for Payer: Galaxy Health WC |
$107.95
|
| Rate for Payer: Galaxy Health WC |
$42.50
|
| Rate for Payer: Global Benefits Group Commercial |
$76.20
|
| Rate for Payer: Global Benefits Group Commercial |
$30.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$8.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$8.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$7.73
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$7.73
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.18
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$80.64
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$31.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$30.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.53
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.94
|
| Rate for Payer: Multiplan Commercial |
$40.00
|
| Rate for Payer: Multiplan Commercial |
$101.60
|
| Rate for Payer: Networks By Design Commercial |
$32.50
|
| Rate for Payer: Networks By Design Commercial |
$82.55
|
| Rate for Payer: Prime Health Services Commercial |
$107.95
|
| Rate for Payer: Prime Health Services Commercial |
$42.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$76.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$30.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$76.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$30.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.19
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.19
|
| Rate for Payer: United Healthcare All Other HMO |
$4.19
|
| Rate for Payer: United Healthcare All Other HMO |
$4.19
|
| Rate for Payer: United Healthcare HMO Rider |
$4.19
|
| Rate for Payer: United Healthcare HMO Rider |
$4.19
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.19
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.19
|
| Rate for Payer: Upland Medical Group Pediatric |
$5.18
|
| Rate for Payer: Upland Medical Group Pediatric |
$5.18
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.77
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.77
|
|
|
HC CREATININE BODY FLUID
|
Facility
|
IP
|
$127.00
|
|
|
Service Code
|
CPT 82570
|
| Hospital Charge Code |
900910377
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$25.40 |
| Max. Negotiated Rate |
$107.95 |
| Rate for Payer: Adventist Health Commercial |
$25.40
|
| Rate for Payer: Cash Price |
$57.15
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$88.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$50.80
|
| Rate for Payer: EPIC Health Plan Senior |
$50.80
|
| Rate for Payer: Galaxy Health WC |
$107.95
|
| Rate for Payer: Global Benefits Group Commercial |
$76.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$80.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$74.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$30.48
|
| Rate for Payer: Multiplan Commercial |
$101.60
|
| Rate for Payer: Networks By Design Commercial |
$82.55
|
| Rate for Payer: Prime Health Services Commercial |
$107.95
|
|
|
HC CREATININE CH
|
Facility
|
IP
|
$85.00
|
|
|
Service Code
|
CPT 82565
|
| Hospital Charge Code |
900912181
|
|
Hospital Revenue Code
|
301
|
| 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
|
|
|
HC CREATININE CH
|
Facility
|
OP
|
$85.00
|
|
|
Service Code
|
CPT 82565
|
| Hospital Charge Code |
900912181
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.15 |
| Max. Negotiated Rate |
$72.25 |
| Rate for Payer: Adventist Health Commercial |
$17.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$42.69
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.63
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$52.81
|
| Rate for Payer: Blue Shield of California Commercial |
$39.19
|
| Rate for Payer: Blue Shield of California Commercial |
$59.24
|
| Rate for Payer: Cash Price |
$38.25
|
| Rate for Payer: Cash Price |
$38.25
|
| Rate for Payer: Cigna of CA HMO |
$54.40
|
| Rate for Payer: Cigna of CA PPO |
$62.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.63
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.12
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$59.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.45
|
| Rate for Payer: EPIC Health Plan Senior |
$5.63
|
| Rate for Payer: Galaxy Health WC |
$72.25
|
| Rate for Payer: Global Benefits Group Commercial |
$51.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$8.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$7.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.12
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$53.98
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.45
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.86
|
| Rate for Payer: Multiplan Commercial |
$68.00
|
| Rate for Payer: Networks By Design Commercial |
$55.25
|
| Rate for Payer: Prime Health Services Commercial |
$72.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$51.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$51.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.15
|
| Rate for Payer: United Healthcare All Other HMO |
$4.15
|
| Rate for Payer: United Healthcare HMO Rider |
$4.15
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.15
|
| Rate for Payer: Upland Medical Group Pediatric |
$5.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.63
|
| Rate for Payer: Vantage Medical Group Senior |
$5.12
|
|
|
HC CREATININE CLEARAN
|
Facility
|
IP
|
$261.00
|
|
|
Service Code
|
CPT 82575
|
| Hospital Charge Code |
900910260
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$52.20 |
| Max. Negotiated Rate |
$221.85 |
| Rate for Payer: Adventist Health Commercial |
$52.20
|
| Rate for Payer: Cash Price |
$117.45
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$182.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$104.40
|
| Rate for Payer: EPIC Health Plan Senior |
$104.40
|
| Rate for Payer: Galaxy Health WC |
$221.85
|
| Rate for Payer: Global Benefits Group Commercial |
$156.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$165.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$153.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$62.64
|
| Rate for Payer: Multiplan Commercial |
$208.80
|
| Rate for Payer: Networks By Design Commercial |
$169.65
|
| Rate for Payer: Prime Health Services Commercial |
$221.85
|
|
|
HC CREATININE CLEARAN
|
Facility
|
OP
|
$261.00
|
|
|
Service Code
|
CPT 82575
|
| Hospital Charge Code |
900910260
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.66 |
| Max. Negotiated Rate |
$221.85 |
| Rate for Payer: Adventist Health Commercial |
$52.20
|
| Rate for Payer: Adventist Health Commercial |
$18.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$78.63
|
| Rate for Payer: Aetna of CA HMO/PPO |
$78.63
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$14.19
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$14.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10.41
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10.41
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9.46
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9.46
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$97.35
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$97.35
|
| Rate for Payer: Blue Shield of California Commercial |
$42.41
|
| Rate for Payer: Blue Shield of California Commercial |
$120.32
|
| Rate for Payer: Blue Shield of California Commercial |
$64.12
|
| Rate for Payer: Blue Shield of California Commercial |
$181.92
|
| Rate for Payer: Cash Price |
$41.40
|
| Rate for Payer: Cash Price |
$41.40
|
| Rate for Payer: Cash Price |
$117.45
|
| Rate for Payer: Cash Price |
$117.45
|
| Rate for Payer: Cigna of CA HMO |
$58.88
|
| Rate for Payer: Cigna of CA HMO |
$167.04
|
| Rate for Payer: Cigna of CA PPO |
$193.14
|
| Rate for Payer: Cigna of CA PPO |
$68.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$14.19
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$14.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$10.41
|
| Rate for Payer: Dignity Health Medi-Cal |
$10.41
|
| Rate for Payer: Dignity Health Medicare Advantage |
$9.46
|
| Rate for Payer: Dignity Health Medicare Advantage |
$9.46
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$182.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$64.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.61
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.61
|
| Rate for Payer: EPIC Health Plan Senior |
$10.41
|
| Rate for Payer: EPIC Health Plan Senior |
$10.41
|
| Rate for Payer: Galaxy Health WC |
$221.85
|
| Rate for Payer: Galaxy Health WC |
$78.20
|
| Rate for Payer: Global Benefits Group Commercial |
$156.60
|
| Rate for Payer: Global Benefits Group Commercial |
$55.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$15.51
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$15.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$14.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$14.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$9.46
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$9.46
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$165.74
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$58.42
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$15.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$15.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$13.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$13.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$62.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.08
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11.92
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$12.68
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$12.68
|
| Rate for Payer: Multiplan Commercial |
$73.60
|
| Rate for Payer: Multiplan Commercial |
$208.80
|
| Rate for Payer: Networks By Design Commercial |
$59.80
|
| Rate for Payer: Networks By Design Commercial |
$169.65
|
| Rate for Payer: Prime Health Services Commercial |
$221.85
|
| Rate for Payer: Prime Health Services Commercial |
$78.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$156.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$55.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$156.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$55.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.66
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.66
|
| Rate for Payer: United Healthcare All Other HMO |
$7.66
|
| Rate for Payer: United Healthcare All Other HMO |
$7.66
|
| Rate for Payer: United Healthcare HMO Rider |
$7.66
|
| Rate for Payer: United Healthcare HMO Rider |
$7.66
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.66
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.66
|
| Rate for Payer: Upland Medical Group Pediatric |
$9.46
|
| Rate for Payer: Upland Medical Group Pediatric |
$9.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$14.19
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$14.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.41
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.41
|
| Rate for Payer: Vantage Medical Group Senior |
$9.46
|
| Rate for Payer: Vantage Medical Group Senior |
$9.46
|
|
|
HC CREATININE INDIVIDUAL
|
Facility
|
IP
|
$98.00
|
|
|
Service Code
|
CPT 82565
|
| Hospital Charge Code |
900910493
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$19.60 |
| Max. Negotiated Rate |
$83.30 |
| Rate for Payer: Adventist Health Commercial |
$19.60
|
| Rate for Payer: Cash Price |
$44.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$68.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$39.20
|
| Rate for Payer: EPIC Health Plan Senior |
$39.20
|
| Rate for Payer: Galaxy Health WC |
$83.30
|
| Rate for Payer: Global Benefits Group Commercial |
$58.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$62.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$57.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23.52
|
| Rate for Payer: Multiplan Commercial |
$78.40
|
| Rate for Payer: Networks By Design Commercial |
$63.70
|
| Rate for Payer: Prime Health Services Commercial |
$83.30
|
|
|
HC CREATININE INDIVIDUAL
|
Facility
|
OP
|
$34.00
|
|
|
Service Code
|
CPT 82565
|
| Hospital Charge Code |
900910493
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.15 |
| Max. Negotiated Rate |
$52.81 |
| Rate for Payer: Adventist Health Commercial |
$6.80
|
| Rate for Payer: Adventist Health Commercial |
$19.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$42.69
|
| Rate for Payer: Aetna of CA HMO/PPO |
$42.69
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.68
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.63
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.63
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$52.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$52.81
|
| Rate for Payer: Blue Shield of California Commercial |
$45.18
|
| Rate for Payer: Blue Shield of California Commercial |
$15.67
|
| Rate for Payer: Blue Shield of California Commercial |
$68.31
|
| Rate for Payer: Blue Shield of California Commercial |
$23.70
|
| Rate for Payer: Cash Price |
$44.10
|
| Rate for Payer: Cash Price |
$44.10
|
| Rate for Payer: Cash Price |
$15.30
|
| Rate for Payer: Cash Price |
$15.30
|
| Rate for Payer: Cigna of CA HMO |
$62.72
|
| Rate for Payer: Cigna of CA HMO |
$21.76
|
| Rate for Payer: Cigna of CA PPO |
$25.16
|
| Rate for Payer: Cigna of CA PPO |
$72.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.63
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.63
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.12
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$23.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$68.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.45
|
| Rate for Payer: EPIC Health Plan Senior |
$5.63
|
| Rate for Payer: EPIC Health Plan Senior |
$5.63
|
| Rate for Payer: Galaxy Health WC |
$28.90
|
| Rate for Payer: Galaxy Health WC |
$83.30
|
| Rate for Payer: Global Benefits Group Commercial |
$20.40
|
| Rate for Payer: Global Benefits Group Commercial |
$58.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$8.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$8.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$7.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$7.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.12
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$21.59
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$62.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23.52
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.45
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.45
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.86
|
| Rate for Payer: Multiplan Commercial |
$78.40
|
| Rate for Payer: Multiplan Commercial |
$27.20
|
| Rate for Payer: Networks By Design Commercial |
$63.70
|
| Rate for Payer: Networks By Design Commercial |
$22.10
|
| Rate for Payer: Prime Health Services Commercial |
$28.90
|
| Rate for Payer: Prime Health Services Commercial |
$83.30
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$20.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$58.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$20.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$58.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.15
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.15
|
| Rate for Payer: United Healthcare All Other HMO |
$4.15
|
| Rate for Payer: United Healthcare All Other HMO |
$4.15
|
| Rate for Payer: United Healthcare HMO Rider |
$4.15
|
| Rate for Payer: United Healthcare HMO Rider |
$4.15
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.15
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.15
|
| Rate for Payer: Upland Medical Group Pediatric |
$5.12
|
| Rate for Payer: Upland Medical Group Pediatric |
$5.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.68
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.63
|
| Rate for Payer: Vantage Medical Group Senior |
$5.12
|
| Rate for Payer: Vantage Medical Group Senior |
$5.12
|
|
|
HC CRITICAL CARE ADDL 30 MIN
|
Facility
|
IP
|
$6,354.00
|
|
|
Service Code
|
CPT 99292
|
| Hospital Charge Code |
900501641
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,270.80 |
| Max. Negotiated Rate |
$5,400.90 |
| Rate for Payer: Adventist Health Commercial |
$1,270.80
|
| Rate for Payer: Cash Price |
$2,859.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,447.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,541.60
|
| Rate for Payer: EPIC Health Plan Senior |
$2,541.60
|
| Rate for Payer: Galaxy Health WC |
$5,400.90
|
| Rate for Payer: Global Benefits Group Commercial |
$3,812.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,034.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,748.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,524.96
|
| Rate for Payer: Multiplan Commercial |
$5,083.20
|
| Rate for Payer: Networks By Design Commercial |
$4,130.10
|
| Rate for Payer: Prime Health Services Commercial |
$5,400.90
|
|
|
HC CRITICAL CARE ADDL 30 MIN
|
Facility
|
IP
|
$6,354.00
|
|
|
Service Code
|
CPT 99292
|
| Hospital Charge Code |
900501641
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$1,270.80 |
| Max. Negotiated Rate |
$5,400.90 |
| Rate for Payer: Adventist Health Commercial |
$1,270.80
|
| Rate for Payer: Cash Price |
$2,859.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,447.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,541.60
|
| Rate for Payer: EPIC Health Plan Senior |
$2,541.60
|
| Rate for Payer: Galaxy Health WC |
$5,400.90
|
| Rate for Payer: Global Benefits Group Commercial |
$3,812.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,034.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,748.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,524.96
|
| Rate for Payer: Multiplan Commercial |
$5,083.20
|
| Rate for Payer: Networks By Design Commercial |
$4,130.10
|
| Rate for Payer: Prime Health Services Commercial |
$5,400.90
|
|
|
HC CRITICAL CARE ADDL 30 MIN
|
Facility
|
OP
|
$6,354.00
|
|
|
Service Code
|
CPT 99292
|
| Hospital Charge Code |
900501641
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$111.91 |
| Max. Negotiated Rate |
$5,400.90 |
| Rate for Payer: Adventist Health Commercial |
$1,270.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,400.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,494.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,765.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,601.00
|
| Rate for Payer: Cash Price |
$2,859.30
|
| Rate for Payer: Cash Price |
$2,859.30
|
| Rate for Payer: Cash Price |
$2,859.30
|
| Rate for Payer: Cigna of CA HMO |
$4,066.56
|
| Rate for Payer: Cigna of CA PPO |
$4,701.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,400.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,400.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5,400.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,447.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,541.60
|
| Rate for Payer: EPIC Health Plan Senior |
$2,541.60
|
| Rate for Payer: Galaxy Health WC |
$5,400.90
|
| Rate for Payer: Global Benefits Group Commercial |
$3,812.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,034.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$111.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,748.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,524.96
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4,447.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4,447.80
|
| Rate for Payer: Multiplan Commercial |
$5,083.20
|
| Rate for Payer: Networks By Design Commercial |
$4,130.10
|
| Rate for Payer: Prime Health Services Commercial |
$5,400.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,812.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,177.00
|
| Rate for Payer: United Healthcare All Other HMO |
$3,177.00
|
| Rate for Payer: United Healthcare HMO Rider |
$3,177.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,177.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,400.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,400.90
|
| Rate for Payer: Vantage Medical Group Senior |
$5,400.90
|
|
|
HC CRITICAL CARE ADDL 30 MIN
|
Facility
|
OP
|
$6,354.00
|
|
|
Service Code
|
CPT 99292
|
| Hospital Charge Code |
900501641
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$111.91 |
| Max. Negotiated Rate |
$5,400.90 |
| Rate for Payer: Adventist Health Commercial |
$2,605.14
|
| Rate for Payer: Aetna of CA HMO/PPO |
$670.40
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,400.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,494.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,765.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,601.00
|
| Rate for Payer: Cash Price |
$2,859.30
|
| Rate for Payer: Cash Price |
$2,859.30
|
| Rate for Payer: Cash Price |
$2,859.30
|
| Rate for Payer: Cigna of CA HMO |
$4,066.56
|
| Rate for Payer: Cigna of CA PPO |
$4,701.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,400.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,400.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5,400.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,447.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,541.60
|
| Rate for Payer: EPIC Health Plan Senior |
$2,541.60
|
| Rate for Payer: Galaxy Health WC |
$5,400.90
|
| Rate for Payer: Global Benefits Group Commercial |
$3,812.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,034.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$111.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,748.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,524.96
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4,447.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4,447.80
|
| Rate for Payer: Multiplan Commercial |
$5,083.20
|
| Rate for Payer: Networks By Design Commercial |
$4,130.10
|
| Rate for Payer: Prime Health Services Commercial |
$5,400.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,812.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,812.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,400.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,400.90
|
| Rate for Payer: Vantage Medical Group Senior |
$5,400.90
|
|
|
HC CRITICAL CARE E&M 30-74 MIN
|
Facility
|
OP
|
$12,719.00
|
|
|
Service Code
|
CPT 99291
|
| Hospital Charge Code |
900509291
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$231.04 |
| Max. Negotiated Rate |
$10,811.15 |
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,168.65
|
| Rate for Payer: Vantage Medical Group Senior |
$1,062.41
|
| Rate for Payer: Adventist Health Commercial |
$2,543.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,593.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,168.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,062.41
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,601.00
|
| Rate for Payer: Cash Price |
$5,723.55
|
| Rate for Payer: Cash Price |
$5,723.55
|
| Rate for Payer: Cash Price |
$5,723.55
|
| Rate for Payer: Cigna of CA HMO |
$8,140.16
|
| Rate for Payer: Cigna of CA PPO |
$9,412.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,593.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,168.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,062.41
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8,903.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,752.98
|
| Rate for Payer: EPIC Health Plan Senior |
$1,168.65
|
| Rate for Payer: Galaxy Health WC |
$10,811.15
|
| Rate for Payer: Global Benefits Group Commercial |
$7,631.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,742.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,062.41
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8,076.56
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$231.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,142.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,052.56
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,338.64
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,423.63
|
| Rate for Payer: Multiplan Commercial |
$10,175.20
|
| Rate for Payer: Multiplan WC |
$1,705.85
|
| Rate for Payer: Networks By Design Commercial |
$8,267.35
|
| Rate for Payer: Prime Health Services Commercial |
$10,811.15
|
| Rate for Payer: Prime Health Services WC |
$1,688.44
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,631.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$8,039.00
|
| Rate for Payer: United Healthcare All Other HMO |
$8,075.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,391.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,770.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,062.41
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,593.62
|
|
|
HC CRITICAL CARE E&M 30-74 MIN
|
Facility
|
IP
|
$12,719.00
|
|
|
Service Code
|
CPT 99291
|
| Hospital Charge Code |
900509291
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$2,543.80 |
| Max. Negotiated Rate |
$10,811.15 |
| Rate for Payer: Adventist Health Commercial |
$2,543.80
|
| Rate for Payer: Cash Price |
$5,723.55
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8,903.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,087.60
|
| Rate for Payer: EPIC Health Plan Senior |
$5,087.60
|
| Rate for Payer: Galaxy Health WC |
$10,811.15
|
| Rate for Payer: Global Benefits Group Commercial |
$7,631.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8,076.56
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7,504.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,052.56
|
| Rate for Payer: Multiplan Commercial |
$10,175.20
|
| Rate for Payer: Networks By Design Commercial |
$8,267.35
|
| Rate for Payer: Prime Health Services Commercial |
$10,811.15
|
|
|
HC CRITICAL CARE E&M 30-74 MIN
|
Facility
|
OP
|
$12,719.00
|
|
|
Service Code
|
CPT 99291
|
| Hospital Charge Code |
900509291
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$231.04 |
| Max. Negotiated Rate |
$10,811.15 |
| Rate for Payer: Adventist Health Commercial |
$5,214.79
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,335.52
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,593.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,168.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,062.41
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,601.00
|
| Rate for Payer: Cash Price |
$5,723.55
|
| Rate for Payer: Cash Price |
$5,723.55
|
| Rate for Payer: Cash Price |
$5,723.55
|
| Rate for Payer: Cigna of CA HMO |
$8,140.16
|
| Rate for Payer: Cigna of CA PPO |
$9,412.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,593.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,168.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,062.41
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8,903.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,752.98
|
| Rate for Payer: EPIC Health Plan Senior |
$1,168.65
|
| Rate for Payer: Galaxy Health WC |
$10,811.15
|
| Rate for Payer: Global Benefits Group Commercial |
$7,631.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,742.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,062.41
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8,076.56
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$231.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,142.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,052.56
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,338.64
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,423.63
|
| Rate for Payer: Multiplan Commercial |
$10,175.20
|
| Rate for Payer: Multiplan WC |
$1,705.85
|
| Rate for Payer: Networks By Design Commercial |
$8,267.35
|
| Rate for Payer: Prime Health Services Commercial |
$10,811.15
|
| Rate for Payer: Prime Health Services WC |
$1,688.44
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,631.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7,631.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,062.41
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,593.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,168.65
|
| Rate for Payer: Vantage Medical Group Senior |
$1,062.41
|
|
|
HC CRITICAL CARE E&M 30-74 MIN
|
Facility
|
IP
|
$12,719.00
|
|
|
Service Code
|
CPT 99291
|
| Hospital Charge Code |
900509291
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,543.80 |
| Max. Negotiated Rate |
$10,811.15 |
| Rate for Payer: Adventist Health Commercial |
$2,543.80
|
| Rate for Payer: Cash Price |
$5,723.55
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8,903.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,087.60
|
| Rate for Payer: EPIC Health Plan Senior |
$5,087.60
|
| Rate for Payer: Galaxy Health WC |
$10,811.15
|
| Rate for Payer: Global Benefits Group Commercial |
$7,631.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8,076.56
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7,504.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,052.56
|
| Rate for Payer: Multiplan Commercial |
$10,175.20
|
| Rate for Payer: Networks By Design Commercial |
$8,267.35
|
| Rate for Payer: Prime Health Services Commercial |
$10,811.15
|
|
|
HC CROSSMATCH COMP
|
Facility
|
OP
|
$269.00
|
|
|
Service Code
|
CPT 86923
|
| Hospital Charge Code |
900904766
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$53.80 |
| Max. Negotiated Rate |
$361.55 |
| Rate for Payer: Adventist Health Commercial |
$53.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$134.73
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$328.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$241.03
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$219.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$87.56
|
| Rate for Payer: Blue Shield of California Commercial |
$124.01
|
| Rate for Payer: Blue Shield of California Commercial |
$187.49
|
| Rate for Payer: Cash Price |
$121.05
|
| Rate for Payer: Cash Price |
$121.05
|
| Rate for Payer: Cigna of CA HMO |
$172.16
|
| Rate for Payer: Cigna of CA PPO |
$199.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$328.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$241.03
|
| Rate for Payer: Dignity Health Medicare Advantage |
$219.12
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$188.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$361.55
|
| Rate for Payer: EPIC Health Plan Senior |
$241.03
|
| Rate for Payer: Galaxy Health WC |
$228.65
|
| Rate for Payer: Global Benefits Group Commercial |
$161.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$359.36
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$219.12
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$170.81
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$306.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$64.56
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$276.09
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$293.62
|
| Rate for Payer: Multiplan Commercial |
$215.20
|
| Rate for Payer: Networks By Design Commercial |
$174.85
|
| Rate for Payer: Prime Health Services Commercial |
$228.65
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$161.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$161.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$123.38
|
| Rate for Payer: United Healthcare All Other HMO |
$123.38
|
| Rate for Payer: United Healthcare HMO Rider |
$123.38
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$123.38
|
| Rate for Payer: Upland Medical Group Pediatric |
$219.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$328.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$241.03
|
| Rate for Payer: Vantage Medical Group Senior |
$219.12
|
|
