|
HC CYSTOURETHROSCOPY, W/DILATION
|
Facility
|
OP
|
$6,765.00
|
|
|
Service Code
|
CPT 52281
|
| Hospital Charge Code |
900501303
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$240.50 |
| Max. Negotiated Rate |
$6,716.00 |
| Rate for Payer: Dignity Health Medi-Cal |
$2,957.44
|
| Rate for Payer: Adventist Health Commercial |
$1,353.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4,032.87
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,957.44
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,688.58
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,716.00
|
| Rate for Payer: Cash Price |
$3,044.25
|
| Rate for Payer: Cash Price |
$3,044.25
|
| Rate for Payer: Cash Price |
$3,044.25
|
| Rate for Payer: Cigna of CA HMO |
$4,329.60
|
| Rate for Payer: Cigna of CA PPO |
$5,006.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,032.87
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,688.58
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,735.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,436.16
|
| Rate for Payer: EPIC Health Plan Senior |
$2,957.44
|
| Rate for Payer: Galaxy Health WC |
$5,750.25
|
| Rate for Payer: Global Benefits Group Commercial |
$4,059.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$4,409.27
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,688.58
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,295.77
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$240.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,890.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,623.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,387.61
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,602.70
|
| Rate for Payer: Multiplan Commercial |
$5,412.00
|
| Rate for Payer: Multiplan WC |
$4,147.14
|
| Rate for Payer: Networks By Design Commercial |
$4,397.25
|
| Rate for Payer: Prime Health Services Commercial |
$5,750.25
|
| Rate for Payer: Prime Health Services WC |
$4,104.83
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,059.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,382.50
|
| Rate for Payer: United Healthcare All Other HMO |
$3,382.50
|
| Rate for Payer: United Healthcare HMO Rider |
$3,382.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,382.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,688.58
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4,032.87
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,957.44
|
| Rate for Payer: Vantage Medical Group Senior |
$2,688.58
|
|
|
HC CYSTOURETHROSCOPY W/RMVL F B
|
Facility
|
OP
|
$7,386.00
|
|
|
Service Code
|
CPT 52310
|
| Hospital Charge Code |
900501293
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$560.23 |
| Max. Negotiated Rate |
$6,716.00 |
| Rate for Payer: Adventist Health Commercial |
$1,477.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4,032.87
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,957.44
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,688.58
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,716.00
|
| Rate for Payer: Cash Price |
$3,323.70
|
| Rate for Payer: Cash Price |
$3,323.70
|
| Rate for Payer: Cash Price |
$3,323.70
|
| Rate for Payer: Cigna of CA HMO |
$4,727.04
|
| Rate for Payer: Cigna of CA PPO |
$5,465.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,032.87
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,957.44
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,688.58
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,170.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,436.16
|
| Rate for Payer: EPIC Health Plan Senior |
$2,957.44
|
| Rate for Payer: Galaxy Health WC |
$6,278.10
|
| Rate for Payer: Global Benefits Group Commercial |
$4,431.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$4,409.27
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,688.58
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,690.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$560.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,890.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,772.64
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,387.61
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,602.70
|
| Rate for Payer: Multiplan Commercial |
$5,908.80
|
| Rate for Payer: Multiplan WC |
$4,147.14
|
| Rate for Payer: Networks By Design Commercial |
$4,800.90
|
| Rate for Payer: Prime Health Services Commercial |
$6,278.10
|
| Rate for Payer: Prime Health Services WC |
$4,104.83
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,431.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,693.00
|
| Rate for Payer: United Healthcare All Other HMO |
$3,693.00
|
| Rate for Payer: United Healthcare HMO Rider |
$3,693.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,693.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,688.58
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4,032.87
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,957.44
|
| Rate for Payer: Vantage Medical Group Senior |
$2,688.58
|
|
|
HC CYSTOURETHROSCOPY W/RMVL F B
|
Facility
|
IP
|
$7,386.00
|
|
|
Service Code
|
CPT 52310
|
| Hospital Charge Code |
900501293
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,477.20 |
| Max. Negotiated Rate |
$6,278.10 |
| Rate for Payer: Adventist Health Commercial |
$1,477.20
|
| Rate for Payer: Cash Price |
$3,323.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,170.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,954.40
|
| Rate for Payer: EPIC Health Plan Senior |
$2,954.40
|
| Rate for Payer: Galaxy Health WC |
$6,278.10
|
| Rate for Payer: Global Benefits Group Commercial |
$4,431.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,690.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,357.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,772.64
|
| Rate for Payer: Multiplan Commercial |
$5,908.80
|
| Rate for Payer: Networks By Design Commercial |
$4,800.90
|
| Rate for Payer: Prime Health Services Commercial |
$6,278.10
|
|
|
HC CYSTOURETHROSCOPY,W/UTERAL CAT
|
Facility
|
OP
|
$8,457.00
|
|
|
Service Code
|
CPT 52005
|
| Hospital Charge Code |
900501312
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$288.61 |
| Max. Negotiated Rate |
$7,188.45 |
| Rate for Payer: Cash Price |
$3,805.65
|
| Rate for Payer: Cash Price |
$3,805.65
|
| Rate for Payer: Cash Price |
$3,805.65
|
| Rate for Payer: Cigna of CA HMO |
$5,412.48
|
| Rate for Payer: Cigna of CA PPO |
$6,258.18
|
| Rate for Payer: Adventist Health Commercial |
$1,691.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4,032.87
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,957.44
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,688.58
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,716.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,032.87
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,957.44
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,688.58
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,919.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,436.16
|
| Rate for Payer: EPIC Health Plan Senior |
$2,957.44
|
| Rate for Payer: Galaxy Health WC |
$7,188.45
|
| Rate for Payer: Global Benefits Group Commercial |
$5,074.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$4,409.27
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,688.58
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,370.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$288.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,890.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,029.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,387.61
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,602.70
|
| Rate for Payer: Multiplan Commercial |
$6,765.60
|
| Rate for Payer: Multiplan WC |
$4,147.14
|
| Rate for Payer: Networks By Design Commercial |
$5,497.05
|
| Rate for Payer: Prime Health Services Commercial |
$7,188.45
|
| Rate for Payer: Prime Health Services WC |
$4,104.83
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,074.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,228.50
|
| Rate for Payer: United Healthcare All Other HMO |
$4,228.50
|
| Rate for Payer: United Healthcare HMO Rider |
$4,228.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,228.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,688.58
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4,032.87
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,957.44
|
| Rate for Payer: Vantage Medical Group Senior |
$2,688.58
|
|
|
HC CYSTOURETHROSCOPY,W/UTERAL CAT
|
Facility
|
IP
|
$8,457.00
|
|
|
Service Code
|
CPT 52005
|
| Hospital Charge Code |
900501312
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,691.40 |
| Max. Negotiated Rate |
$7,188.45 |
| Rate for Payer: Adventist Health Commercial |
$1,691.40
|
| Rate for Payer: Cash Price |
$3,805.65
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,919.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,382.80
|
| Rate for Payer: EPIC Health Plan Senior |
$3,382.80
|
| Rate for Payer: Galaxy Health WC |
$7,188.45
|
| Rate for Payer: Global Benefits Group Commercial |
$5,074.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,370.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,989.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,029.68
|
| Rate for Payer: Multiplan Commercial |
$6,765.60
|
| Rate for Payer: Networks By Design Commercial |
$5,497.05
|
| Rate for Payer: Prime Health Services Commercial |
$7,188.45
|
|
|
HC CYSTOURETHRO W LITHO INC STNT
|
Facility
|
OP
|
$10,364.00
|
|
|
Service Code
|
CPT 52356
|
| Hospital Charge Code |
900052356
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$672.71 |
| Max. Negotiated Rate |
$11,378.68 |
| Rate for Payer: Networks By Design Commercial |
$6,736.60
|
| Rate for Payer: Multiplan Commercial |
$8,291.20
|
| Rate for Payer: Multiplan WC |
$10,291.67
|
| Rate for Payer: Adventist Health Commercial |
$2,072.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10,344.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7,585.79
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6,896.17
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,716.00
|
| Rate for Payer: Cash Price |
$4,663.80
|
| Rate for Payer: Cash Price |
$4,663.80
|
| Rate for Payer: Cash Price |
$4,663.80
|
| Rate for Payer: Cigna of CA HMO |
$6,632.96
|
| Rate for Payer: Cigna of CA PPO |
$7,669.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,344.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,585.79
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6,896.17
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7,254.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$11,378.68
|
| Rate for Payer: EPIC Health Plan Senior |
$7,585.79
|
| Rate for Payer: Galaxy Health WC |
$8,809.40
|
| Rate for Payer: Global Benefits Group Commercial |
$6,218.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$11,309.72
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6,896.17
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,581.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$672.71
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7,413.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,487.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8,689.17
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9,240.87
|
| Rate for Payer: Prime Health Services Commercial |
$8,809.40
|
| Rate for Payer: Prime Health Services WC |
$10,186.65
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,218.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,182.00
|
| Rate for Payer: United Healthcare All Other HMO |
$5,182.00
|
| Rate for Payer: United Healthcare HMO Rider |
$5,182.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,182.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$6,896.17
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,344.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,585.79
|
| Rate for Payer: Vantage Medical Group Senior |
$6,896.17
|
|
|
HC CYSTOURETHRO W LITHO INC STNT
|
Facility
|
IP
|
$10,364.00
|
|
|
Service Code
|
CPT 52356
|
| Hospital Charge Code |
900052356
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,072.80 |
| Max. Negotiated Rate |
$8,809.40 |
| Rate for Payer: Adventist Health Commercial |
$2,072.80
|
| Rate for Payer: Cash Price |
$4,663.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7,254.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,145.60
|
| Rate for Payer: EPIC Health Plan Senior |
$4,145.60
|
| Rate for Payer: Galaxy Health WC |
$8,809.40
|
| Rate for Payer: Global Benefits Group Commercial |
$6,218.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,581.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6,114.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,487.36
|
| Rate for Payer: Multiplan Commercial |
$8,291.20
|
| Rate for Payer: Networks By Design Commercial |
$6,736.60
|
| Rate for Payer: Prime Health Services Commercial |
$8,809.40
|
|
|
HC CYTO FNA EVAL, 1ST EA SITE
|
Facility
|
OP
|
$104.00
|
|
|
Service Code
|
CPT 88172
|
| Hospital Charge Code |
903800008
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$20.80 |
| Max. Negotiated Rate |
$361.55 |
| Rate for Payer: Adventist Health Commercial |
$20.80
|
| Rate for Payer: Adventist Health Commercial |
$73.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$148.43
|
| Rate for Payer: Aetna of CA HMO/PPO |
$148.43
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$328.68
|
| 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 Medi-Cal |
$241.03
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$219.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$219.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$107.36
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$107.36
|
| Rate for Payer: Blue Shield of California Commercial |
$168.73
|
| Rate for Payer: Blue Shield of California Commercial |
$47.94
|
| Rate for Payer: Blue Shield of California Commercial |
$255.10
|
| Rate for Payer: Blue Shield of California Commercial |
$72.49
|
| Rate for Payer: Cash Price |
$164.70
|
| Rate for Payer: Cash Price |
$164.70
|
| Rate for Payer: Cash Price |
$46.80
|
| Rate for Payer: Cash Price |
$46.80
|
| Rate for Payer: Cigna of CA HMO |
$234.24
|
| Rate for Payer: Cigna of CA HMO |
$66.56
|
| Rate for Payer: Cigna of CA PPO |
$76.96
|
| Rate for Payer: Cigna of CA PPO |
$270.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$328.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$328.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$241.03
|
| Rate for Payer: Dignity Health Medi-Cal |
$241.03
|
| Rate for Payer: Dignity Health Medicare Advantage |
$219.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$219.12
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$72.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$256.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$361.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$361.55
|
| Rate for Payer: EPIC Health Plan Senior |
$241.03
|
| Rate for Payer: EPIC Health Plan Senior |
$241.03
|
| Rate for Payer: Galaxy Health WC |
$88.40
|
| Rate for Payer: Galaxy Health WC |
$311.10
|
| Rate for Payer: Global Benefits Group Commercial |
$62.40
|
| Rate for Payer: Global Benefits Group Commercial |
$219.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$359.36
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$359.36
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$47.53
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$47.53
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$219.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$219.12
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$66.04
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$232.41
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$53.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$53.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$306.77
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$306.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$87.84
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$276.09
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$276.09
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$293.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$293.62
|
| Rate for Payer: Multiplan Commercial |
$292.80
|
| Rate for Payer: Multiplan Commercial |
$83.20
|
| Rate for Payer: Networks By Design Commercial |
$237.90
|
| Rate for Payer: Networks By Design Commercial |
$67.60
|
| Rate for Payer: Prime Health Services Commercial |
$88.40
|
| Rate for Payer: Prime Health Services Commercial |
$311.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$62.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$219.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$62.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$219.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$123.38
|
| 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 All Other HMO |
$123.38
|
| Rate for Payer: United Healthcare HMO Rider |
$123.38
|
| Rate for Payer: United Healthcare HMO Rider |
$123.38
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$123.38
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$123.38
|
| Rate for Payer: Upland Medical Group Pediatric |
$219.12
|
| 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 Commercial/Exchange |
$328.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$241.03
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$241.03
|
| Rate for Payer: Vantage Medical Group Senior |
$219.12
|
| Rate for Payer: Vantage Medical Group Senior |
$219.12
|
|
|
HC CYTO FNA EVAL, 1ST EA SITE
|
Facility
|
IP
|
$366.00
|
|
|
Service Code
|
CPT 88172
|
| Hospital Charge Code |
903800008
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$73.20 |
| Max. Negotiated Rate |
$311.10 |
| Rate for Payer: Adventist Health Commercial |
$73.20
|
| Rate for Payer: Cash Price |
$164.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$256.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$146.40
|
| Rate for Payer: EPIC Health Plan Senior |
$146.40
|
| Rate for Payer: Galaxy Health WC |
$311.10
|
| Rate for Payer: Global Benefits Group Commercial |
$219.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$232.41
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$215.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$87.84
|
| Rate for Payer: Multiplan Commercial |
$292.80
|
| Rate for Payer: Networks By Design Commercial |
$237.90
|
| Rate for Payer: Prime Health Services Commercial |
$311.10
|
|
|
HC CYTO FNA EVAL,EA ADDL SAME SIT
|
Facility
|
OP
|
$26.00
|
|
|
Service Code
|
CPT 88177
|
| Hospital Charge Code |
903800180
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$5.20 |
| Max. Negotiated Rate |
$46.49 |
| Rate for Payer: Adventist Health Commercial |
$5.20
|
| Rate for Payer: Adventist Health Commercial |
$40.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$45.54
|
| Rate for Payer: Aetna of CA HMO/PPO |
$45.54
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$170.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$22.10
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$110.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.30
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$150.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$19.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$46.49
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$46.49
|
| Rate for Payer: Blue Shield of California Commercial |
$18.12
|
| Rate for Payer: Blue Shield of California Commercial |
$92.20
|
| Rate for Payer: Blue Shield of California Commercial |
$139.40
|
| Rate for Payer: Blue Shield of California Commercial |
$11.99
|
| Rate for Payer: Cash Price |
$11.70
|
| Rate for Payer: Cash Price |
$90.00
|
| Rate for Payer: Cash Price |
$11.70
|
| Rate for Payer: Cash Price |
$90.00
|
| Rate for Payer: Cigna of CA HMO |
$16.64
|
| Rate for Payer: Cigna of CA HMO |
$128.00
|
| Rate for Payer: Cigna of CA PPO |
$148.00
|
| Rate for Payer: Cigna of CA PPO |
$19.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$170.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$22.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$170.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$22.10
|
| Rate for Payer: Dignity Health Medicare Advantage |
$170.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$22.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$18.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$140.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$80.00
|
| Rate for Payer: EPIC Health Plan Senior |
$10.40
|
| Rate for Payer: EPIC Health Plan Senior |
$80.00
|
| Rate for Payer: Galaxy Health WC |
$22.10
|
| Rate for Payer: Galaxy Health WC |
$170.00
|
| Rate for Payer: Global Benefits Group Commercial |
$120.00
|
| Rate for Payer: Global Benefits Group Commercial |
$15.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$36.52
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$36.52
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$16.51
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$127.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$41.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$41.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$118.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$15.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$48.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$140.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$140.00
|
| Rate for Payer: Multiplan Commercial |
$20.80
|
| Rate for Payer: Multiplan Commercial |
$160.00
|
| Rate for Payer: Networks By Design Commercial |
$130.00
|
| Rate for Payer: Networks By Design Commercial |
$16.90
|
| Rate for Payer: Prime Health Services Commercial |
$22.10
|
| Rate for Payer: Prime Health Services Commercial |
$170.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$120.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$15.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$120.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.89
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.89
|
| Rate for Payer: United Healthcare All Other HMO |
$5.89
|
| Rate for Payer: United Healthcare All Other HMO |
$5.89
|
| Rate for Payer: United Healthcare HMO Rider |
$5.89
|
| Rate for Payer: United Healthcare HMO Rider |
$5.89
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.89
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.89
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$22.10
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$170.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$170.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$22.10
|
| Rate for Payer: Vantage Medical Group Senior |
$22.10
|
| Rate for Payer: Vantage Medical Group Senior |
$170.00
|
|
|
HC CYTO FNA EVAL,EA ADDL SAME SIT
|
Facility
|
IP
|
$200.00
|
|
|
Service Code
|
CPT 88177
|
| Hospital Charge Code |
903800180
|
|
Hospital Revenue Code
|
311
|
| 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: Emerging Therapy Solutions (LifeTrac) Transplant |
$140.00
|
| 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 Foundation Hospitals Commercial/Self Funded |
$127.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$118.00
|
| 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 CYTOLOGIC EXAM, IOC
|
Facility
|
IP
|
$944.00
|
|
|
Service Code
|
CPT 88333
|
| Hospital Charge Code |
903800181
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$188.80 |
| Max. Negotiated Rate |
$802.40 |
| Rate for Payer: Adventist Health Commercial |
$188.80
|
| Rate for Payer: Cash Price |
$424.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$660.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$377.60
|
| Rate for Payer: EPIC Health Plan Senior |
$377.60
|
| Rate for Payer: Galaxy Health WC |
$802.40
|
| Rate for Payer: Global Benefits Group Commercial |
$566.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$599.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$556.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$226.56
|
| Rate for Payer: Multiplan Commercial |
$755.20
|
| Rate for Payer: Networks By Design Commercial |
$613.60
|
| Rate for Payer: Prime Health Services Commercial |
$802.40
|
|
|
HC CYTOLOGIC EXAM, IOC
|
Facility
|
OP
|
$78.00
|
|
|
Service Code
|
CPT 88333
|
| Hospital Charge Code |
903800181
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$15.60 |
| Max. Negotiated Rate |
$1,709.80 |
| Rate for Payer: Adventist Health Commercial |
$15.60
|
| Rate for Payer: Adventist Health Commercial |
$188.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$251.32
|
| Rate for Payer: Aetna of CA HMO/PPO |
$251.32
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,554.36
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,554.36
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,139.86
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,139.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,036.24
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,036.24
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$169.41
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$169.41
|
| Rate for Payer: Blue Shield of California Commercial |
$435.18
|
| Rate for Payer: Blue Shield of California Commercial |
$35.96
|
| Rate for Payer: Blue Shield of California Commercial |
$657.97
|
| Rate for Payer: Blue Shield of California Commercial |
$54.37
|
| Rate for Payer: Cash Price |
$424.80
|
| Rate for Payer: Cash Price |
$424.80
|
| Rate for Payer: Cash Price |
$35.10
|
| Rate for Payer: Cash Price |
$35.10
|
| Rate for Payer: Cigna of CA HMO |
$604.16
|
| Rate for Payer: Cigna of CA HMO |
$49.92
|
| Rate for Payer: Cigna of CA PPO |
$57.72
|
| Rate for Payer: Cigna of CA PPO |
$698.56
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,554.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,554.36
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,139.86
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,139.86
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,036.24
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,036.24
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$54.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$660.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,709.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,709.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,139.86
|
| Rate for Payer: EPIC Health Plan Senior |
$1,139.86
|
| Rate for Payer: Galaxy Health WC |
$66.30
|
| Rate for Payer: Galaxy Health WC |
$802.40
|
| Rate for Payer: Global Benefits Group Commercial |
$46.80
|
| Rate for Payer: Global Benefits Group Commercial |
$566.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,699.43
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,699.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$133.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$133.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,036.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,036.24
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$49.53
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$599.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$150.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$150.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,450.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,450.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$226.56
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,305.66
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,305.66
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,388.56
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,388.56
|
| Rate for Payer: Multiplan Commercial |
$755.20
|
| Rate for Payer: Multiplan Commercial |
$62.40
|
| Rate for Payer: Networks By Design Commercial |
$613.60
|
| Rate for Payer: Networks By Design Commercial |
$50.70
|
| Rate for Payer: Prime Health Services Commercial |
$66.30
|
| Rate for Payer: Prime Health Services Commercial |
$802.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$46.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$566.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$46.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$566.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$542.12
|
| Rate for Payer: United Healthcare All Other Commercial |
$542.12
|
| Rate for Payer: United Healthcare All Other HMO |
$542.12
|
| Rate for Payer: United Healthcare All Other HMO |
$542.12
|
| Rate for Payer: United Healthcare HMO Rider |
$542.12
|
| Rate for Payer: United Healthcare HMO Rider |
$542.12
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$542.12
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$542.12
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,036.24
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,036.24
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,554.36
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,554.36
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,139.86
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,139.86
|
| Rate for Payer: Vantage Medical Group Senior |
$1,036.24
|
| Rate for Payer: Vantage Medical Group Senior |
$1,036.24
|
|
|
HC CYTOLOGY IOC EA ADDL
|
Facility
|
OP
|
$71.00
|
|
|
Service Code
|
CPT 88334
|
| Hospital Charge Code |
903800182
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$14.20 |
| Max. Negotiated Rate |
$158.23 |
| Rate for Payer: Adventist Health Commercial |
$14.20
|
| Rate for Payer: Adventist Health Commercial |
$58.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$158.23
|
| Rate for Payer: Aetna of CA HMO/PPO |
$158.23
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$249.90
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$60.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$161.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$39.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$220.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$53.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$103.61
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$103.61
|
| Rate for Payer: Blue Shield of California Commercial |
$49.49
|
| Rate for Payer: Blue Shield of California Commercial |
$204.92
|
| Rate for Payer: Blue Shield of California Commercial |
$135.53
|
| Rate for Payer: Blue Shield of California Commercial |
$32.73
|
| Rate for Payer: Cash Price |
$31.95
|
| Rate for Payer: Cash Price |
$132.30
|
| Rate for Payer: Cash Price |
$31.95
|
| Rate for Payer: Cash Price |
$132.30
|
| Rate for Payer: Cigna of CA HMO |
$45.44
|
| Rate for Payer: Cigna of CA HMO |
$188.16
|
| Rate for Payer: Cigna of CA PPO |
$217.56
|
| Rate for Payer: Cigna of CA PPO |
$52.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$249.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$60.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$249.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$60.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$249.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$60.35
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$49.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$205.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$28.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$117.60
|
| Rate for Payer: EPIC Health Plan Senior |
$28.40
|
| Rate for Payer: EPIC Health Plan Senior |
$117.60
|
| Rate for Payer: Galaxy Health WC |
$60.35
|
| Rate for Payer: Galaxy Health WC |
$249.90
|
| Rate for Payer: Global Benefits Group Commercial |
$176.40
|
| Rate for Payer: Global Benefits Group Commercial |
$42.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$83.46
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$83.46
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$45.09
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$186.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$94.39
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$94.39
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$173.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$41.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$70.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$17.04
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$49.70
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$205.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$49.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$205.80
|
| Rate for Payer: Multiplan Commercial |
$56.80
|
| Rate for Payer: Multiplan Commercial |
$235.20
|
| Rate for Payer: Networks By Design Commercial |
$191.10
|
| Rate for Payer: Networks By Design Commercial |
$46.15
|
| Rate for Payer: Prime Health Services Commercial |
$60.35
|
| Rate for Payer: Prime Health Services Commercial |
$249.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$176.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$42.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$42.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$176.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$15.70
|
| Rate for Payer: United Healthcare All Other Commercial |
$15.70
|
| Rate for Payer: United Healthcare All Other HMO |
$15.70
|
| Rate for Payer: United Healthcare All Other HMO |
$15.70
|
| Rate for Payer: United Healthcare HMO Rider |
$15.70
|
| Rate for Payer: United Healthcare HMO Rider |
$15.70
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15.70
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15.70
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$60.35
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$249.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$249.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$60.35
|
| Rate for Payer: Vantage Medical Group Senior |
$60.35
|
| Rate for Payer: Vantage Medical Group Senior |
$249.90
|
|
|
HC CYTOLOGY IOC EA ADDL
|
Facility
|
IP
|
$294.00
|
|
|
Service Code
|
CPT 88334
|
| Hospital Charge Code |
903800182
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$58.80 |
| Max. Negotiated Rate |
$249.90 |
| Rate for Payer: Adventist Health Commercial |
$58.80
|
| Rate for Payer: Cash Price |
$132.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$205.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$117.60
|
| Rate for Payer: EPIC Health Plan Senior |
$117.60
|
| Rate for Payer: Galaxy Health WC |
$249.90
|
| Rate for Payer: Global Benefits Group Commercial |
$176.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$186.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$173.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$70.56
|
| Rate for Payer: Multiplan Commercial |
$235.20
|
| Rate for Payer: Networks By Design Commercial |
$191.10
|
| Rate for Payer: Prime Health Services Commercial |
$249.90
|
|
|
HC CYTOMEG DNA QUANT
|
Facility
|
IP
|
$313.00
|
|
|
Service Code
|
CPT 87497
|
| Hospital Charge Code |
900912312
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$62.60 |
| Max. Negotiated Rate |
$266.05 |
| Rate for Payer: Adventist Health Commercial |
$62.60
|
| Rate for Payer: Cash Price |
$140.85
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$219.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$125.20
|
| Rate for Payer: EPIC Health Plan Senior |
$125.20
|
| Rate for Payer: Galaxy Health WC |
$266.05
|
| Rate for Payer: Global Benefits Group Commercial |
$187.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$198.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$184.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$75.12
|
| Rate for Payer: Multiplan Commercial |
$250.40
|
| Rate for Payer: Networks By Design Commercial |
$203.45
|
| Rate for Payer: Prime Health Services Commercial |
$266.05
|
|
|
HC CYTOMEG DNA QUANT
|
Facility
|
OP
|
$266.00
|
|
|
Service Code
|
CPT 87497
|
| Hospital Charge Code |
900912312
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$34.70 |
| Max. Negotiated Rate |
$356.23 |
| Rate for Payer: Vantage Medical Group Medi-Cal |
$47.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$47.12
|
| Rate for Payer: Vantage Medical Group Senior |
$42.84
|
| Rate for Payer: Vantage Medical Group Senior |
$42.84
|
| Rate for Payer: Adventist Health Commercial |
$53.20
|
| Rate for Payer: Adventist Health Commercial |
$62.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$356.23
|
| Rate for Payer: Aetna of CA HMO/PPO |
$356.23
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$64.26
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$64.26
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$47.12
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$47.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$42.84
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$42.84
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$267.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$267.05
|
| Rate for Payer: Blue Shield of California Commercial |
$144.29
|
| Rate for Payer: Blue Shield of California Commercial |
$122.63
|
| Rate for Payer: Blue Shield of California Commercial |
$218.16
|
| Rate for Payer: Blue Shield of California Commercial |
$185.40
|
| Rate for Payer: Cash Price |
$140.85
|
| Rate for Payer: Cash Price |
$140.85
|
| Rate for Payer: Cash Price |
$119.70
|
| Rate for Payer: Cash Price |
$119.70
|
| Rate for Payer: Cigna of CA HMO |
$200.32
|
| Rate for Payer: Cigna of CA HMO |
$170.24
|
| Rate for Payer: Cigna of CA PPO |
$196.84
|
| Rate for Payer: Cigna of CA PPO |
$231.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$64.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$64.26
|
| Rate for Payer: Dignity Health Medi-Cal |
$47.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$47.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$42.84
|
| Rate for Payer: Dignity Health Medicare Advantage |
$42.84
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$186.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$219.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$70.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$70.69
|
| Rate for Payer: EPIC Health Plan Senior |
$47.12
|
| Rate for Payer: EPIC Health Plan Senior |
$47.12
|
| Rate for Payer: Galaxy Health WC |
$226.10
|
| Rate for Payer: Galaxy Health WC |
$266.05
|
| Rate for Payer: Global Benefits Group Commercial |
$159.60
|
| Rate for Payer: Global Benefits Group Commercial |
$187.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$70.26
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$70.26
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$63.97
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$63.97
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$42.84
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$42.84
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$168.91
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$198.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$72.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$72.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$59.98
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$59.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$63.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$75.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$53.98
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$53.98
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$57.41
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$57.41
|
| Rate for Payer: Multiplan Commercial |
$250.40
|
| Rate for Payer: Multiplan Commercial |
$212.80
|
| Rate for Payer: Networks By Design Commercial |
$203.45
|
| Rate for Payer: Networks By Design Commercial |
$172.90
|
| Rate for Payer: Prime Health Services Commercial |
$226.10
|
| Rate for Payer: Prime Health Services Commercial |
$266.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$159.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$187.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$159.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$187.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$34.70
|
| Rate for Payer: United Healthcare All Other Commercial |
$34.70
|
| Rate for Payer: United Healthcare All Other HMO |
$34.70
|
| Rate for Payer: United Healthcare All Other HMO |
$34.70
|
| Rate for Payer: United Healthcare HMO Rider |
$34.70
|
| Rate for Payer: United Healthcare HMO Rider |
$34.70
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$34.70
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$34.70
|
| Rate for Payer: Upland Medical Group Pediatric |
$42.84
|
| Rate for Payer: Upland Medical Group Pediatric |
$42.84
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$64.26
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$64.26
|
|
|
HC CYTOPATH CONCENTRATION, PG
|
Facility
|
OP
|
$105.00
|
|
|
Service Code
|
CPT 88108
|
| Hospital Charge Code |
903800210
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$21.00 |
| Max. Negotiated Rate |
$346.85 |
| Rate for Payer: Adventist Health Commercial |
$21.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$346.85
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$72.06
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$52.84
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$48.04
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$68.03
|
| Rate for Payer: Blue Shield of California Commercial |
$48.41
|
| Rate for Payer: Blue Shield of California Commercial |
$73.19
|
| Rate for Payer: Cash Price |
$47.25
|
| Rate for Payer: Cash Price |
$47.25
|
| Rate for Payer: Cigna of CA HMO |
$67.20
|
| Rate for Payer: Cigna of CA PPO |
$77.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$72.06
|
| Rate for Payer: Dignity Health Medi-Cal |
$52.84
|
| Rate for Payer: Dignity Health Medicare Advantage |
$48.04
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$73.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$79.27
|
| Rate for Payer: EPIC Health Plan Senior |
$52.84
|
| Rate for Payer: Galaxy Health WC |
$89.25
|
| Rate for Payer: Global Benefits Group Commercial |
$63.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$78.79
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$48.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$48.04
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$66.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$54.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$67.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$60.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$64.37
|
| Rate for Payer: Multiplan Commercial |
$84.00
|
| Rate for Payer: Networks By Design Commercial |
$68.25
|
| Rate for Payer: Prime Health Services Commercial |
$89.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$63.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$63.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$28.00
|
| Rate for Payer: United Healthcare All Other HMO |
$28.00
|
| Rate for Payer: United Healthcare HMO Rider |
$28.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$28.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$48.04
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$72.06
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$52.84
|
| Rate for Payer: Vantage Medical Group Senior |
$48.04
|
|
|
HC CYTOPATH CONCENTRATION, PG
|
Facility
|
IP
|
$105.00
|
|
|
Service Code
|
CPT 88108
|
| Hospital Charge Code |
903800210
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$21.00 |
| Max. Negotiated Rate |
$89.25 |
| Rate for Payer: Adventist Health Commercial |
$21.00
|
| Rate for Payer: Cash Price |
$47.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$73.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$42.00
|
| Rate for Payer: EPIC Health Plan Senior |
$42.00
|
| Rate for Payer: Galaxy Health WC |
$89.25
|
| Rate for Payer: Global Benefits Group Commercial |
$63.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$66.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$61.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.20
|
| Rate for Payer: Multiplan Commercial |
$84.00
|
| Rate for Payer: Networks By Design Commercial |
$68.25
|
| Rate for Payer: Prime Health Services Commercial |
$89.25
|
|
|
HC CYTOPATH-CONCENTRATION TECH
|
Facility
|
IP
|
$496.00
|
|
|
Service Code
|
CPT 88108
|
| Hospital Charge Code |
903800002
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$99.20 |
| Max. Negotiated Rate |
$421.60 |
| Rate for Payer: Adventist Health Commercial |
$99.20
|
| Rate for Payer: Cash Price |
$223.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$347.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$198.40
|
| Rate for Payer: EPIC Health Plan Senior |
$198.40
|
| Rate for Payer: Galaxy Health WC |
$421.60
|
| Rate for Payer: Global Benefits Group Commercial |
$297.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$314.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$292.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$119.04
|
| Rate for Payer: Multiplan Commercial |
$396.80
|
| Rate for Payer: Networks By Design Commercial |
$322.40
|
| Rate for Payer: Prime Health Services Commercial |
$421.60
|
|
|
HC CYTOPATH-CONCENTRATION TECH
|
Facility
|
OP
|
$107.00
|
|
|
Service Code
|
CPT 88108
|
| Hospital Charge Code |
903800002
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$21.40 |
| Max. Negotiated Rate |
$346.85 |
| Rate for Payer: Adventist Health Commercial |
$21.40
|
| Rate for Payer: Adventist Health Commercial |
$99.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$346.85
|
| Rate for Payer: Aetna of CA HMO/PPO |
$346.85
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$72.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$72.06
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$52.84
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$52.84
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$48.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$48.04
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$68.03
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$68.03
|
| Rate for Payer: Blue Shield of California Commercial |
$228.66
|
| Rate for Payer: Blue Shield of California Commercial |
$49.33
|
| Rate for Payer: Blue Shield of California Commercial |
$345.71
|
| Rate for Payer: Blue Shield of California Commercial |
$74.58
|
| Rate for Payer: Cash Price |
$223.20
|
| Rate for Payer: Cash Price |
$223.20
|
| Rate for Payer: Cash Price |
$48.15
|
| Rate for Payer: Cash Price |
$48.15
|
| Rate for Payer: Cigna of CA HMO |
$317.44
|
| Rate for Payer: Cigna of CA HMO |
$68.48
|
| Rate for Payer: Cigna of CA PPO |
$79.18
|
| Rate for Payer: Cigna of CA PPO |
$367.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$72.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$72.06
|
| Rate for Payer: Dignity Health Medi-Cal |
$52.84
|
| Rate for Payer: Dignity Health Medi-Cal |
$52.84
|
| Rate for Payer: Dignity Health Medicare Advantage |
$48.04
|
| Rate for Payer: Dignity Health Medicare Advantage |
$48.04
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$74.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$347.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$79.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$79.27
|
| Rate for Payer: EPIC Health Plan Senior |
$52.84
|
| Rate for Payer: EPIC Health Plan Senior |
$52.84
|
| Rate for Payer: Galaxy Health WC |
$90.95
|
| Rate for Payer: Galaxy Health WC |
$421.60
|
| Rate for Payer: Global Benefits Group Commercial |
$64.20
|
| Rate for Payer: Global Benefits Group Commercial |
$297.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$78.79
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$78.79
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$48.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$48.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$48.04
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$48.04
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$67.94
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$314.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$54.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$54.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$67.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$67.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$119.04
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$60.53
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$60.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$64.37
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$64.37
|
| Rate for Payer: Multiplan Commercial |
$396.80
|
| Rate for Payer: Multiplan Commercial |
$85.60
|
| Rate for Payer: Networks By Design Commercial |
$322.40
|
| Rate for Payer: Networks By Design Commercial |
$69.55
|
| Rate for Payer: Prime Health Services Commercial |
$90.95
|
| Rate for Payer: Prime Health Services Commercial |
$421.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$64.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$297.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$64.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$297.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$28.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$28.00
|
| Rate for Payer: United Healthcare All Other HMO |
$28.00
|
| Rate for Payer: United Healthcare All Other HMO |
$28.00
|
| Rate for Payer: United Healthcare HMO Rider |
$28.00
|
| Rate for Payer: United Healthcare HMO Rider |
$28.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$28.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$28.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$48.04
|
| Rate for Payer: Upland Medical Group Pediatric |
$48.04
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$72.06
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$72.06
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$52.84
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$52.84
|
| Rate for Payer: Vantage Medical Group Senior |
$48.04
|
| Rate for Payer: Vantage Medical Group Senior |
$48.04
|
|
|
HC CYTOPATH, EXTENDED STUDY
|
Facility
|
IP
|
$239.00
|
|
|
Service Code
|
CPT 88162
|
| Hospital Charge Code |
903800004
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$47.80 |
| Max. Negotiated Rate |
$203.15 |
| Rate for Payer: Adventist Health Commercial |
$47.80
|
| Rate for Payer: Cash Price |
$107.55
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$167.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$95.60
|
| Rate for Payer: EPIC Health Plan Senior |
$95.60
|
| Rate for Payer: Galaxy Health WC |
$203.15
|
| Rate for Payer: Global Benefits Group Commercial |
$143.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$151.76
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$141.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$57.36
|
| Rate for Payer: Multiplan Commercial |
$191.20
|
| Rate for Payer: Networks By Design Commercial |
$155.35
|
| Rate for Payer: Prime Health Services Commercial |
$203.15
|
|
|
HC CYTOPATH, EXTENDED STUDY
|
Facility
|
OP
|
$107.00
|
|
|
Service Code
|
CPT 88162
|
| Hospital Charge Code |
903800004
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$21.40 |
| Max. Negotiated Rate |
$295.40 |
| Rate for Payer: Adventist Health Commercial |
$21.40
|
| Rate for Payer: Adventist Health Commercial |
$47.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$295.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$295.40
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$100.53
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$100.53
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$73.72
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$73.72
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$67.02
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$67.02
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$106.46
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$106.46
|
| Rate for Payer: Blue Shield of California Commercial |
$110.18
|
| Rate for Payer: Blue Shield of California Commercial |
$49.33
|
| Rate for Payer: Blue Shield of California Commercial |
$166.58
|
| Rate for Payer: Blue Shield of California Commercial |
$74.58
|
| Rate for Payer: Cash Price |
$107.55
|
| Rate for Payer: Cash Price |
$107.55
|
| Rate for Payer: Cash Price |
$48.15
|
| Rate for Payer: Cash Price |
$48.15
|
| Rate for Payer: Cigna of CA HMO |
$152.96
|
| Rate for Payer: Cigna of CA HMO |
$68.48
|
| Rate for Payer: Cigna of CA PPO |
$79.18
|
| Rate for Payer: Cigna of CA PPO |
$176.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$100.53
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$100.53
|
| Rate for Payer: Dignity Health Medi-Cal |
$73.72
|
| Rate for Payer: Dignity Health Medi-Cal |
$73.72
|
| Rate for Payer: Dignity Health Medicare Advantage |
$67.02
|
| Rate for Payer: Dignity Health Medicare Advantage |
$67.02
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$74.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$167.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$110.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$110.58
|
| Rate for Payer: EPIC Health Plan Senior |
$73.72
|
| Rate for Payer: EPIC Health Plan Senior |
$73.72
|
| Rate for Payer: Galaxy Health WC |
$90.95
|
| Rate for Payer: Galaxy Health WC |
$203.15
|
| Rate for Payer: Global Benefits Group Commercial |
$64.20
|
| Rate for Payer: Global Benefits Group Commercial |
$143.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$109.91
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$109.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$81.82
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$81.82
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$67.02
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$67.02
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$67.94
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$151.76
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$92.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$92.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$93.83
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$93.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$57.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$84.45
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$84.45
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$89.81
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$89.81
|
| Rate for Payer: Multiplan Commercial |
$191.20
|
| Rate for Payer: Multiplan Commercial |
$85.60
|
| Rate for Payer: Networks By Design Commercial |
$155.35
|
| Rate for Payer: Networks By Design Commercial |
$69.55
|
| Rate for Payer: Prime Health Services Commercial |
$90.95
|
| Rate for Payer: Prime Health Services Commercial |
$203.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$64.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$143.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$64.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$143.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$41.11
|
| Rate for Payer: United Healthcare All Other Commercial |
$41.11
|
| Rate for Payer: United Healthcare All Other HMO |
$41.11
|
| Rate for Payer: United Healthcare All Other HMO |
$41.11
|
| Rate for Payer: United Healthcare HMO Rider |
$41.11
|
| Rate for Payer: United Healthcare HMO Rider |
$41.11
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$41.11
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$41.11
|
| Rate for Payer: Upland Medical Group Pediatric |
$67.02
|
| Rate for Payer: Upland Medical Group Pediatric |
$67.02
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$100.53
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$100.53
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$73.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$73.72
|
| Rate for Payer: Vantage Medical Group Senior |
$67.02
|
| Rate for Payer: Vantage Medical Group Senior |
$67.02
|
|
|
HC CYTOPATH-NGYN SMEAR
|
Facility
|
OP
|
$143.00
|
|
|
Service Code
|
CPT 88104
|
| Hospital Charge Code |
903800005
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$28.00 |
| Max. Negotiated Rate |
$270.93 |
| Rate for Payer: Adventist Health Commercial |
$28.60
|
| Rate for Payer: Adventist Health Commercial |
$63.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$270.93
|
| Rate for Payer: Aetna of CA HMO/PPO |
$270.93
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$72.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$72.06
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$52.84
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$52.84
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$48.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$48.04
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$65.46
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$65.46
|
| Rate for Payer: Blue Shield of California Commercial |
$146.14
|
| Rate for Payer: Blue Shield of California Commercial |
$65.92
|
| Rate for Payer: Blue Shield of California Commercial |
$220.95
|
| Rate for Payer: Blue Shield of California Commercial |
$99.67
|
| Rate for Payer: Cash Price |
$142.65
|
| Rate for Payer: Cash Price |
$142.65
|
| Rate for Payer: Cash Price |
$64.35
|
| Rate for Payer: Cash Price |
$64.35
|
| Rate for Payer: Cigna of CA HMO |
$202.88
|
| Rate for Payer: Cigna of CA HMO |
$91.52
|
| Rate for Payer: Cigna of CA PPO |
$105.82
|
| Rate for Payer: Cigna of CA PPO |
$234.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$72.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$72.06
|
| Rate for Payer: Dignity Health Medi-Cal |
$52.84
|
| Rate for Payer: Dignity Health Medi-Cal |
$52.84
|
| Rate for Payer: Dignity Health Medicare Advantage |
$48.04
|
| Rate for Payer: Dignity Health Medicare Advantage |
$48.04
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$100.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$221.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$79.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$79.27
|
| Rate for Payer: EPIC Health Plan Senior |
$52.84
|
| Rate for Payer: EPIC Health Plan Senior |
$52.84
|
| Rate for Payer: Galaxy Health WC |
$121.55
|
| Rate for Payer: Galaxy Health WC |
$269.45
|
| Rate for Payer: Global Benefits Group Commercial |
$85.80
|
| Rate for Payer: Global Benefits Group Commercial |
$190.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$78.79
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$78.79
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$43.38
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$43.38
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$48.04
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$48.04
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$90.81
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$201.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$49.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$49.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$67.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$67.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$34.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$76.08
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$60.53
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$60.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$64.37
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$64.37
|
| Rate for Payer: Multiplan Commercial |
$253.60
|
| Rate for Payer: Multiplan Commercial |
$114.40
|
| Rate for Payer: Networks By Design Commercial |
$206.05
|
| Rate for Payer: Networks By Design Commercial |
$92.95
|
| Rate for Payer: Prime Health Services Commercial |
$121.55
|
| Rate for Payer: Prime Health Services Commercial |
$269.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$85.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$190.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$85.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$190.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$28.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$28.00
|
| Rate for Payer: United Healthcare All Other HMO |
$28.00
|
| Rate for Payer: United Healthcare All Other HMO |
$28.00
|
| Rate for Payer: United Healthcare HMO Rider |
$28.00
|
| Rate for Payer: United Healthcare HMO Rider |
$28.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$28.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$28.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$48.04
|
| Rate for Payer: Upland Medical Group Pediatric |
$48.04
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$72.06
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$72.06
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$52.84
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$52.84
|
| Rate for Payer: Vantage Medical Group Senior |
$48.04
|
| Rate for Payer: Vantage Medical Group Senior |
$48.04
|
|
|
HC CYTOPATH-NGYN SMEAR
|
Facility
|
IP
|
$317.00
|
|
|
Service Code
|
CPT 88104
|
| Hospital Charge Code |
903800005
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$63.40 |
| Max. Negotiated Rate |
$269.45 |
| Rate for Payer: Adventist Health Commercial |
$63.40
|
| Rate for Payer: Cash Price |
$142.65
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$221.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$126.80
|
| Rate for Payer: EPIC Health Plan Senior |
$126.80
|
| Rate for Payer: Galaxy Health WC |
$269.45
|
| Rate for Payer: Global Benefits Group Commercial |
$190.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$201.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$187.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$76.08
|
| Rate for Payer: Multiplan Commercial |
$253.60
|
| Rate for Payer: Networks By Design Commercial |
$206.05
|
| Rate for Payer: Prime Health Services Commercial |
$269.45
|
|
