|
HC FETAL SHUNT PLACMNT ADDL FETUS
|
Facility
|
OP
|
$509.00
|
|
|
Service Code
|
CPT 59076
|
| Hospital Charge Code |
910400093
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$101.80 |
| Max. Negotiated Rate |
$6,716.00 |
| Rate for Payer: Adventist Health Commercial |
$101.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,542.77
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$587.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$431.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$391.93
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,716.00
|
| Rate for Payer: Cash Price |
$229.05
|
| Rate for Payer: Cash Price |
$229.05
|
| Rate for Payer: Cash Price |
$229.05
|
| Rate for Payer: Cigna of CA HMO |
$325.76
|
| Rate for Payer: Cigna of CA PPO |
$376.66
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$587.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$431.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$391.93
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$356.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$646.68
|
| Rate for Payer: EPIC Health Plan Senior |
$431.12
|
| Rate for Payer: Galaxy Health WC |
$432.65
|
| Rate for Payer: Global Benefits Group Commercial |
$305.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$642.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$742.29
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$391.93
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$323.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$839.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$548.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$122.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$493.83
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$525.19
|
| Rate for Payer: Multiplan Commercial |
$407.20
|
| Rate for Payer: Networks By Design Commercial |
$330.85
|
| Rate for Payer: Prime Health Services Commercial |
$432.65
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$305.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$305.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$254.50
|
| Rate for Payer: United Healthcare All Other HMO |
$254.50
|
| Rate for Payer: United Healthcare HMO Rider |
$254.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$254.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$391.93
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$587.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$431.12
|
| Rate for Payer: Vantage Medical Group Senior |
$391.93
|
|
|
HC FIBRIN DEGRAD SPLIT PRODUCTS
|
Facility
|
IP
|
$262.00
|
|
|
Service Code
|
CPT 85362
|
| Hospital Charge Code |
900910069
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$52.40 |
| Max. Negotiated Rate |
$222.70 |
| Rate for Payer: Adventist Health Commercial |
$52.40
|
| Rate for Payer: Cash Price |
$117.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$183.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$104.80
|
| Rate for Payer: EPIC Health Plan Senior |
$104.80
|
| Rate for Payer: Galaxy Health WC |
$222.70
|
| Rate for Payer: Global Benefits Group Commercial |
$157.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$166.37
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$154.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$62.88
|
| Rate for Payer: Multiplan Commercial |
$209.60
|
| Rate for Payer: Networks By Design Commercial |
$170.30
|
| Rate for Payer: Prime Health Services Commercial |
$222.70
|
|
|
HC FIBRIN DEGRAD SPLIT PRODUCTS
|
Facility
|
OP
|
$262.00
|
|
|
Service Code
|
CPT 85362
|
| Hospital Charge Code |
900910069
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$5.58 |
| Max. Negotiated Rate |
$222.70 |
| Rate for Payer: Adventist Health Commercial |
$52.40
|
| Rate for Payer: Adventist Health Commercial |
$7.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$54.51
|
| Rate for Payer: Aetna of CA HMO/PPO |
$54.51
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10.34
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10.34
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.58
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.58
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6.89
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6.89
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$71.02
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$71.02
|
| Rate for Payer: Blue Shield of California Commercial |
$17.06
|
| Rate for Payer: Blue Shield of California Commercial |
$120.78
|
| Rate for Payer: Blue Shield of California Commercial |
$25.79
|
| Rate for Payer: Blue Shield of California Commercial |
$182.61
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cash Price |
$117.90
|
| Rate for Payer: Cash Price |
$117.90
|
| Rate for Payer: Cigna of CA HMO |
$23.68
|
| Rate for Payer: Cigna of CA HMO |
$167.68
|
| Rate for Payer: Cigna of CA PPO |
$193.88
|
| Rate for Payer: Cigna of CA PPO |
$27.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.34
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.58
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.58
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6.89
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6.89
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$183.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$25.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.37
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.37
|
| Rate for Payer: EPIC Health Plan Senior |
$7.58
|
| Rate for Payer: EPIC Health Plan Senior |
$7.58
|
| Rate for Payer: Galaxy Health WC |
$222.70
|
| Rate for Payer: Galaxy Health WC |
$31.45
|
| Rate for Payer: Global Benefits Group Commercial |
$157.20
|
| Rate for Payer: Global Benefits Group Commercial |
$22.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$11.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$11.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$9.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$9.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6.89
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6.89
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$166.37
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$23.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$11.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$11.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$62.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.88
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8.68
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9.23
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9.23
|
| Rate for Payer: Multiplan Commercial |
$29.60
|
| Rate for Payer: Multiplan Commercial |
$209.60
|
| Rate for Payer: Networks By Design Commercial |
$24.05
|
| Rate for Payer: Networks By Design Commercial |
$170.30
|
| Rate for Payer: Prime Health Services Commercial |
$222.70
|
| Rate for Payer: Prime Health Services Commercial |
$31.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$157.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$22.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$157.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$22.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.58
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.58
|
| Rate for Payer: United Healthcare All Other HMO |
$5.58
|
| Rate for Payer: United Healthcare All Other HMO |
$5.58
|
| Rate for Payer: United Healthcare HMO Rider |
$5.58
|
| Rate for Payer: United Healthcare HMO Rider |
$5.58
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.58
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.58
|
| Rate for Payer: Upland Medical Group Pediatric |
$6.89
|
| Rate for Payer: Upland Medical Group Pediatric |
$6.89
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10.34
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10.34
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.58
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.58
|
| Rate for Payer: Vantage Medical Group Senior |
$6.89
|
| Rate for Payer: Vantage Medical Group Senior |
$6.89
|
|
|
HC FIBRINOGEN ASSAY
|
Facility
|
OP
|
$299.00
|
|
|
Service Code
|
CPT 85384
|
| Hospital Charge Code |
900910013
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$7.88 |
| Max. Negotiated Rate |
$254.15 |
| Rate for Payer: Aetna of CA HMO/PPO |
$70.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.69
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.69
|
| Rate for Payer: Vantage Medical Group Senior |
$9.72
|
| Rate for Payer: Vantage Medical Group Senior |
$9.72
|
| Rate for Payer: Adventist Health Commercial |
$59.80
|
| Rate for Payer: Adventist Health Commercial |
$16.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$70.63
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$14.58
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$14.58
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10.69
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10.69
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9.72
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9.72
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$87.14
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$87.14
|
| Rate for Payer: Blue Shield of California Commercial |
$38.72
|
| Rate for Payer: Blue Shield of California Commercial |
$137.84
|
| Rate for Payer: Blue Shield of California Commercial |
$58.55
|
| Rate for Payer: Blue Shield of California Commercial |
$208.40
|
| Rate for Payer: Cash Price |
$37.80
|
| Rate for Payer: Cash Price |
$37.80
|
| Rate for Payer: Cash Price |
$134.55
|
| Rate for Payer: Cash Price |
$134.55
|
| Rate for Payer: Cigna of CA HMO |
$53.76
|
| Rate for Payer: Cigna of CA HMO |
$191.36
|
| Rate for Payer: Cigna of CA PPO |
$221.26
|
| Rate for Payer: Cigna of CA PPO |
$62.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$14.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$14.58
|
| Rate for Payer: Dignity Health Medi-Cal |
$10.69
|
| Rate for Payer: Dignity Health Medi-Cal |
$10.69
|
| Rate for Payer: Dignity Health Medicare Advantage |
$9.72
|
| Rate for Payer: Dignity Health Medicare Advantage |
$9.72
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$209.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$58.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.04
|
| Rate for Payer: EPIC Health Plan Senior |
$10.69
|
| Rate for Payer: EPIC Health Plan Senior |
$10.69
|
| Rate for Payer: Galaxy Health WC |
$254.15
|
| Rate for Payer: Galaxy Health WC |
$71.40
|
| Rate for Payer: Global Benefits Group Commercial |
$179.40
|
| Rate for Payer: Global Benefits Group Commercial |
$50.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$15.94
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$15.94
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$12.82
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$12.82
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$9.72
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$9.72
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$189.87
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$53.34
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$14.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$14.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$13.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$13.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$71.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$12.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$12.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$13.02
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$13.02
|
| Rate for Payer: Multiplan Commercial |
$67.20
|
| Rate for Payer: Multiplan Commercial |
$239.20
|
| Rate for Payer: Networks By Design Commercial |
$54.60
|
| Rate for Payer: Networks By Design Commercial |
$194.35
|
| Rate for Payer: Prime Health Services Commercial |
$254.15
|
| Rate for Payer: Prime Health Services Commercial |
$71.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$179.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$50.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$179.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$50.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.88
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.88
|
| Rate for Payer: United Healthcare All Other HMO |
$7.88
|
| Rate for Payer: United Healthcare All Other HMO |
$7.88
|
| Rate for Payer: United Healthcare HMO Rider |
$7.88
|
| Rate for Payer: United Healthcare HMO Rider |
$7.88
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.88
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.88
|
| Rate for Payer: Upland Medical Group Pediatric |
$9.72
|
| Rate for Payer: Upland Medical Group Pediatric |
$9.72
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$14.58
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$14.58
|
|
|
HC FIBRINOGEN ASSAY
|
Facility
|
IP
|
$299.00
|
|
|
Service Code
|
CPT 85384
|
| Hospital Charge Code |
900910013
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$59.80 |
| Max. Negotiated Rate |
$254.15 |
| Rate for Payer: Adventist Health Commercial |
$59.80
|
| Rate for Payer: Cash Price |
$134.55
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$209.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$119.60
|
| Rate for Payer: EPIC Health Plan Senior |
$119.60
|
| Rate for Payer: Galaxy Health WC |
$254.15
|
| Rate for Payer: Global Benefits Group Commercial |
$179.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$189.87
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$176.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$71.76
|
| Rate for Payer: Multiplan Commercial |
$239.20
|
| Rate for Payer: Networks By Design Commercial |
$194.35
|
| Rate for Payer: Prime Health Services Commercial |
$254.15
|
|
|
HC FINE NDLE ASPIR W/GUIDANCE
|
Facility
|
OP
|
$2,540.00
|
|
|
Service Code
|
CPT 62267
|
| Hospital Charge Code |
909000240
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$195.77 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$508.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,366.17
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,001.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$910.78
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,924.01
|
| Rate for Payer: Blue Shield of California Commercial |
$2,912.69
|
| Rate for Payer: Cash Price |
$1,143.00
|
| Rate for Payer: Cash Price |
$1,143.00
|
| Rate for Payer: Cash Price |
$1,143.00
|
| Rate for Payer: Cigna of CA HMO |
$1,625.60
|
| Rate for Payer: Cigna of CA PPO |
$1,879.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,366.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,001.86
|
| Rate for Payer: Dignity Health Medicare Advantage |
$910.78
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,778.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,502.79
|
| Rate for Payer: EPIC Health Plan Senior |
$1,001.86
|
| Rate for Payer: Galaxy Health WC |
$2,159.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,524.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,493.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$195.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$910.78
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,612.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$221.41
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,275.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$609.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,147.58
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,220.45
|
| Rate for Payer: Multiplan Commercial |
$2,032.00
|
| Rate for Payer: Multiplan WC |
$1,424.40
|
| Rate for Payer: Networks By Design Commercial |
$1,651.00
|
| Rate for Payer: Prime Health Services Commercial |
$2,159.00
|
| Rate for Payer: Prime Health Services WC |
$1,409.87
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,524.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,270.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$910.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,366.17
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,001.86
|
| Rate for Payer: Vantage Medical Group Senior |
$910.78
|
|
|
HC FINE NDLE ASPIR W/GUIDANCE
|
Facility
|
IP
|
$2,540.00
|
|
|
Service Code
|
CPT 62267
|
| Hospital Charge Code |
909000240
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$508.00 |
| Max. Negotiated Rate |
$2,159.00 |
| Rate for Payer: Adventist Health Commercial |
$508.00
|
| Rate for Payer: Cash Price |
$1,143.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,778.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,016.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,016.00
|
| Rate for Payer: Galaxy Health WC |
$2,159.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,524.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,612.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,498.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$609.60
|
| Rate for Payer: Multiplan Commercial |
$2,032.00
|
| Rate for Payer: Networks By Design Commercial |
$1,651.00
|
| Rate for Payer: Prime Health Services Commercial |
$2,159.00
|
|
|
HC FINE NEEDLE ASPIRATION
|
Facility
|
IP
|
$755.00
|
|
|
Service Code
|
CPT 88173
|
| Hospital Charge Code |
903800007
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$151.00 |
| Max. Negotiated Rate |
$641.75 |
| Rate for Payer: Adventist Health Commercial |
$151.00
|
| Rate for Payer: Cash Price |
$339.75
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$528.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$302.00
|
| Rate for Payer: EPIC Health Plan Senior |
$302.00
|
| Rate for Payer: Galaxy Health WC |
$641.75
|
| Rate for Payer: Global Benefits Group Commercial |
$453.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$479.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$445.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$181.20
|
| Rate for Payer: Multiplan Commercial |
$604.00
|
| Rate for Payer: Networks By Design Commercial |
$490.75
|
| Rate for Payer: Prime Health Services Commercial |
$641.75
|
|
|
HC FINE NEEDLE ASPIRATION
|
Facility
|
OP
|
$328.00
|
|
|
Service Code
|
CPT 88173
|
| Hospital Charge Code |
903800007
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$41.11 |
| Max. Negotiated Rate |
$498.68 |
| Rate for Payer: Adventist Health Commercial |
$65.60
|
| Rate for Payer: Adventist Health Commercial |
$151.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$498.68
|
| Rate for Payer: Aetna of CA HMO/PPO |
$498.68
|
| 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 |
$112.85
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$112.85
|
| Rate for Payer: Blue Shield of California Commercial |
$348.06
|
| Rate for Payer: Blue Shield of California Commercial |
$151.21
|
| Rate for Payer: Blue Shield of California Commercial |
$526.24
|
| Rate for Payer: Blue Shield of California Commercial |
$228.62
|
| Rate for Payer: Cash Price |
$339.75
|
| Rate for Payer: Cash Price |
$339.75
|
| Rate for Payer: Cash Price |
$147.60
|
| Rate for Payer: Cash Price |
$147.60
|
| Rate for Payer: Cigna of CA HMO |
$483.20
|
| Rate for Payer: Cigna of CA HMO |
$209.92
|
| Rate for Payer: Cigna of CA PPO |
$242.72
|
| Rate for Payer: Cigna of CA PPO |
$558.70
|
| 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 |
$229.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$528.50
|
| 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 |
$278.80
|
| Rate for Payer: Galaxy Health WC |
$641.75
|
| Rate for Payer: Global Benefits Group Commercial |
$196.80
|
| Rate for Payer: Global Benefits Group Commercial |
$453.00
|
| 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 |
$87.33
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$87.33
|
| 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 |
$208.28
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$479.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$98.76
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$98.76
|
| 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 |
$78.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$181.20
|
| 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 |
$604.00
|
| Rate for Payer: Multiplan Commercial |
$262.40
|
| Rate for Payer: Networks By Design Commercial |
$490.75
|
| Rate for Payer: Networks By Design Commercial |
$213.20
|
| Rate for Payer: Prime Health Services Commercial |
$278.80
|
| Rate for Payer: Prime Health Services Commercial |
$641.75
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$196.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$453.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$196.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$453.00
|
| 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 FINE NEEDLE ASPIRATION PG
|
Facility
|
IP
|
$122.00
|
|
|
Service Code
|
CPT 88173
|
| Hospital Charge Code |
903800290
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$24.40 |
| Max. Negotiated Rate |
$103.70 |
| Rate for Payer: Adventist Health Commercial |
$24.40
|
| Rate for Payer: Cash Price |
$54.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$85.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$48.80
|
| Rate for Payer: EPIC Health Plan Senior |
$48.80
|
| Rate for Payer: Galaxy Health WC |
$103.70
|
| Rate for Payer: Global Benefits Group Commercial |
$73.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$77.47
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$71.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$29.28
|
| Rate for Payer: Multiplan Commercial |
$97.60
|
| Rate for Payer: Networks By Design Commercial |
$79.30
|
| Rate for Payer: Prime Health Services Commercial |
$103.70
|
|
|
HC FINE NEEDLE ASPIRATION PG
|
Facility
|
OP
|
$122.00
|
|
|
Service Code
|
CPT 88173
|
| Hospital Charge Code |
903800290
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$24.40 |
| Max. Negotiated Rate |
$498.68 |
| Rate for Payer: Adventist Health Commercial |
$24.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$498.68
|
| 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 Medicare Advantage/Dual Product |
$67.02
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$112.85
|
| Rate for Payer: Blue Shield of California Commercial |
$56.24
|
| Rate for Payer: Blue Shield of California Commercial |
$85.03
|
| Rate for Payer: Cash Price |
$54.90
|
| Rate for Payer: Cash Price |
$54.90
|
| Rate for Payer: Cigna of CA HMO |
$78.08
|
| Rate for Payer: Cigna of CA PPO |
$90.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$100.53
|
| Rate for Payer: Dignity Health Medi-Cal |
$73.72
|
| Rate for Payer: Dignity Health Medicare Advantage |
$67.02
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$85.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$110.58
|
| Rate for Payer: EPIC Health Plan Senior |
$73.72
|
| Rate for Payer: Galaxy Health WC |
$103.70
|
| Rate for Payer: Global Benefits Group Commercial |
$73.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$109.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$87.33
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$67.02
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$77.47
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$98.76
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$93.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$29.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$84.45
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$89.81
|
| Rate for Payer: Multiplan Commercial |
$97.60
|
| Rate for Payer: Networks By Design Commercial |
$79.30
|
| Rate for Payer: Prime Health Services Commercial |
$103.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$73.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$73.20
|
| 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 HMO Rider |
$41.11
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$41.11
|
| 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 Medi-Cal |
$73.72
|
| Rate for Payer: Vantage Medical Group Senior |
$67.02
|
|
|
HC FINE NEEDLE ASP W IMAGE
|
Facility
|
OP
|
$1,748.00
|
|
|
Service Code
|
CPT 10022
|
| Hospital Charge Code |
903800168
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$349.60 |
| Max. Negotiated Rate |
$1,485.80 |
| Rate for Payer: Adventist Health Commercial |
$349.60
|
| Rate for Payer: Adventist Health Commercial |
$58.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$192.18
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,146.51
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$249.05
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,485.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$161.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$961.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,311.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$219.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$188.02
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,121.69
|
| Rate for Payer: Blue Shield of California Commercial |
$204.22
|
| Rate for Payer: Blue Shield of California Commercial |
$1,218.36
|
| Rate for Payer: Blue Shield of California Commercial |
$805.83
|
| Rate for Payer: Blue Shield of California Commercial |
$135.07
|
| Rate for Payer: Cash Price |
$131.85
|
| Rate for Payer: Cash Price |
$786.60
|
| Rate for Payer: Cigna of CA HMO |
$1,118.72
|
| Rate for Payer: Cigna of CA HMO |
$187.52
|
| Rate for Payer: Cigna of CA PPO |
$1,293.52
|
| Rate for Payer: Cigna of CA PPO |
$216.82
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$249.05
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,485.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,485.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$249.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,485.80
|
| Rate for Payer: Dignity Health Medicare Advantage |
$249.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$205.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,223.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$699.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$117.20
|
| Rate for Payer: EPIC Health Plan Senior |
$117.20
|
| Rate for Payer: EPIC Health Plan Senior |
$699.20
|
| Rate for Payer: Galaxy Health WC |
$1,485.80
|
| Rate for Payer: Galaxy Health WC |
$249.05
|
| Rate for Payer: Global Benefits Group Commercial |
$175.80
|
| Rate for Payer: Global Benefits Group Commercial |
$1,048.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,109.98
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$186.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$634.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$106.36
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$172.87
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,031.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$419.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$70.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,223.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$205.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$205.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,223.60
|
| Rate for Payer: Multiplan Commercial |
$1,398.40
|
| Rate for Payer: Multiplan Commercial |
$234.40
|
| Rate for Payer: Networks By Design Commercial |
$190.45
|
| Rate for Payer: Networks By Design Commercial |
$1,136.20
|
| Rate for Payer: Prime Health Services Commercial |
$1,485.80
|
| Rate for Payer: Prime Health Services Commercial |
$249.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$175.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,048.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,048.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$175.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$874.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$146.50
|
| Rate for Payer: United Healthcare All Other HMO |
$146.50
|
| Rate for Payer: United Healthcare All Other HMO |
$874.00
|
| Rate for Payer: United Healthcare HMO Rider |
$146.50
|
| Rate for Payer: United Healthcare HMO Rider |
$874.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$146.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$874.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$249.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,485.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,485.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$249.05
|
| Rate for Payer: Vantage Medical Group Senior |
$249.05
|
| Rate for Payer: Vantage Medical Group Senior |
$1,485.80
|
|
|
HC FINE NEEDLE ASP W IMAGE
|
Facility
|
IP
|
$1,748.00
|
|
|
Service Code
|
CPT 10022
|
| Hospital Charge Code |
903800168
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$349.60 |
| Max. Negotiated Rate |
$1,485.80 |
| Rate for Payer: Adventist Health Commercial |
$349.60
|
| Rate for Payer: Cash Price |
$786.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,223.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$699.20
|
| Rate for Payer: EPIC Health Plan Senior |
$699.20
|
| Rate for Payer: Galaxy Health WC |
$1,485.80
|
| Rate for Payer: Global Benefits Group Commercial |
$1,048.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,109.98
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,031.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$419.52
|
| Rate for Payer: Multiplan Commercial |
$1,398.40
|
| Rate for Payer: Networks By Design Commercial |
$1,136.20
|
| Rate for Payer: Prime Health Services Commercial |
$1,485.80
|
|
|
HC FINE NEEDLE ASP W IMAGE
|
Facility
|
IP
|
$1,748.00
|
|
|
Service Code
|
CPT 10022
|
| Hospital Charge Code |
903800168
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$349.60 |
| Max. Negotiated Rate |
$1,485.80 |
| Rate for Payer: Adventist Health Commercial |
$349.60
|
| Rate for Payer: Cash Price |
$786.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,223.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$699.20
|
| Rate for Payer: EPIC Health Plan Senior |
$699.20
|
| Rate for Payer: Galaxy Health WC |
$1,485.80
|
| Rate for Payer: Global Benefits Group Commercial |
$1,048.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,109.98
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,031.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$419.52
|
| Rate for Payer: Multiplan Commercial |
$1,398.40
|
| Rate for Payer: Networks By Design Commercial |
$1,136.20
|
| Rate for Payer: Prime Health Services Commercial |
$1,485.80
|
|
|
HC FINE NEEDLE ASP W IMAGE
|
Facility
|
OP
|
$293.00
|
|
|
Service Code
|
CPT 10022
|
| Hospital Charge Code |
903800168
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$58.60 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$58.60
|
| Rate for Payer: Adventist Health Commercial |
$349.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$249.05
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,485.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$161.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$961.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$219.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,311.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,121.69
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$188.02
|
| Rate for Payer: Blue Shield of California Commercial |
$7,196.06
|
| Rate for Payer: Blue Shield of California Commercial |
$4,753.44
|
| Rate for Payer: Blue Shield of California Commercial |
$7,196.06
|
| Rate for Payer: Blue Shield of California Commercial |
$4,753.44
|
| Rate for Payer: Cash Price |
$131.85
|
| Rate for Payer: Cash Price |
$131.85
|
| Rate for Payer: Cash Price |
$786.60
|
| Rate for Payer: Cash Price |
$786.60
|
| Rate for Payer: Cigna of CA HMO |
$1,118.72
|
| Rate for Payer: Cigna of CA HMO |
$187.52
|
| Rate for Payer: Cigna of CA PPO |
$1,293.52
|
| Rate for Payer: Cigna of CA PPO |
$216.82
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,485.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$249.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,485.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$249.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$249.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,485.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,223.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$205.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$117.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$699.20
|
| Rate for Payer: EPIC Health Plan Senior |
$699.20
|
| Rate for Payer: EPIC Health Plan Senior |
$117.20
|
| Rate for Payer: Galaxy Health WC |
$249.05
|
| Rate for Payer: Galaxy Health WC |
$1,485.80
|
| Rate for Payer: Global Benefits Group Commercial |
$1,048.80
|
| Rate for Payer: Global Benefits Group Commercial |
$175.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,109.98
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$186.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$106.36
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$634.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,031.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$172.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$419.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$70.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$205.10
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,223.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,223.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$205.10
|
| Rate for Payer: Multiplan Commercial |
$234.40
|
| Rate for Payer: Multiplan Commercial |
$1,398.40
|
| Rate for Payer: Networks By Design Commercial |
$1,136.20
|
| Rate for Payer: Networks By Design Commercial |
$190.45
|
| Rate for Payer: Prime Health Services Commercial |
$249.05
|
| Rate for Payer: Prime Health Services Commercial |
$1,485.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,048.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$175.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$874.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$146.50
|
| Rate for Payer: United Healthcare All Other HMO |
$146.50
|
| Rate for Payer: United Healthcare All Other HMO |
$874.00
|
| Rate for Payer: United Healthcare HMO Rider |
$146.50
|
| Rate for Payer: United Healthcare HMO Rider |
$874.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$146.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$874.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$249.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,485.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,485.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$249.05
|
| Rate for Payer: Vantage Medical Group Senior |
$249.05
|
| Rate for Payer: Vantage Medical Group Senior |
$1,485.80
|
|
|
HC FINE NEEDLE ASP WO IMAGE
|
Facility
|
IP
|
$1,229.00
|
|
|
Service Code
|
CPT 10021
|
| Hospital Charge Code |
903800167
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$245.80 |
| Max. Negotiated Rate |
$1,044.65 |
| Rate for Payer: Adventist Health Commercial |
$245.80
|
| Rate for Payer: Cash Price |
$553.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$860.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$491.60
|
| Rate for Payer: EPIC Health Plan Senior |
$491.60
|
| Rate for Payer: Galaxy Health WC |
$1,044.65
|
| Rate for Payer: Global Benefits Group Commercial |
$737.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$780.41
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$725.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$294.96
|
| Rate for Payer: Multiplan Commercial |
$983.20
|
| Rate for Payer: Networks By Design Commercial |
$798.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,044.65
|
|
|
HC FINE NEEDLE ASP WO IMAGE
|
Facility
|
OP
|
$1,229.00
|
|
|
Service Code
|
CPT 10021
|
| Hospital Charge Code |
903800167
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$245.80 |
| Max. Negotiated Rate |
$5,641.00 |
| Rate for Payer: Adventist Health Commercial |
$245.80
|
| Rate for Payer: Adventist Health Commercial |
$63.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$428.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$428.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$784.27
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$784.27
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$575.13
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$575.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$522.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$522.85
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Blue Shield of California Commercial |
$222.34
|
| Rate for Payer: Blue Shield of California Commercial |
$856.61
|
| Rate for Payer: Blue Shield of California Commercial |
$566.57
|
| Rate for Payer: Blue Shield of California Commercial |
$147.06
|
| Rate for Payer: Cash Price |
$553.05
|
| Rate for Payer: Cash Price |
$143.55
|
| Rate for Payer: Cash Price |
$553.05
|
| Rate for Payer: Cash Price |
$143.55
|
| Rate for Payer: Cash Price |
$553.05
|
| Rate for Payer: Cash Price |
$143.55
|
| Rate for Payer: Cigna of CA HMO |
$786.56
|
| Rate for Payer: Cigna of CA HMO |
$204.16
|
| Rate for Payer: Cigna of CA PPO |
$236.06
|
| Rate for Payer: Cigna of CA PPO |
$909.46
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$784.27
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$784.27
|
| Rate for Payer: Dignity Health Medi-Cal |
$575.13
|
| Rate for Payer: Dignity Health Medi-Cal |
$575.13
|
| Rate for Payer: Dignity Health Medicare Advantage |
$522.85
|
| Rate for Payer: Dignity Health Medicare Advantage |
$522.85
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$223.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$860.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$862.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$862.70
|
| Rate for Payer: EPIC Health Plan Senior |
$575.13
|
| Rate for Payer: EPIC Health Plan Senior |
$575.13
|
| Rate for Payer: Galaxy Health WC |
$1,044.65
|
| Rate for Payer: Galaxy Health WC |
$271.15
|
| Rate for Payer: Global Benefits Group Commercial |
$191.40
|
| Rate for Payer: Global Benefits Group Commercial |
$737.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$857.47
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$857.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$522.85
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$522.85
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$202.56
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$780.41
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$731.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$731.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$76.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$294.96
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$658.79
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$658.79
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$700.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$700.62
|
| Rate for Payer: Multiplan Commercial |
$255.20
|
| Rate for Payer: Multiplan Commercial |
$983.20
|
| Rate for Payer: Networks By Design Commercial |
$207.35
|
| Rate for Payer: Networks By Design Commercial |
$798.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,044.65
|
| Rate for Payer: Prime Health Services Commercial |
$271.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$191.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$737.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$737.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$191.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$159.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$614.50
|
| Rate for Payer: United Healthcare All Other HMO |
$159.50
|
| Rate for Payer: United Healthcare All Other HMO |
$614.50
|
| Rate for Payer: United Healthcare HMO Rider |
$159.50
|
| Rate for Payer: United Healthcare HMO Rider |
$614.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$159.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$614.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$522.85
|
| Rate for Payer: Upland Medical Group Pediatric |
$522.85
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$784.27
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$784.27
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$575.13
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$575.13
|
| Rate for Payer: Vantage Medical Group Senior |
$522.85
|
| Rate for Payer: Vantage Medical Group Senior |
$522.85
|
|
|
HC FINGERS MIN 2 VIEWS
|
Facility
|
OP
|
$518.00
|
|
|
Service Code
|
CPT 73140
|
| Hospital Charge Code |
909001521
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$26.19 |
| Max. Negotiated Rate |
$440.30 |
| Rate for Payer: Adventist Health Commercial |
$103.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$177.84
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$167.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$123.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$111.93
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$124.59
|
| Rate for Payer: Blue Shield of California Commercial |
$218.08
|
| Rate for Payer: Blue Shield of California Commercial |
$330.48
|
| Rate for Payer: Cash Price |
$233.10
|
| Rate for Payer: Cash Price |
$233.10
|
| Rate for Payer: Cigna of CA HMO |
$331.52
|
| Rate for Payer: Cigna of CA PPO |
$383.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$167.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$123.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$111.93
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$362.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$184.68
|
| Rate for Payer: EPIC Health Plan Senior |
$123.12
|
| Rate for Payer: Galaxy Health WC |
$440.30
|
| Rate for Payer: Global Benefits Group Commercial |
$310.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$183.57
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$26.19
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$111.93
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$328.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$29.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$156.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$124.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$141.03
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$149.99
|
| Rate for Payer: Multiplan Commercial |
$414.40
|
| Rate for Payer: Networks By Design Commercial |
$336.70
|
| Rate for Payer: Prime Health Services Commercial |
$440.30
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$310.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$310.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$114.69
|
| Rate for Payer: United Healthcare All Other HMO |
$114.69
|
| Rate for Payer: United Healthcare HMO Rider |
$114.69
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$114.69
|
| Rate for Payer: Upland Medical Group Pediatric |
$111.93
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$167.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$123.12
|
| Rate for Payer: Vantage Medical Group Senior |
$111.93
|
|
|
HC FINGERS MIN 2 VIEWS
|
Facility
|
IP
|
$518.00
|
|
|
Service Code
|
CPT 73140
|
| Hospital Charge Code |
909001521
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$103.60 |
| Max. Negotiated Rate |
$440.30 |
| Rate for Payer: Adventist Health Commercial |
$103.60
|
| Rate for Payer: Cash Price |
$233.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$362.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$207.20
|
| Rate for Payer: EPIC Health Plan Senior |
$207.20
|
| Rate for Payer: Galaxy Health WC |
$440.30
|
| Rate for Payer: Global Benefits Group Commercial |
$310.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$328.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$305.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$124.32
|
| Rate for Payer: Multiplan Commercial |
$414.40
|
| Rate for Payer: Networks By Design Commercial |
$336.70
|
| Rate for Payer: Prime Health Services Commercial |
$440.30
|
|
|
HC FISH INTERPHASE 100-300 CELLS
|
Facility
|
IP
|
$592.00
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
900918011
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$118.40 |
| Max. Negotiated Rate |
$503.20 |
| Rate for Payer: Adventist Health Commercial |
$118.40
|
| Rate for Payer: Cash Price |
$266.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$414.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$236.80
|
| Rate for Payer: EPIC Health Plan Senior |
$236.80
|
| Rate for Payer: Galaxy Health WC |
$503.20
|
| Rate for Payer: Global Benefits Group Commercial |
$355.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$375.92
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$349.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$142.08
|
| Rate for Payer: Multiplan Commercial |
$473.60
|
| Rate for Payer: Networks By Design Commercial |
$384.80
|
| Rate for Payer: Prime Health Services Commercial |
$503.20
|
|
|
HC FISH INTERPHASE 100-300 CELLS
|
Facility
|
OP
|
$515.00
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
900918011
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$41.46 |
| Max. Negotiated Rate |
$2,701.73 |
| Rate for Payer: Vantage Medical Group Medi-Cal |
$56.31
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$56.31
|
| Rate for Payer: Vantage Medical Group Senior |
$51.19
|
| Rate for Payer: Vantage Medical Group Senior |
$51.19
|
| Rate for Payer: Adventist Health Commercial |
$103.00
|
| Rate for Payer: Adventist Health Commercial |
$118.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$333.91
|
| Rate for Payer: Aetna of CA HMO/PPO |
$333.91
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$76.78
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$76.78
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$56.31
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$56.31
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$51.19
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$51.19
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,701.73
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,701.73
|
| Rate for Payer: Blue Shield of California Commercial |
$272.91
|
| Rate for Payer: Blue Shield of California Commercial |
$237.41
|
| Rate for Payer: Blue Shield of California Commercial |
$412.62
|
| Rate for Payer: Blue Shield of California Commercial |
$358.95
|
| Rate for Payer: Cash Price |
$266.40
|
| Rate for Payer: Cash Price |
$266.40
|
| Rate for Payer: Cash Price |
$231.75
|
| Rate for Payer: Cash Price |
$231.75
|
| Rate for Payer: Cigna of CA HMO |
$378.88
|
| Rate for Payer: Cigna of CA HMO |
$329.60
|
| Rate for Payer: Cigna of CA PPO |
$381.10
|
| Rate for Payer: Cigna of CA PPO |
$438.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$76.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$76.78
|
| Rate for Payer: Dignity Health Medi-Cal |
$56.31
|
| Rate for Payer: Dignity Health Medi-Cal |
$56.31
|
| Rate for Payer: Dignity Health Medicare Advantage |
$51.19
|
| Rate for Payer: Dignity Health Medicare Advantage |
$51.19
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$360.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$414.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$84.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$84.46
|
| Rate for Payer: EPIC Health Plan Senior |
$56.31
|
| Rate for Payer: EPIC Health Plan Senior |
$56.31
|
| Rate for Payer: Galaxy Health WC |
$437.75
|
| Rate for Payer: Galaxy Health WC |
$503.20
|
| Rate for Payer: Global Benefits Group Commercial |
$309.00
|
| Rate for Payer: Global Benefits Group Commercial |
$355.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$83.95
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$83.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$53.22
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$53.22
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$51.19
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$51.19
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$327.02
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$375.92
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$60.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$60.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$71.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$71.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$123.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$142.08
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$64.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$64.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$68.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$68.59
|
| Rate for Payer: Multiplan Commercial |
$473.60
|
| Rate for Payer: Multiplan Commercial |
$412.00
|
| Rate for Payer: Networks By Design Commercial |
$384.80
|
| Rate for Payer: Networks By Design Commercial |
$334.75
|
| Rate for Payer: Prime Health Services Commercial |
$437.75
|
| Rate for Payer: Prime Health Services Commercial |
$503.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$309.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$355.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$309.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$355.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$41.46
|
| Rate for Payer: United Healthcare All Other Commercial |
$41.46
|
| Rate for Payer: United Healthcare All Other HMO |
$41.46
|
| Rate for Payer: United Healthcare All Other HMO |
$41.46
|
| Rate for Payer: United Healthcare HMO Rider |
$41.46
|
| Rate for Payer: United Healthcare HMO Rider |
$41.46
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$41.46
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$41.46
|
| Rate for Payer: Upland Medical Group Pediatric |
$51.19
|
| Rate for Payer: Upland Medical Group Pediatric |
$51.19
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$76.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$76.78
|
|
|
HC FISH INTERPHASE 25-99 CELLS
|
Facility
|
IP
|
$213.00
|
|
|
Service Code
|
CPT 88274
|
| Hospital Charge Code |
900918010
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$42.60 |
| Max. Negotiated Rate |
$181.05 |
| Rate for Payer: Adventist Health Commercial |
$42.60
|
| Rate for Payer: Cash Price |
$95.85
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$149.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$85.20
|
| Rate for Payer: EPIC Health Plan Senior |
$85.20
|
| Rate for Payer: Galaxy Health WC |
$181.05
|
| Rate for Payer: Global Benefits Group Commercial |
$127.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$135.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$125.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$51.12
|
| Rate for Payer: Multiplan Commercial |
$170.40
|
| Rate for Payer: Networks By Design Commercial |
$138.45
|
| Rate for Payer: Prime Health Services Commercial |
$181.05
|
|
|
HC FISH INTERPHASE 25-99 CELLS
|
Facility
|
OP
|
$154.00
|
|
|
Service Code
|
CPT 88274
|
| Hospital Charge Code |
900918010
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$30.80 |
| Max. Negotiated Rate |
$2,161.39 |
| Rate for Payer: Adventist Health Commercial |
$30.80
|
| Rate for Payer: Adventist Health Commercial |
$42.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$289.49
|
| Rate for Payer: Aetna of CA HMO/PPO |
$289.49
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$63.57
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$63.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$46.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$46.62
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$42.38
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$42.38
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,161.39
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,161.39
|
| Rate for Payer: Blue Shield of California Commercial |
$148.46
|
| Rate for Payer: Blue Shield of California Commercial |
$107.34
|
| Rate for Payer: Blue Shield of California Commercial |
$98.19
|
| Rate for Payer: Blue Shield of California Commercial |
$70.99
|
| Rate for Payer: Cash Price |
$95.85
|
| Rate for Payer: Cash Price |
$95.85
|
| Rate for Payer: Cash Price |
$69.30
|
| Rate for Payer: Cash Price |
$69.30
|
| Rate for Payer: Cigna of CA HMO |
$136.32
|
| Rate for Payer: Cigna of CA HMO |
$98.56
|
| Rate for Payer: Cigna of CA PPO |
$113.96
|
| Rate for Payer: Cigna of CA PPO |
$157.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$63.57
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$63.57
|
| Rate for Payer: Dignity Health Medi-Cal |
$46.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$46.62
|
| Rate for Payer: Dignity Health Medicare Advantage |
$42.38
|
| Rate for Payer: Dignity Health Medicare Advantage |
$42.38
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$107.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$149.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$69.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$69.93
|
| Rate for Payer: EPIC Health Plan Senior |
$46.62
|
| Rate for Payer: EPIC Health Plan Senior |
$46.62
|
| Rate for Payer: Galaxy Health WC |
$130.90
|
| Rate for Payer: Galaxy Health WC |
$181.05
|
| Rate for Payer: Global Benefits Group Commercial |
$92.40
|
| Rate for Payer: Global Benefits Group Commercial |
$127.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$69.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$69.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$56.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$56.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$42.38
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$42.38
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$97.79
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$135.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$64.41
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$64.41
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$59.33
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$59.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$36.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$51.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$53.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$53.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$56.79
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$56.79
|
| Rate for Payer: Multiplan Commercial |
$170.40
|
| Rate for Payer: Multiplan Commercial |
$123.20
|
| Rate for Payer: Networks By Design Commercial |
$138.45
|
| Rate for Payer: Networks By Design Commercial |
$100.10
|
| Rate for Payer: Prime Health Services Commercial |
$130.90
|
| Rate for Payer: Prime Health Services Commercial |
$181.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$92.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$127.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$92.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$127.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$34.33
|
| Rate for Payer: United Healthcare All Other Commercial |
$34.33
|
| Rate for Payer: United Healthcare All Other HMO |
$34.33
|
| Rate for Payer: United Healthcare All Other HMO |
$34.33
|
| Rate for Payer: United Healthcare HMO Rider |
$34.33
|
| Rate for Payer: United Healthcare HMO Rider |
$34.33
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$34.33
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$34.33
|
| Rate for Payer: Upland Medical Group Pediatric |
$42.38
|
| Rate for Payer: Upland Medical Group Pediatric |
$42.38
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$63.57
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$63.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$46.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$46.62
|
| Rate for Payer: Vantage Medical Group Senior |
$42.38
|
| Rate for Payer: Vantage Medical Group Senior |
$42.38
|
|
|
HC FISH PROBE CYTOGEN 10-30 CELLS
|
Facility
|
IP
|
$201.00
|
|
|
Service Code
|
CPT 88273
|
| Hospital Charge Code |
900918009
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$40.20 |
| Max. Negotiated Rate |
$170.85 |
| Rate for Payer: Adventist Health Commercial |
$40.20
|
| Rate for Payer: Cash Price |
$90.45
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$140.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$80.40
|
| Rate for Payer: EPIC Health Plan Senior |
$80.40
|
| Rate for Payer: Galaxy Health WC |
$170.85
|
| Rate for Payer: Global Benefits Group Commercial |
$120.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$127.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$118.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$48.24
|
| Rate for Payer: Multiplan Commercial |
$160.80
|
| Rate for Payer: Networks By Design Commercial |
$130.65
|
| Rate for Payer: Prime Health Services Commercial |
$170.85
|
|
|
HC FISH PROBE CYTOGEN 10-30 CELLS
|
Facility
|
OP
|
$143.00
|
|
|
Service Code
|
CPT 88273
|
| Hospital Charge Code |
900918009
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$28.20 |
| Max. Negotiated Rate |
$1,961.26 |
| Rate for Payer: Adventist Health Commercial |
$28.60
|
| Rate for Payer: Adventist Health Commercial |
$40.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$267.17
|
| Rate for Payer: Aetna of CA HMO/PPO |
$267.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$52.22
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$52.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$38.29
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$38.29
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$34.81
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$34.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,961.26
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,961.26
|
| Rate for Payer: Blue Shield of California Commercial |
$140.10
|
| Rate for Payer: Blue Shield of California Commercial |
$65.92
|
| Rate for Payer: Blue Shield of California Commercial |
$92.66
|
| Rate for Payer: Blue Shield of California Commercial |
$99.67
|
| Rate for Payer: Cash Price |
$90.45
|
| Rate for Payer: Cash Price |
$90.45
|
| Rate for Payer: Cash Price |
$64.35
|
| Rate for Payer: Cash Price |
$64.35
|
| Rate for Payer: Cigna of CA HMO |
$128.64
|
| 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 |
$148.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$52.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$52.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$38.29
|
| Rate for Payer: Dignity Health Medi-Cal |
$38.29
|
| Rate for Payer: Dignity Health Medicare Advantage |
$34.81
|
| Rate for Payer: Dignity Health Medicare Advantage |
$34.81
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$100.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$140.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$57.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$57.44
|
| Rate for Payer: EPIC Health Plan Senior |
$38.29
|
| Rate for Payer: EPIC Health Plan Senior |
$38.29
|
| Rate for Payer: Galaxy Health WC |
$121.55
|
| Rate for Payer: Galaxy Health WC |
$170.85
|
| Rate for Payer: Global Benefits Group Commercial |
$85.80
|
| Rate for Payer: Global Benefits Group Commercial |
$120.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$57.09
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$57.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$47.98
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$47.98
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$34.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$34.81
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$90.81
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$127.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$54.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$54.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$48.73
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$48.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$34.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$48.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$43.86
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$43.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$46.65
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$46.65
|
| Rate for Payer: Multiplan Commercial |
$160.80
|
| Rate for Payer: Multiplan Commercial |
$114.40
|
| Rate for Payer: Networks By Design Commercial |
$130.65
|
| 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 |
$170.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$85.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$120.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$85.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$120.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$28.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$28.20
|
| Rate for Payer: United Healthcare All Other HMO |
$28.20
|
| Rate for Payer: United Healthcare All Other HMO |
$28.20
|
| Rate for Payer: United Healthcare HMO Rider |
$28.20
|
| Rate for Payer: United Healthcare HMO Rider |
$28.20
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$28.20
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$28.20
|
| Rate for Payer: Upland Medical Group Pediatric |
$34.81
|
| Rate for Payer: Upland Medical Group Pediatric |
$34.81
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$52.22
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$52.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$38.29
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$38.29
|
| Rate for Payer: Vantage Medical Group Senior |
$34.81
|
| Rate for Payer: Vantage Medical Group Senior |
$34.81
|
|
