|
HC TRICHROME TEST
|
Facility
OP
|
$84.00
|
|
|
Service Code
|
CPT 88313
|
| Hospital Charge Code |
900911728
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$20.16 |
| Max. Negotiated Rate |
$420.96 |
| Rate for Payer: Aetna of CA HMO/PPO |
$420.96
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$114.63
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$84.06
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$76.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$26.54
|
| Rate for Payer: BCBS Transplant Transplant |
$50.40
|
| Rate for Payer: Blue Shield of California Commercial |
$54.26
|
| Rate for Payer: Blue Shield of California EPN |
$43.01
|
| Rate for Payer: Cash Price |
$37.80
|
| Rate for Payer: Cash Price |
$37.80
|
| Rate for Payer: Cigna of CA HMO |
$53.76
|
| Rate for Payer: Cigna of CA PPO |
$62.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$114.63
|
| Rate for Payer: Dignity Health Media |
$76.42
|
| Rate for Payer: Dignity Health Medi-Cal |
$84.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$103.17
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$76.42
|
| Rate for Payer: EPIC Health Plan Transplant |
$76.42
|
| Rate for Payer: Galaxy Health WC |
$71.40
|
| Rate for Payer: Global Benefits Group Commercial |
$50.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$63.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$125.33
|
| Rate for Payer: Heritage Provider Network Transplant |
$125.33
|
| Rate for Payer: IEHP Medi-Cal |
$123.80
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$123.80
|
| Rate for Payer: IEHP Medicare Advantage |
$76.42
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$56.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$65.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$76.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$96.29
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$102.40
|
| Rate for Payer: Multiplan Commercial |
$67.20
|
| Rate for Payer: Networks By Design Commercial |
$54.60
|
| Rate for Payer: Prime Health Services Commercial |
$71.40
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$50.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$50.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$50.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$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: Vantage Medical Group Commercial/Exchange |
$114.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$84.06
|
| Rate for Payer: Vantage Medical Group Senior |
$76.42
|
|
|
HC TRIGLYCERIDES
|
Facility
OP
|
$19.00
|
|
|
Service Code
|
CPT 84478
|
| Hospital Charge Code |
900910234
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.56 |
| Max. Negotiated Rate |
$52.21 |
| Rate for Payer: Aetna of CA HMO/PPO |
$47.90
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$8.61
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$6.31
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$5.74
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$52.21
|
| Rate for Payer: BCBS Transplant Transplant |
$11.40
|
| Rate for Payer: Blue Shield of California Commercial |
$12.27
|
| Rate for Payer: Blue Shield of California EPN |
$9.73
|
| Rate for Payer: Cash Price |
$8.55
|
| Rate for Payer: Cash Price |
$8.55
|
| Rate for Payer: Cigna of CA HMO |
$12.16
|
| Rate for Payer: Cigna of CA PPO |
$14.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8.61
|
| Rate for Payer: Dignity Health Media |
$5.74
|
| Rate for Payer: Dignity Health Medi-Cal |
$6.31
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.75
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$5.74
|
| Rate for Payer: EPIC Health Plan Transplant |
$5.74
|
| Rate for Payer: Galaxy Health WC |
$16.15
|
| Rate for Payer: Global Benefits Group Commercial |
$11.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$14.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$9.41
|
| Rate for Payer: Heritage Provider Network Transplant |
$9.41
|
| Rate for Payer: IEHP Medi-Cal |
$9.30
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$9.30
|
| Rate for Payer: IEHP Medicare Advantage |
$5.74
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.54
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.56
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$7.23
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$7.69
|
| Rate for Payer: Multiplan Commercial |
$15.20
|
| Rate for Payer: Networks By Design Commercial |
$12.35
|
| Rate for Payer: Prime Health Services Commercial |
$16.15
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$11.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$11.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$11.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.65
|
| Rate for Payer: United Healthcare All Other HMO |
$4.65
|
| Rate for Payer: United Healthcare HMO Rider |
$4.65
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.65
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$8.61
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6.31
|
| Rate for Payer: Vantage Medical Group Senior |
$5.74
|
|
|
HC TRIGLYCERIDES BODY FLUID
|
Facility
OP
|
$17.00
|
|
|
Service Code
|
CPT 84478
|
| Hospital Charge Code |
900912247
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.08 |
| Max. Negotiated Rate |
$52.21 |
| Rate for Payer: Aetna of CA HMO/PPO |
$47.90
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$8.61
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$6.31
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$5.74
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$52.21
|
| Rate for Payer: BCBS Transplant Transplant |
$10.20
|
| Rate for Payer: Blue Shield of California Commercial |
$10.98
|
| Rate for Payer: Blue Shield of California EPN |
$8.70
|
| Rate for Payer: Cash Price |
$7.65
|
| Rate for Payer: Cash Price |
$7.65
|
| Rate for Payer: Cigna of CA HMO |
$10.88
|
| Rate for Payer: Cigna of CA PPO |
$12.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8.61
|
| Rate for Payer: Dignity Health Media |
$5.74
|
| Rate for Payer: Dignity Health Medi-Cal |
$6.31
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.75
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$5.74
|
| Rate for Payer: EPIC Health Plan Transplant |
$5.74
|
| Rate for Payer: Galaxy Health WC |
$14.45
|
| Rate for Payer: Global Benefits Group Commercial |
$10.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$12.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$9.41
|
| Rate for Payer: Heritage Provider Network Transplant |
$9.41
|
| Rate for Payer: IEHP Medi-Cal |
$9.30
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$9.30
|
| Rate for Payer: IEHP Medicare Advantage |
$5.74
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.54
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.08
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$7.23
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$7.69
|
| Rate for Payer: Multiplan Commercial |
$13.60
|
| Rate for Payer: Networks By Design Commercial |
$11.05
|
| Rate for Payer: Prime Health Services Commercial |
$14.45
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$10.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$10.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.65
|
| Rate for Payer: United Healthcare All Other HMO |
$4.65
|
| Rate for Payer: United Healthcare HMO Rider |
$4.65
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.65
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$8.61
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6.31
|
| Rate for Payer: Vantage Medical Group Senior |
$5.74
|
|
|
HC TRIGLYCERIDES INDIVIDUAL
|
Facility
OP
|
$19.00
|
|
|
Service Code
|
CPT 84478
|
| Hospital Charge Code |
900910526
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.56 |
| Max. Negotiated Rate |
$52.21 |
| Rate for Payer: Aetna of CA HMO/PPO |
$47.90
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$8.61
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$6.31
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$5.74
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$52.21
|
| Rate for Payer: BCBS Transplant Transplant |
$11.40
|
| Rate for Payer: Blue Shield of California Commercial |
$12.27
|
| Rate for Payer: Blue Shield of California EPN |
$9.73
|
| Rate for Payer: Cash Price |
$8.55
|
| Rate for Payer: Cash Price |
$8.55
|
| Rate for Payer: Cigna of CA HMO |
$12.16
|
| Rate for Payer: Cigna of CA PPO |
$14.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8.61
|
| Rate for Payer: Dignity Health Media |
$5.74
|
| Rate for Payer: Dignity Health Medi-Cal |
$6.31
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.75
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$5.74
|
| Rate for Payer: EPIC Health Plan Transplant |
$5.74
|
| Rate for Payer: Galaxy Health WC |
$16.15
|
| Rate for Payer: Global Benefits Group Commercial |
$11.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$14.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$9.41
|
| Rate for Payer: Heritage Provider Network Transplant |
$9.41
|
| Rate for Payer: IEHP Medi-Cal |
$9.30
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$9.30
|
| Rate for Payer: IEHP Medicare Advantage |
$5.74
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.54
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.56
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$7.23
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$7.69
|
| Rate for Payer: Multiplan Commercial |
$15.20
|
| Rate for Payer: Networks By Design Commercial |
$12.35
|
| Rate for Payer: Prime Health Services Commercial |
$16.15
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$11.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$11.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$11.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.65
|
| Rate for Payer: United Healthcare All Other HMO |
$4.65
|
| Rate for Payer: United Healthcare HMO Rider |
$4.65
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.65
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$8.61
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6.31
|
| Rate for Payer: Vantage Medical Group Senior |
$5.74
|
|
|
HC TRIIODOTHYRONINE, FREE
|
Facility
OP
|
$65.00
|
|
|
Service Code
|
CPT 84481
|
| Hospital Charge Code |
900912135
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.72 |
| Max. Negotiated Rate |
$154.60 |
| Rate for Payer: Aetna of CA HMO/PPO |
$140.85
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$25.41
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$18.63
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$16.94
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$154.60
|
| Rate for Payer: BCBS Transplant Transplant |
$39.00
|
| Rate for Payer: Blue Shield of California Commercial |
$41.99
|
| Rate for Payer: Blue Shield of California EPN |
$33.28
|
| Rate for Payer: Cash Price |
$29.25
|
| Rate for Payer: Cash Price |
$29.25
|
| Rate for Payer: Cigna of CA HMO |
$41.60
|
| Rate for Payer: Cigna of CA PPO |
$48.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$25.41
|
| Rate for Payer: Dignity Health Media |
$16.94
|
| Rate for Payer: Dignity Health Medi-Cal |
$18.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$22.87
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$16.94
|
| Rate for Payer: EPIC Health Plan Transplant |
$16.94
|
| Rate for Payer: Galaxy Health WC |
$55.25
|
| Rate for Payer: Global Benefits Group Commercial |
$39.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$48.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$27.78
|
| Rate for Payer: Heritage Provider Network Transplant |
$27.78
|
| Rate for Payer: IEHP Medi-Cal |
$27.44
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$27.44
|
| Rate for Payer: IEHP Medicare Advantage |
$16.94
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$43.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$22.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$21.34
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$22.70
|
| Rate for Payer: Multiplan Commercial |
$52.00
|
| Rate for Payer: Networks By Design Commercial |
$42.25
|
| Rate for Payer: Prime Health Services Commercial |
$55.25
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$39.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$39.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$39.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$13.72
|
| Rate for Payer: United Healthcare All Other HMO |
$13.72
|
| Rate for Payer: United Healthcare HMO Rider |
$13.72
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$13.72
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$25.41
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$18.63
|
| Rate for Payer: Vantage Medical Group Senior |
$16.94
|
|
|
HC TRIMMING NONDYSTROPHIC NAILS
|
Facility
IP
|
$382.00
|
|
|
Service Code
|
CPT 11719
|
| Hospital Charge Code |
900501406
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$91.68 |
| Max. Negotiated Rate |
$324.70 |
| Rate for Payer: Cash Price |
$171.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$152.80
|
| Rate for Payer: Galaxy Health WC |
$324.70
|
| Rate for Payer: Global Benefits Group Commercial |
$229.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$254.79
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$145.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$91.68
|
| Rate for Payer: Multiplan Commercial |
$305.60
|
| Rate for Payer: Networks By Design Commercial |
$248.30
|
| Rate for Payer: Prime Health Services Commercial |
$324.70
|
|
|
HC TRIMMING NONDYSTROPHIC NAILS
|
Facility
OP
|
$382.00
|
|
|
Service Code
|
CPT 11719
|
| Hospital Charge Code |
900501406
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$76.42 |
| Max. Negotiated Rate |
$3,171.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$114.63
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$84.06
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$76.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,299.00
|
| Rate for Payer: BCBS Transplant Transplant |
$229.20
|
| Rate for Payer: Cash Price |
$171.90
|
| Rate for Payer: Cash Price |
$171.90
|
| Rate for Payer: Cash Price |
$171.90
|
| Rate for Payer: Cigna of CA PPO |
$282.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$114.63
|
| Rate for Payer: Dignity Health Media |
$76.42
|
| Rate for Payer: Dignity Health Medi-Cal |
$84.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$103.17
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$76.42
|
| Rate for Payer: EPIC Health Plan Transplant |
$76.42
|
| Rate for Payer: Galaxy Health WC |
$324.70
|
| Rate for Payer: Global Benefits Group Commercial |
$229.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$286.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$125.33
|
| Rate for Payer: Heritage Provider Network Transplant |
$125.33
|
| Rate for Payer: IEHP Medi-Cal |
$936.00
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$76.42
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$254.79
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$145.54
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$76.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$91.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$96.29
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$102.40
|
| Rate for Payer: Multiplan Commercial |
$305.60
|
| Rate for Payer: Networks By Design Commercial |
$248.30
|
| Rate for Payer: Prime Health Services Commercial |
$324.70
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$229.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$229.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$191.00
|
| Rate for Payer: United Healthcare All Other HMO |
$191.00
|
| Rate for Payer: United Healthcare HMO Rider |
$191.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$191.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$114.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$84.06
|
| Rate for Payer: Vantage Medical Group Senior |
$76.42
|
|
|
HC TRLUML BLLN ANGIO ADDL ART
|
Facility
OP
|
$13,062.00
|
|
|
Service Code
|
CPT 37247
|
| Hospital Charge Code |
909037247
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$951.00 |
| Max. Negotiated Rate |
$11,102.70 |
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$11,102.70
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$7,184.10
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$7,184.10
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,049.00
|
| Rate for Payer: BCBS Transplant Transplant |
$7,837.20
|
| Rate for Payer: Blue Shield of California Commercial |
$6,668.88
|
| Rate for Payer: Blue Shield of California EPN |
$4,340.48
|
| Rate for Payer: Cash Price |
$5,877.90
|
| Rate for Payer: Cash Price |
$5,877.90
|
| Rate for Payer: Cash Price |
$5,877.90
|
| Rate for Payer: Cigna of CA PPO |
$9,665.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11,102.70
|
| Rate for Payer: Dignity Health Media |
$11,102.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,102.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,224.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$5,224.80
|
| Rate for Payer: Galaxy Health WC |
$11,102.70
|
| Rate for Payer: Global Benefits Group Commercial |
$7,837.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$9,796.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,712.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,500.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,134.88
|
| Rate for Payer: Multiplan Commercial |
$10,449.60
|
| Rate for Payer: Networks By Design Commercial |
$8,490.30
|
| Rate for Payer: Prime Health Services Commercial |
$11,102.70
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$7,837.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,837.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,834.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,517.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,041.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$951.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11,102.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,102.70
|
| Rate for Payer: Vantage Medical Group Senior |
$11,102.70
|
|
|
HC TRLUML BLLN ANGIO ADDL ART
|
Facility
IP
|
$13,062.00
|
|
|
Service Code
|
CPT 37247
|
| Hospital Charge Code |
909037247
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,134.88 |
| Max. Negotiated Rate |
$11,102.70 |
| Rate for Payer: Cash Price |
$5,877.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,224.80
|
| Rate for Payer: Galaxy Health WC |
$11,102.70
|
| Rate for Payer: Global Benefits Group Commercial |
$7,837.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,712.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,976.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,134.88
|
| Rate for Payer: Multiplan Commercial |
$10,449.60
|
| Rate for Payer: Networks By Design Commercial |
$8,490.30
|
| Rate for Payer: Prime Health Services Commercial |
$11,102.70
|
|
|
HC TRLUML BLLN ANGIO ADDL VEIN
|
Facility
IP
|
$12,759.00
|
|
|
Service Code
|
CPT 37249
|
| Hospital Charge Code |
909037249
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,062.16 |
| Max. Negotiated Rate |
$10,845.15 |
| Rate for Payer: Cash Price |
$5,741.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,103.60
|
| Rate for Payer: Galaxy Health WC |
$10,845.15
|
| Rate for Payer: Global Benefits Group Commercial |
$7,655.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,510.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,861.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,062.16
|
| Rate for Payer: Multiplan Commercial |
$10,207.20
|
| Rate for Payer: Networks By Design Commercial |
$8,293.35
|
| Rate for Payer: Prime Health Services Commercial |
$10,845.15
|
|
|
HC TRLUML BLLN ANGIO ADDL VEIN
|
Facility
OP
|
$12,759.00
|
|
|
Service Code
|
CPT 37249
|
| Hospital Charge Code |
909037249
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$951.00 |
| Max. Negotiated Rate |
$10,845.15 |
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$10,845.15
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$7,017.45
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$7,017.45
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,049.00
|
| Rate for Payer: BCBS Transplant Transplant |
$7,655.40
|
| Rate for Payer: Blue Shield of California Commercial |
$6,668.88
|
| Rate for Payer: Blue Shield of California EPN |
$4,340.48
|
| Rate for Payer: Cash Price |
$5,741.55
|
| Rate for Payer: Cash Price |
$5,741.55
|
| Rate for Payer: Cash Price |
$5,741.55
|
| Rate for Payer: Cigna of CA PPO |
$9,441.66
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,845.15
|
| Rate for Payer: Dignity Health Media |
$10,845.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$10,845.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,103.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$5,103.60
|
| Rate for Payer: Galaxy Health WC |
$10,845.15
|
| Rate for Payer: Global Benefits Group Commercial |
$7,655.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$9,569.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,510.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,096.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,062.16
|
| Rate for Payer: Multiplan Commercial |
$10,207.20
|
| Rate for Payer: Networks By Design Commercial |
$8,293.35
|
| Rate for Payer: Prime Health Services Commercial |
$10,845.15
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$7,655.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,655.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,834.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,517.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,041.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$951.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,845.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10,845.15
|
| Rate for Payer: Vantage Medical Group Senior |
$10,845.15
|
|
|
HC TRLUML BLLN ANGIO INIT ART
|
Facility
OP
|
$29,780.00
|
|
|
Service Code
|
CPT 37246
|
| Hospital Charge Code |
909037246
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,756.86 |
| Max. Negotiated Rate |
$27,445.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$11,370.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$10,712.02
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$7,855.48
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$7,141.35
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,049.00
|
| Rate for Payer: BCBS Transplant Transplant |
$17,868.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,699.31
|
| Rate for Payer: Blue Shield of California EPN |
$1,756.86
|
| Rate for Payer: Cash Price |
$13,401.00
|
| Rate for Payer: Cash Price |
$13,401.00
|
| Rate for Payer: Cigna of CA PPO |
$22,037.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,712.02
|
| Rate for Payer: Dignity Health Media |
$7,141.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,855.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,640.82
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$7,141.35
|
| Rate for Payer: EPIC Health Plan Transplant |
$7,141.35
|
| Rate for Payer: Galaxy Health WC |
$25,313.00
|
| Rate for Payer: Global Benefits Group Commercial |
$17,868.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$22,335.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$11,711.81
|
| Rate for Payer: Heritage Provider Network Transplant |
$11,711.81
|
| Rate for Payer: IEHP Medi-Cal |
$11,568.99
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$11,568.99
|
| Rate for Payer: IEHP Medicare Advantage |
$7,141.35
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$19,863.26
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,725.01
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,141.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,147.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8,998.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9,569.41
|
| Rate for Payer: Multiplan Commercial |
$23,824.00
|
| Rate for Payer: Networks By Design Commercial |
$19,357.00
|
| Rate for Payer: Prime Health Services Commercial |
$25,313.00
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$17,868.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$17,868.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$16,813.00
|
| Rate for Payer: United Healthcare All Other HMO |
$27,445.00
|
| Rate for Payer: United Healthcare HMO Rider |
$17,214.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15,742.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,712.02
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,855.48
|
| Rate for Payer: Vantage Medical Group Senior |
$7,141.35
|
|
|
HC TRLUML BLLN ANGIO INIT ART
|
Facility
IP
|
$29,780.00
|
|
|
Service Code
|
CPT 37246
|
| Hospital Charge Code |
909037246
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$7,147.20 |
| Max. Negotiated Rate |
$25,313.00 |
| Rate for Payer: Cash Price |
$13,401.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$11,912.00
|
| Rate for Payer: Galaxy Health WC |
$25,313.00
|
| Rate for Payer: Global Benefits Group Commercial |
$17,868.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$19,863.26
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11,346.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,147.20
|
| Rate for Payer: Multiplan Commercial |
$23,824.00
|
| Rate for Payer: Networks By Design Commercial |
$19,357.00
|
| Rate for Payer: Prime Health Services Commercial |
$25,313.00
|
|
|
HC TRLUML BLLN ANGIO INIT VEIN
|
Facility
OP
|
$25,518.00
|
|
|
Service Code
|
CPT 37248
|
| Hospital Charge Code |
909037248
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,756.86 |
| Max. Negotiated Rate |
$27,445.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$11,370.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$10,712.02
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$7,855.48
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$7,141.35
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,049.00
|
| Rate for Payer: BCBS Transplant Transplant |
$15,310.80
|
| Rate for Payer: Blue Shield of California Commercial |
$2,699.31
|
| Rate for Payer: Blue Shield of California EPN |
$1,756.86
|
| Rate for Payer: Cash Price |
$11,483.10
|
| Rate for Payer: Cash Price |
$11,483.10
|
| Rate for Payer: Cigna of CA PPO |
$18,883.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,712.02
|
| Rate for Payer: Dignity Health Media |
$7,141.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,855.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,640.82
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$7,141.35
|
| Rate for Payer: EPIC Health Plan Transplant |
$7,141.35
|
| Rate for Payer: Galaxy Health WC |
$21,690.30
|
| Rate for Payer: Global Benefits Group Commercial |
$15,310.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$19,138.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$11,711.81
|
| Rate for Payer: Heritage Provider Network Transplant |
$11,711.81
|
| Rate for Payer: IEHP Medi-Cal |
$11,568.99
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$11,568.99
|
| Rate for Payer: IEHP Medicare Advantage |
$7,141.35
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17,020.51
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,568.46
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,141.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,124.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8,998.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9,569.41
|
| Rate for Payer: Multiplan Commercial |
$20,414.40
|
| Rate for Payer: Networks By Design Commercial |
$16,586.70
|
| Rate for Payer: Prime Health Services Commercial |
$21,690.30
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$15,310.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15,310.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$16,813.00
|
| Rate for Payer: United Healthcare All Other HMO |
$27,445.00
|
| Rate for Payer: United Healthcare HMO Rider |
$17,214.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15,742.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,712.02
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,855.48
|
| Rate for Payer: Vantage Medical Group Senior |
$7,141.35
|
|
|
HC TRLUML BLLN ANGIO INIT VEIN
|
Facility
IP
|
$25,518.00
|
|
|
Service Code
|
CPT 37248
|
| Hospital Charge Code |
909037248
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,124.32 |
| Max. Negotiated Rate |
$21,690.30 |
| Rate for Payer: Cash Price |
$11,483.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,207.20
|
| Rate for Payer: Galaxy Health WC |
$21,690.30
|
| Rate for Payer: Global Benefits Group Commercial |
$15,310.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17,020.51
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9,722.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,124.32
|
| Rate for Payer: Multiplan Commercial |
$20,414.40
|
| Rate for Payer: Networks By Design Commercial |
$16,586.70
|
| Rate for Payer: Prime Health Services Commercial |
$21,690.30
|
|
|
HC TRMNT SPEECH/LANG/DYSPHAGIA GRP
|
Facility
OP
|
$463.00
|
|
|
Service Code
|
CPT 92508
|
| Hospital Charge Code |
908600386
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$4.67 |
| Max. Negotiated Rate |
$421.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$152.18
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$393.55
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$254.65
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$254.65
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$421.00
|
| Rate for Payer: BCBS Transplant Transplant |
$277.80
|
| Rate for Payer: Blue Shield of California Commercial |
$407.00
|
| Rate for Payer: Blue Shield of California EPN |
$293.00
|
| Rate for Payer: Cash Price |
$208.35
|
| Rate for Payer: Cash Price |
$208.35
|
| Rate for Payer: Cash Price |
$208.35
|
| Rate for Payer: Cash Price |
$208.35
|
| Rate for Payer: Cigna of CA HMO |
$296.32
|
| Rate for Payer: Cigna of CA PPO |
$342.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$393.55
|
| Rate for Payer: Dignity Health Media |
$393.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$393.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$185.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$185.20
|
| Rate for Payer: Galaxy Health WC |
$393.55
|
| Rate for Payer: Global Benefits Group Commercial |
$277.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$347.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$308.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$111.12
|
| Rate for Payer: Multiplan Commercial |
$370.40
|
| Rate for Payer: Networks By Design Commercial |
$300.95
|
| Rate for Payer: Prime Health Services Commercial |
$393.55
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$277.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$277.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$277.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$396.00
|
| Rate for Payer: United Healthcare All Other HMO |
$281.00
|
| Rate for Payer: United Healthcare HMO Rider |
$213.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$196.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$393.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$393.55
|
| Rate for Payer: Vantage Medical Group Senior |
$393.55
|
|
|
HC TRMNT SPEECH/LANG/DYSPHAGIA GRP
|
Facility
IP
|
$463.00
|
|
|
Service Code
|
CPT 92508
|
| Hospital Charge Code |
908600386
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$111.12 |
| Max. Negotiated Rate |
$393.55 |
| Rate for Payer: Cash Price |
$208.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$185.20
|
| Rate for Payer: Galaxy Health WC |
$393.55
|
| Rate for Payer: Global Benefits Group Commercial |
$277.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$308.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$176.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$111.12
|
| Rate for Payer: Multiplan Commercial |
$370.40
|
| Rate for Payer: Networks By Design Commercial |
$300.95
|
| Rate for Payer: Prime Health Services Commercial |
$393.55
|
|
|
HC TRMNT SPEECH/LANG/DYSPHAGIA GRP MCAL
|
Facility
OP
|
$665.00
|
|
|
Service Code
|
CPT X4302
|
| Hospital Charge Code |
907000038
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$50.48 |
| Max. Negotiated Rate |
$565.25 |
| Rate for Payer: Aetna of CA HMO/PPO |
$436.17
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$565.25
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$365.75
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$365.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$421.00
|
| Rate for Payer: BCBS Transplant Transplant |
$399.00
|
| Rate for Payer: Blue Shield of California Commercial |
$407.00
|
| Rate for Payer: Blue Shield of California EPN |
$293.00
|
| Rate for Payer: Cash Price |
$299.25
|
| Rate for Payer: Cash Price |
$299.25
|
| Rate for Payer: Cash Price |
$299.25
|
| Rate for Payer: Cash Price |
$299.25
|
| Rate for Payer: Cigna of CA HMO |
$425.60
|
| Rate for Payer: Cigna of CA PPO |
$492.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$565.25
|
| Rate for Payer: Dignity Health Media |
$565.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$565.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$266.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$266.00
|
| Rate for Payer: Galaxy Health WC |
$565.25
|
| Rate for Payer: Global Benefits Group Commercial |
$399.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$498.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$443.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$50.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$159.60
|
| Rate for Payer: Multiplan Commercial |
$532.00
|
| Rate for Payer: Networks By Design Commercial |
$432.25
|
| Rate for Payer: Prime Health Services Commercial |
$565.25
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$399.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$399.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$399.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$396.00
|
| Rate for Payer: United Healthcare All Other HMO |
$281.00
|
| Rate for Payer: United Healthcare HMO Rider |
$213.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$196.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$565.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$565.25
|
| Rate for Payer: Vantage Medical Group Senior |
$565.25
|
|
|
HC TRMNT SPEECH/LANG/DYSPHAGIA GRP MCAL
|
Facility
IP
|
$665.00
|
|
|
Service Code
|
CPT X4302
|
| Hospital Charge Code |
907000038
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$159.60 |
| Max. Negotiated Rate |
$565.25 |
| Rate for Payer: Cash Price |
$299.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$266.00
|
| Rate for Payer: Galaxy Health WC |
$565.25
|
| Rate for Payer: Global Benefits Group Commercial |
$399.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$443.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$253.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$159.60
|
| Rate for Payer: Multiplan Commercial |
$532.00
|
| Rate for Payer: Networks By Design Commercial |
$432.25
|
| Rate for Payer: Prime Health Services Commercial |
$565.25
|
|
|
HC TRMNT SPEECH/LANG/VOICE INDIV MCAL
|
Facility
OP
|
$795.00
|
|
|
Service Code
|
CPT 92507
|
| Hospital Charge Code |
907000041
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$56.47 |
| Max. Negotiated Rate |
$675.75 |
| Rate for Payer: Aetna of CA HMO/PPO |
$458.91
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$675.75
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$437.25
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$437.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$421.00
|
| Rate for Payer: BCBS Transplant Transplant |
$477.00
|
| Rate for Payer: Blue Shield of California Commercial |
$407.00
|
| Rate for Payer: Blue Shield of California EPN |
$293.00
|
| Rate for Payer: Cash Price |
$357.75
|
| Rate for Payer: Cash Price |
$357.75
|
| Rate for Payer: Cash Price |
$357.75
|
| Rate for Payer: Cash Price |
$357.75
|
| Rate for Payer: Cigna of CA HMO |
$508.80
|
| Rate for Payer: Cigna of CA PPO |
$588.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$675.75
|
| Rate for Payer: Dignity Health Media |
$675.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$675.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$318.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$318.00
|
| Rate for Payer: Galaxy Health WC |
$675.75
|
| Rate for Payer: Global Benefits Group Commercial |
$477.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$596.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$530.26
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$56.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$190.80
|
| Rate for Payer: Multiplan Commercial |
$636.00
|
| Rate for Payer: Networks By Design Commercial |
$516.75
|
| Rate for Payer: Prime Health Services Commercial |
$675.75
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$477.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$477.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$477.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$396.00
|
| Rate for Payer: United Healthcare All Other HMO |
$281.00
|
| Rate for Payer: United Healthcare HMO Rider |
$213.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$196.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$675.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$675.75
|
| Rate for Payer: Vantage Medical Group Senior |
$675.75
|
|
|
HC TRMNT SPEECH/LANG/VOICE INDIV MCAL
|
Facility
IP
|
$795.00
|
|
|
Service Code
|
CPT 92507
|
| Hospital Charge Code |
907000041
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$190.80 |
| Max. Negotiated Rate |
$675.75 |
| Rate for Payer: Cash Price |
$357.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$318.00
|
| Rate for Payer: Galaxy Health WC |
$675.75
|
| Rate for Payer: Global Benefits Group Commercial |
$477.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$530.26
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$302.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$190.80
|
| Rate for Payer: Multiplan Commercial |
$636.00
|
| Rate for Payer: Networks By Design Commercial |
$516.75
|
| Rate for Payer: Prime Health Services Commercial |
$675.75
|
|
|
HC TRMNT STRESS MANAGEMENT
|
Facility
IP
|
$228.00
|
|
|
Service Code
|
CPT 90834
|
| Hospital Charge Code |
907804066
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$54.72 |
| Max. Negotiated Rate |
$193.80 |
| Rate for Payer: Cash Price |
$102.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$91.20
|
| Rate for Payer: Galaxy Health WC |
$193.80
|
| Rate for Payer: Global Benefits Group Commercial |
$136.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$152.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$86.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$54.72
|
| Rate for Payer: Multiplan Commercial |
$182.40
|
| Rate for Payer: Networks By Design Commercial |
$148.20
|
| Rate for Payer: Prime Health Services Commercial |
$193.80
|
|
|
HC TRMNT STRESS MANAGEMENT
|
Facility
OP
|
$228.00
|
|
|
Service Code
|
CPT 90834
|
| Hospital Charge Code |
907804066
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$54.72 |
| Max. Negotiated Rate |
$3,171.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$298.82
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$219.13
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$199.21
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,299.00
|
| Rate for Payer: BCBS Transplant Transplant |
$136.80
|
| Rate for Payer: Cash Price |
$102.60
|
| Rate for Payer: Cash Price |
$102.60
|
| Rate for Payer: Cash Price |
$102.60
|
| Rate for Payer: Cigna of CA PPO |
$168.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$298.82
|
| Rate for Payer: Dignity Health Media |
$199.21
|
| Rate for Payer: Dignity Health Medi-Cal |
$219.13
|
| Rate for Payer: EPIC Health Plan Commercial |
$268.93
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$199.21
|
| Rate for Payer: EPIC Health Plan Transplant |
$199.21
|
| Rate for Payer: Galaxy Health WC |
$193.80
|
| Rate for Payer: Global Benefits Group Commercial |
$136.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$171.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$326.70
|
| Rate for Payer: Heritage Provider Network Transplant |
$326.70
|
| Rate for Payer: IEHP Medi-Cal |
$936.00
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$199.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$152.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$127.60
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$199.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$54.72
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$251.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$266.94
|
| Rate for Payer: Multiplan Commercial |
$182.40
|
| Rate for Payer: Networks By Design Commercial |
$148.20
|
| Rate for Payer: Prime Health Services Commercial |
$193.80
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$136.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$136.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$114.00
|
| Rate for Payer: United Healthcare All Other HMO |
$114.00
|
| Rate for Payer: United Healthcare HMO Rider |
$114.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$114.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$298.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$219.13
|
| Rate for Payer: Vantage Medical Group Senior |
$199.21
|
|
|
HC TROPONIN - I
|
Facility
OP
|
$18.00
|
|
|
Service Code
|
CPT 84484
|
| Hospital Charge Code |
900910994
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.32 |
| Max. Negotiated Rate |
$174.08 |
| Rate for Payer: Aetna of CA HMO/PPO |
$81.83
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$18.70
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$13.72
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$12.47
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$174.08
|
| Rate for Payer: BCBS Transplant Transplant |
$10.80
|
| Rate for Payer: Blue Shield of California Commercial |
$11.63
|
| Rate for Payer: Blue Shield of California EPN |
$9.22
|
| Rate for Payer: Cash Price |
$8.10
|
| Rate for Payer: Cash Price |
$8.10
|
| Rate for Payer: Cigna of CA HMO |
$11.52
|
| Rate for Payer: Cigna of CA PPO |
$13.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$18.70
|
| Rate for Payer: Dignity Health Media |
$12.47
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.72
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.83
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$12.47
|
| Rate for Payer: EPIC Health Plan Transplant |
$12.47
|
| Rate for Payer: Galaxy Health WC |
$15.30
|
| Rate for Payer: Global Benefits Group Commercial |
$10.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$13.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$20.45
|
| Rate for Payer: Heritage Provider Network Transplant |
$20.45
|
| Rate for Payer: IEHP Medi-Cal |
$20.20
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$20.20
|
| Rate for Payer: IEHP Medicare Advantage |
$12.47
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$16.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$15.71
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16.71
|
| Rate for Payer: Multiplan Commercial |
$14.40
|
| Rate for Payer: Networks By Design Commercial |
$11.70
|
| Rate for Payer: Prime Health Services Commercial |
$15.30
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$10.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$10.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.10
|
| Rate for Payer: United Healthcare All Other HMO |
$10.10
|
| Rate for Payer: United Healthcare HMO Rider |
$10.10
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.10
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$18.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.72
|
| Rate for Payer: Vantage Medical Group Senior |
$12.47
|
|
|
HC TROPONIN-T
|
Facility
OP
|
$29.00
|
|
|
Service Code
|
CPT 84484
|
| Hospital Charge Code |
900912119
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.96 |
| Max. Negotiated Rate |
$174.08 |
| Rate for Payer: Aetna of CA HMO/PPO |
$81.83
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$18.70
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$13.72
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$12.47
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$174.08
|
| Rate for Payer: BCBS Transplant Transplant |
$17.40
|
| Rate for Payer: Blue Shield of California Commercial |
$18.73
|
| Rate for Payer: Blue Shield of California EPN |
$14.85
|
| Rate for Payer: Cash Price |
$13.05
|
| Rate for Payer: Cash Price |
$13.05
|
| Rate for Payer: Cigna of CA HMO |
$18.56
|
| Rate for Payer: Cigna of CA PPO |
$21.46
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$18.70
|
| Rate for Payer: Dignity Health Media |
$12.47
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.72
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.83
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$12.47
|
| Rate for Payer: EPIC Health Plan Transplant |
$12.47
|
| Rate for Payer: Galaxy Health WC |
$24.65
|
| Rate for Payer: Global Benefits Group Commercial |
$17.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$21.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$20.45
|
| Rate for Payer: Heritage Provider Network Transplant |
$20.45
|
| Rate for Payer: IEHP Medi-Cal |
$20.20
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$20.20
|
| Rate for Payer: IEHP Medicare Advantage |
$12.47
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$19.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$16.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.96
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$15.71
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16.71
|
| Rate for Payer: Multiplan Commercial |
$23.20
|
| Rate for Payer: Networks By Design Commercial |
$18.85
|
| Rate for Payer: Prime Health Services Commercial |
$24.65
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$17.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$17.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$17.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.10
|
| Rate for Payer: United Healthcare All Other HMO |
$10.10
|
| Rate for Payer: United Healthcare HMO Rider |
$10.10
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.10
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$18.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.72
|
| Rate for Payer: Vantage Medical Group Senior |
$12.47
|
|
