|
HC URIC ACID BODY FLUID
|
Facility
OP
|
$17.00
|
|
|
Service Code
|
CPT 84560
|
| Hospital Charge Code |
900912248
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.08 |
| Max. Negotiated Rate |
$43.30 |
| Rate for Payer: Aetna of CA HMO/PPO |
$39.49
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$7.62
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$5.59
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$5.08
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$43.30
|
| 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 |
$7.62
|
| Rate for Payer: Dignity Health Media |
$5.08
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.59
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.86
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$5.08
|
| Rate for Payer: EPIC Health Plan Transplant |
$5.08
|
| 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 |
$8.33
|
| Rate for Payer: Heritage Provider Network Transplant |
$8.33
|
| Rate for Payer: IEHP Medi-Cal |
$8.23
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$8.23
|
| Rate for Payer: IEHP Medicare Advantage |
$5.08
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.02
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.08
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.81
|
| 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 |
$4.11
|
| Rate for Payer: United Healthcare All Other HMO |
$4.11
|
| Rate for Payer: United Healthcare HMO Rider |
$4.11
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.11
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.59
|
| Rate for Payer: Vantage Medical Group Senior |
$5.08
|
|
|
HC URIC ACID URINE
|
Facility
OP
|
$18.00
|
|
|
Service Code
|
CPT 84560
|
| Hospital Charge Code |
900910216
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.11 |
| Max. Negotiated Rate |
$43.30 |
| Rate for Payer: Aetna of CA HMO/PPO |
$39.49
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$7.62
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$5.59
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$5.08
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$43.30
|
| 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 |
$7.62
|
| Rate for Payer: Dignity Health Media |
$5.08
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.59
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.86
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$5.08
|
| Rate for Payer: EPIC Health Plan Transplant |
$5.08
|
| 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 |
$8.33
|
| Rate for Payer: Heritage Provider Network Transplant |
$8.33
|
| Rate for Payer: IEHP Medi-Cal |
$8.23
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$8.23
|
| Rate for Payer: IEHP Medicare Advantage |
$5.08
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.02
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.81
|
| 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 |
$4.11
|
| Rate for Payer: United Healthcare All Other HMO |
$4.11
|
| Rate for Payer: United Healthcare HMO Rider |
$4.11
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.11
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.59
|
| Rate for Payer: Vantage Medical Group Senior |
$5.08
|
|
|
HC URINE CHEMISTRY SCREEN
|
Facility
OP
|
$12.00
|
|
|
Service Code
|
CPT 81003
|
| Hospital Charge Code |
900910180
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$1.83 |
| Max. Negotiated Rate |
$20.52 |
| Rate for Payer: Dignity Health Medi-Cal |
$2.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.04
|
| Rate for Payer: Aetna of CA HMO/PPO |
$18.70
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$3.38
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2.48
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$2.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$20.52
|
| Rate for Payer: BCBS Transplant Transplant |
$7.20
|
| Rate for Payer: Blue Shield of California Commercial |
$7.75
|
| Rate for Payer: Blue Shield of California EPN |
$6.14
|
| Rate for Payer: Cash Price |
$5.40
|
| Rate for Payer: Cash Price |
$5.40
|
| Rate for Payer: Cigna of CA HMO |
$7.68
|
| Rate for Payer: Cigna of CA PPO |
$8.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3.38
|
| Rate for Payer: Dignity Health Media |
$2.25
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2.25
|
| Rate for Payer: EPIC Health Plan Transplant |
$2.25
|
| Rate for Payer: Galaxy Health WC |
$10.20
|
| Rate for Payer: Global Benefits Group Commercial |
$7.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$9.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$3.69
|
| Rate for Payer: Heritage Provider Network Transplant |
$3.69
|
| Rate for Payer: IEHP Medi-Cal |
$3.64
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$3.64
|
| Rate for Payer: IEHP Medicare Advantage |
$2.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.72
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.88
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2.84
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3.02
|
| Rate for Payer: Multiplan Commercial |
$9.60
|
| Rate for Payer: Networks By Design Commercial |
$7.80
|
| Rate for Payer: Prime Health Services Commercial |
$10.20
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$7.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.83
|
| Rate for Payer: United Healthcare All Other HMO |
$1.83
|
| Rate for Payer: United Healthcare HMO Rider |
$1.83
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.83
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3.38
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2.48
|
| Rate for Payer: Vantage Medical Group Senior |
$2.25
|
|
|
HC UROGRAPHY ANTEGRADE
|
Facility
OP
|
$1,163.00
|
|
|
Service Code
|
CPT 74425
|
| Hospital Charge Code |
909001935
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$95.36 |
| Max. Negotiated Rate |
$1,120.07 |
| Rate for Payer: Aetna of CA HMO/PPO |
$1,120.07
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$720.75
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$528.55
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$480.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$338.26
|
| Rate for Payer: BCBS Transplant Transplant |
$697.80
|
| Rate for Payer: Blue Shield of California Commercial |
$687.33
|
| Rate for Payer: Blue Shield of California EPN |
$545.45
|
| Rate for Payer: Cash Price |
$523.35
|
| Rate for Payer: Cash Price |
$523.35
|
| Rate for Payer: Cigna of CA HMO |
$744.32
|
| Rate for Payer: Cigna of CA PPO |
$860.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$720.75
|
| Rate for Payer: Dignity Health Media |
$480.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$528.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$648.68
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$480.50
|
| Rate for Payer: EPIC Health Plan Transplant |
$480.50
|
| Rate for Payer: Galaxy Health WC |
$988.55
|
| Rate for Payer: Global Benefits Group Commercial |
$697.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$872.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$788.02
|
| Rate for Payer: Heritage Provider Network Transplant |
$788.02
|
| Rate for Payer: IEHP Medi-Cal |
$778.41
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$778.41
|
| Rate for Payer: IEHP Medicare Advantage |
$480.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$775.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$95.36
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$480.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$279.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$605.43
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$643.87
|
| Rate for Payer: Multiplan Commercial |
$930.40
|
| Rate for Payer: Networks By Design Commercial |
$755.95
|
| Rate for Payer: Prime Health Services Commercial |
$988.55
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$697.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$697.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$697.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$470.69
|
| Rate for Payer: United Healthcare All Other HMO |
$470.69
|
| Rate for Payer: United Healthcare HMO Rider |
$470.69
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$470.69
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$720.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$528.55
|
| Rate for Payer: Vantage Medical Group Senior |
$480.50
|
|
|
HC UROGRAPHY ANTEGRADE
|
Facility
IP
|
$1,163.00
|
|
|
Service Code
|
CPT 74425
|
| Hospital Charge Code |
909001935
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$279.12 |
| Max. Negotiated Rate |
$988.55 |
| Rate for Payer: Cash Price |
$523.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$465.20
|
| Rate for Payer: Galaxy Health WC |
$988.55
|
| Rate for Payer: Global Benefits Group Commercial |
$697.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$775.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$443.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$279.12
|
| Rate for Payer: Multiplan Commercial |
$930.40
|
| Rate for Payer: Networks By Design Commercial |
$755.95
|
| Rate for Payer: Prime Health Services Commercial |
$988.55
|
|
|
HC US 1ST TRI FETAL NUCHAL TRANSL
|
Facility
OP
|
$776.00
|
|
|
Service Code
|
CPT 76813
|
| Hospital Charge Code |
910400120
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$137.36 |
| Max. Negotiated Rate |
$659.60 |
| Rate for Payer: Aetna of CA HMO/PPO |
$440.49
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$206.04
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$151.10
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$137.36
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$462.34
|
| Rate for Payer: BCBS Transplant Transplant |
$465.60
|
| Rate for Payer: Blue Shield of California Commercial |
$571.91
|
| Rate for Payer: Blue Shield of California EPN |
$453.18
|
| Rate for Payer: Cash Price |
$349.20
|
| Rate for Payer: Cash Price |
$349.20
|
| Rate for Payer: Cigna of CA HMO |
$496.64
|
| Rate for Payer: Cigna of CA PPO |
$574.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$206.04
|
| Rate for Payer: Dignity Health Media |
$137.36
|
| Rate for Payer: Dignity Health Medi-Cal |
$151.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$185.44
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$137.36
|
| Rate for Payer: EPIC Health Plan Transplant |
$137.36
|
| Rate for Payer: Galaxy Health WC |
$659.60
|
| Rate for Payer: Global Benefits Group Commercial |
$465.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$582.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$225.27
|
| Rate for Payer: Heritage Provider Network Transplant |
$225.27
|
| Rate for Payer: IEHP Medi-Cal |
$222.52
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$222.52
|
| Rate for Payer: IEHP Medicare Advantage |
$137.36
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$517.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$206.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$137.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$186.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$173.07
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$184.06
|
| Rate for Payer: Multiplan Commercial |
$620.80
|
| Rate for Payer: Networks By Design Commercial |
$504.40
|
| Rate for Payer: Prime Health Services Commercial |
$659.60
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$465.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$465.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$465.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$388.00
|
| Rate for Payer: United Healthcare All Other HMO |
$388.00
|
| Rate for Payer: United Healthcare HMO Rider |
$388.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$388.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$206.04
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$151.10
|
| Rate for Payer: Vantage Medical Group Senior |
$137.36
|
|
|
HC US 1ST TRI FETAL NUCHAL TRANSL
|
Facility
IP
|
$776.00
|
|
|
Service Code
|
CPT 76813
|
| Hospital Charge Code |
906601317
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$186.24 |
| Max. Negotiated Rate |
$659.60 |
| Rate for Payer: Cash Price |
$349.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$310.40
|
| Rate for Payer: Galaxy Health WC |
$659.60
|
| Rate for Payer: Global Benefits Group Commercial |
$465.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$517.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$295.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$186.24
|
| Rate for Payer: Multiplan Commercial |
$620.80
|
| Rate for Payer: Networks By Design Commercial |
$504.40
|
| Rate for Payer: Prime Health Services Commercial |
$659.60
|
|
|
HC US 1ST TRI FETAL NUCHAL TRANSL
|
Facility
OP
|
$776.00
|
|
|
Service Code
|
CPT 76813
|
| Hospital Charge Code |
906601317
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$137.36 |
| Max. Negotiated Rate |
$659.60 |
| Rate for Payer: Aetna of CA HMO/PPO |
$440.49
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$206.04
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$151.10
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$137.36
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$462.34
|
| Rate for Payer: BCBS Transplant Transplant |
$465.60
|
| Rate for Payer: Blue Shield of California Commercial |
$458.62
|
| Rate for Payer: Blue Shield of California EPN |
$363.94
|
| Rate for Payer: Cash Price |
$349.20
|
| Rate for Payer: Cash Price |
$349.20
|
| Rate for Payer: Cigna of CA HMO |
$496.64
|
| Rate for Payer: Cigna of CA PPO |
$574.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$206.04
|
| Rate for Payer: Dignity Health Media |
$137.36
|
| Rate for Payer: Dignity Health Medi-Cal |
$151.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$185.44
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$137.36
|
| Rate for Payer: EPIC Health Plan Transplant |
$137.36
|
| Rate for Payer: Galaxy Health WC |
$659.60
|
| Rate for Payer: Global Benefits Group Commercial |
$465.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$582.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$225.27
|
| Rate for Payer: Heritage Provider Network Transplant |
$225.27
|
| Rate for Payer: IEHP Medi-Cal |
$222.52
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$222.52
|
| Rate for Payer: IEHP Medicare Advantage |
$137.36
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$517.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$206.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$137.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$186.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$173.07
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$184.06
|
| Rate for Payer: Multiplan Commercial |
$620.80
|
| Rate for Payer: Networks By Design Commercial |
$504.40
|
| Rate for Payer: Prime Health Services Commercial |
$659.60
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$465.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$465.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$465.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$161.07
|
| Rate for Payer: United Healthcare All Other HMO |
$161.07
|
| Rate for Payer: United Healthcare HMO Rider |
$161.07
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$161.07
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$206.04
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$151.10
|
| Rate for Payer: Vantage Medical Group Senior |
$137.36
|
|
|
HC US 1ST TRI FETAL NUCHAL TRANSL
|
Facility
IP
|
$776.00
|
|
|
Service Code
|
CPT 76813
|
| Hospital Charge Code |
910400120
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$186.24 |
| Max. Negotiated Rate |
$659.60 |
| Rate for Payer: Cash Price |
$349.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$310.40
|
| Rate for Payer: Galaxy Health WC |
$659.60
|
| Rate for Payer: Global Benefits Group Commercial |
$465.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$517.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$295.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$186.24
|
| Rate for Payer: Multiplan Commercial |
$620.80
|
| Rate for Payer: Networks By Design Commercial |
$504.40
|
| Rate for Payer: Prime Health Services Commercial |
$659.60
|
|
|
HC US 1ST TRI FETAL NUCHAL TRANSL ADDL FETUS
|
Facility
OP
|
$370.00
|
|
|
Service Code
|
CPT 76814
|
| Hospital Charge Code |
906601318
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$88.80 |
| Max. Negotiated Rate |
$314.50 |
| Rate for Payer: Aetna of CA HMO/PPO |
$206.69
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$314.50
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$203.50
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$203.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$220.45
|
| Rate for Payer: BCBS Transplant Transplant |
$222.00
|
| Rate for Payer: Blue Shield of California Commercial |
$218.67
|
| Rate for Payer: Blue Shield of California EPN |
$173.53
|
| Rate for Payer: Cash Price |
$166.50
|
| Rate for Payer: Cash Price |
$166.50
|
| Rate for Payer: Cigna of CA HMO |
$236.80
|
| Rate for Payer: Cigna of CA PPO |
$273.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$314.50
|
| Rate for Payer: Dignity Health Media |
$314.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$314.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$148.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$148.00
|
| Rate for Payer: Galaxy Health WC |
$314.50
|
| Rate for Payer: Global Benefits Group Commercial |
$222.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$277.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$246.79
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$132.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$88.80
|
| Rate for Payer: Multiplan Commercial |
$296.00
|
| Rate for Payer: Networks By Design Commercial |
$240.50
|
| Rate for Payer: Prime Health Services Commercial |
$314.50
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$222.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$222.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$222.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$161.07
|
| Rate for Payer: United Healthcare All Other HMO |
$161.07
|
| Rate for Payer: United Healthcare HMO Rider |
$161.07
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$161.07
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$314.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$314.50
|
| Rate for Payer: Vantage Medical Group Senior |
$314.50
|
|
|
HC US 1ST TRI FETAL NUCHAL TRANSL ADDL FETUS
|
Facility
IP
|
$370.00
|
|
|
Service Code
|
CPT 76814
|
| Hospital Charge Code |
906601318
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$88.80 |
| Max. Negotiated Rate |
$314.50 |
| Rate for Payer: Cash Price |
$166.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$148.00
|
| Rate for Payer: Galaxy Health WC |
$314.50
|
| Rate for Payer: Global Benefits Group Commercial |
$222.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$246.79
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$140.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$88.80
|
| Rate for Payer: Multiplan Commercial |
$296.00
|
| Rate for Payer: Networks By Design Commercial |
$240.50
|
| Rate for Payer: Prime Health Services Commercial |
$314.50
|
|
|
HC US ABD AORTA SCREENING AAA
|
Facility
IP
|
$411.00
|
|
|
Service Code
|
CPT 76706
|
| Hospital Charge Code |
906676706
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$98.64 |
| Max. Negotiated Rate |
$349.35 |
| Rate for Payer: Cash Price |
$184.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$164.40
|
| Rate for Payer: Galaxy Health WC |
$349.35
|
| Rate for Payer: Global Benefits Group Commercial |
$246.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$274.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$156.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$98.64
|
| Rate for Payer: Multiplan Commercial |
$328.80
|
| Rate for Payer: Networks By Design Commercial |
$267.15
|
| Rate for Payer: Prime Health Services Commercial |
$349.35
|
|
|
HC US ABD AORTA SCREENING AAA
|
Facility
OP
|
$411.00
|
|
|
Service Code
|
CPT 76706
|
| Hospital Charge Code |
906676706
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$98.64 |
| Max. Negotiated Rate |
$426.93 |
| Rate for Payer: Aetna of CA HMO/PPO |
$426.93
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$206.04
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$151.10
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$137.36
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$244.87
|
| Rate for Payer: BCBS Transplant Transplant |
$246.60
|
| Rate for Payer: Blue Shield of California Commercial |
$242.90
|
| Rate for Payer: Blue Shield of California EPN |
$192.76
|
| Rate for Payer: Cash Price |
$184.95
|
| Rate for Payer: Cash Price |
$184.95
|
| Rate for Payer: Cigna of CA HMO |
$263.04
|
| Rate for Payer: Cigna of CA PPO |
$304.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$206.04
|
| Rate for Payer: Dignity Health Media |
$137.36
|
| Rate for Payer: Dignity Health Medi-Cal |
$151.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$185.44
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$137.36
|
| Rate for Payer: EPIC Health Plan Transplant |
$137.36
|
| Rate for Payer: Galaxy Health WC |
$349.35
|
| Rate for Payer: Global Benefits Group Commercial |
$246.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$308.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$225.27
|
| Rate for Payer: Heritage Provider Network Transplant |
$225.27
|
| Rate for Payer: IEHP Medi-Cal |
$222.52
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$222.52
|
| Rate for Payer: IEHP Medicare Advantage |
$137.36
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$274.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$162.36
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$137.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$98.64
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$173.07
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$184.06
|
| Rate for Payer: Multiplan Commercial |
$328.80
|
| Rate for Payer: Networks By Design Commercial |
$267.15
|
| Rate for Payer: Prime Health Services Commercial |
$349.35
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$246.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$246.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$246.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$288.48
|
| Rate for Payer: United Healthcare All Other HMO |
$288.48
|
| Rate for Payer: United Healthcare HMO Rider |
$288.48
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$288.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$206.04
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$151.10
|
| Rate for Payer: Vantage Medical Group Senior |
$137.36
|
|
|
HC US ELASTOGRAPHY 1ST TRGT LSN
|
Facility
IP
|
$861.00
|
|
|
Service Code
|
CPT 76982
|
| Hospital Charge Code |
906676982
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$206.64 |
| Max. Negotiated Rate |
$731.85 |
| Rate for Payer: Cash Price |
$387.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$344.40
|
| Rate for Payer: Galaxy Health WC |
$731.85
|
| Rate for Payer: Global Benefits Group Commercial |
$516.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$574.29
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$328.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$206.64
|
| Rate for Payer: Multiplan Commercial |
$688.80
|
| Rate for Payer: Networks By Design Commercial |
$559.65
|
| Rate for Payer: Prime Health Services Commercial |
$731.85
|
|
|
HC US ELASTOGRAPHY 1ST TRGT LSN
|
Facility
OP
|
$861.00
|
|
|
Service Code
|
CPT 76982
|
| Hospital Charge Code |
906676982
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$137.36 |
| Max. Negotiated Rate |
$731.85 |
| Rate for Payer: Aetna of CA HMO/PPO |
$427.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$206.04
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$151.10
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$137.36
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$512.98
|
| Rate for Payer: BCBS Transplant Transplant |
$516.60
|
| Rate for Payer: Blue Shield of California Commercial |
$508.85
|
| Rate for Payer: Blue Shield of California EPN |
$403.81
|
| Rate for Payer: Cash Price |
$387.45
|
| Rate for Payer: Cash Price |
$387.45
|
| Rate for Payer: Cigna of CA HMO |
$551.04
|
| Rate for Payer: Cigna of CA PPO |
$637.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$206.04
|
| Rate for Payer: Dignity Health Media |
$137.36
|
| Rate for Payer: Dignity Health Medi-Cal |
$151.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$185.44
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$137.36
|
| Rate for Payer: EPIC Health Plan Transplant |
$137.36
|
| Rate for Payer: Galaxy Health WC |
$731.85
|
| Rate for Payer: Global Benefits Group Commercial |
$516.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$645.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$225.27
|
| Rate for Payer: Heritage Provider Network Transplant |
$225.27
|
| Rate for Payer: IEHP Medi-Cal |
$222.52
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$222.52
|
| Rate for Payer: IEHP Medicare Advantage |
$137.36
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$574.29
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$166.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$137.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$206.64
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$173.07
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$184.06
|
| Rate for Payer: Multiplan Commercial |
$688.80
|
| Rate for Payer: Networks By Design Commercial |
$559.65
|
| Rate for Payer: Prime Health Services Commercial |
$731.85
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$516.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$516.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$516.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$288.03
|
| Rate for Payer: United Healthcare All Other HMO |
$288.03
|
| Rate for Payer: United Healthcare HMO Rider |
$288.03
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$288.03
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$206.04
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$151.10
|
| Rate for Payer: Vantage Medical Group Senior |
$137.36
|
|
|
HC US ELASTOGRAPHY PARENCHYMA
|
Facility
IP
|
$861.00
|
|
|
Service Code
|
CPT 76981
|
| Hospital Charge Code |
906676981
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$206.64 |
| Max. Negotiated Rate |
$731.85 |
| Rate for Payer: Cash Price |
$387.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$344.40
|
| Rate for Payer: Galaxy Health WC |
$731.85
|
| Rate for Payer: Global Benefits Group Commercial |
$516.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$574.29
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$328.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$206.64
|
| Rate for Payer: Multiplan Commercial |
$688.80
|
| Rate for Payer: Networks By Design Commercial |
$559.65
|
| Rate for Payer: Prime Health Services Commercial |
$731.85
|
|
|
HC US ELASTOGRAPHY PARENCHYMA
|
Facility
OP
|
$861.00
|
|
|
Service Code
|
CPT 76981
|
| Hospital Charge Code |
906676981
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$137.36 |
| Max. Negotiated Rate |
$731.85 |
| Rate for Payer: Aetna of CA HMO/PPO |
$500.21
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$206.04
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$151.10
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$137.36
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$512.98
|
| Rate for Payer: BCBS Transplant Transplant |
$516.60
|
| Rate for Payer: Blue Shield of California Commercial |
$508.85
|
| Rate for Payer: Blue Shield of California EPN |
$403.81
|
| Rate for Payer: Cash Price |
$387.45
|
| Rate for Payer: Cash Price |
$387.45
|
| Rate for Payer: Cigna of CA HMO |
$551.04
|
| Rate for Payer: Cigna of CA PPO |
$637.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$206.04
|
| Rate for Payer: Dignity Health Media |
$137.36
|
| Rate for Payer: Dignity Health Medi-Cal |
$151.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$185.44
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$137.36
|
| Rate for Payer: EPIC Health Plan Transplant |
$137.36
|
| Rate for Payer: Galaxy Health WC |
$731.85
|
| Rate for Payer: Global Benefits Group Commercial |
$516.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$645.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$225.27
|
| Rate for Payer: Heritage Provider Network Transplant |
$225.27
|
| Rate for Payer: IEHP Medi-Cal |
$222.52
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$222.52
|
| Rate for Payer: IEHP Medicare Advantage |
$137.36
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$574.29
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$185.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$137.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$206.64
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$173.07
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$184.06
|
| Rate for Payer: Multiplan Commercial |
$688.80
|
| Rate for Payer: Networks By Design Commercial |
$559.65
|
| Rate for Payer: Prime Health Services Commercial |
$731.85
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$516.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$516.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$516.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$288.03
|
| Rate for Payer: United Healthcare All Other HMO |
$288.03
|
| Rate for Payer: United Healthcare HMO Rider |
$288.03
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$288.03
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$206.04
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$151.10
|
| Rate for Payer: Vantage Medical Group Senior |
$137.36
|
|
|
HC US ELASTRGRPHY EA ADD TRGT LSN
|
Facility
IP
|
$431.00
|
|
|
Service Code
|
CPT 76983
|
| Hospital Charge Code |
906676983
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$103.44 |
| Max. Negotiated Rate |
$366.35 |
| Rate for Payer: Cash Price |
$193.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$172.40
|
| Rate for Payer: Galaxy Health WC |
$366.35
|
| Rate for Payer: Global Benefits Group Commercial |
$258.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$287.48
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$164.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$103.44
|
| Rate for Payer: Multiplan Commercial |
$344.80
|
| Rate for Payer: Networks By Design Commercial |
$280.15
|
| Rate for Payer: Prime Health Services Commercial |
$366.35
|
|
|
HC US ELASTRGRPHY EA ADD TRGT LSN
|
Facility
OP
|
$431.00
|
|
|
Service Code
|
CPT 76983
|
| Hospital Charge Code |
906676983
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$101.25 |
| Max. Negotiated Rate |
$366.35 |
| Rate for Payer: Aetna of CA HMO/PPO |
$217.33
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$366.35
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$237.05
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$237.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$256.79
|
| Rate for Payer: BCBS Transplant Transplant |
$258.60
|
| Rate for Payer: Blue Shield of California Commercial |
$254.72
|
| Rate for Payer: Blue Shield of California EPN |
$202.14
|
| Rate for Payer: Cash Price |
$193.95
|
| Rate for Payer: Cash Price |
$193.95
|
| Rate for Payer: Cigna of CA HMO |
$275.84
|
| Rate for Payer: Cigna of CA PPO |
$318.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$366.35
|
| Rate for Payer: Dignity Health Media |
$366.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$366.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$172.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$172.40
|
| Rate for Payer: Galaxy Health WC |
$366.35
|
| Rate for Payer: Global Benefits Group Commercial |
$258.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$323.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$287.48
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$101.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$103.44
|
| Rate for Payer: Multiplan Commercial |
$344.80
|
| Rate for Payer: Networks By Design Commercial |
$280.15
|
| Rate for Payer: Prime Health Services Commercial |
$366.35
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$258.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$258.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$258.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$215.50
|
| Rate for Payer: United Healthcare All Other HMO |
$215.50
|
| Rate for Payer: United Healthcare HMO Rider |
$215.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$215.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$366.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$366.35
|
| Rate for Payer: Vantage Medical Group Senior |
$366.35
|
|
|
HC US GUID AMNIOCENTESIS
|
Facility
OP
|
$1,433.00
|
|
|
Service Code
|
CPT 76946
|
| Hospital Charge Code |
902400752
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$54.44 |
| Max. Negotiated Rate |
$1,218.05 |
| Rate for Payer: Aetna of CA HMO/PPO |
$122.29
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,218.05
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$788.15
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$788.15
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$853.78
|
| Rate for Payer: BCBS Transplant Transplant |
$859.80
|
| Rate for Payer: Blue Shield of California Commercial |
$846.90
|
| Rate for Payer: Blue Shield of California EPN |
$672.08
|
| Rate for Payer: Cash Price |
$644.85
|
| Rate for Payer: Cash Price |
$644.85
|
| Rate for Payer: Cigna of CA HMO |
$917.12
|
| Rate for Payer: Cigna of CA PPO |
$1,060.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,218.05
|
| Rate for Payer: Dignity Health Media |
$1,218.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,218.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$573.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$573.20
|
| Rate for Payer: Galaxy Health WC |
$1,218.05
|
| Rate for Payer: Global Benefits Group Commercial |
$859.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,074.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$955.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$54.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$343.92
|
| Rate for Payer: Multiplan Commercial |
$1,146.40
|
| Rate for Payer: Networks By Design Commercial |
$931.45
|
| Rate for Payer: Prime Health Services Commercial |
$1,218.05
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$859.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$859.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$859.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$716.50
|
| Rate for Payer: United Healthcare All Other HMO |
$716.50
|
| Rate for Payer: United Healthcare HMO Rider |
$716.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$716.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,218.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,218.05
|
| Rate for Payer: Vantage Medical Group Senior |
$1,218.05
|
|
|
HC US GUID AMNIOCENTESIS
|
Facility
IP
|
$1,433.00
|
|
|
Service Code
|
CPT 76946
|
| Hospital Charge Code |
902400752
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$343.92 |
| Max. Negotiated Rate |
$1,218.05 |
| Rate for Payer: Cash Price |
$644.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$573.20
|
| Rate for Payer: Galaxy Health WC |
$1,218.05
|
| Rate for Payer: Global Benefits Group Commercial |
$859.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$955.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$545.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$343.92
|
| Rate for Payer: Multiplan Commercial |
$1,146.40
|
| Rate for Payer: Networks By Design Commercial |
$931.45
|
| Rate for Payer: Prime Health Services Commercial |
$1,218.05
|
|
|
HC US GUID CHOR VILUS SAMPLING
|
Facility
IP
|
$1,228.00
|
|
|
Service Code
|
CPT 76945
|
| Hospital Charge Code |
910400115
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$294.72 |
| Max. Negotiated Rate |
$1,043.80 |
| Rate for Payer: Cash Price |
$552.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$491.20
|
| Rate for Payer: Galaxy Health WC |
$1,043.80
|
| Rate for Payer: Global Benefits Group Commercial |
$736.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$819.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$467.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$294.72
|
| Rate for Payer: Multiplan Commercial |
$982.40
|
| Rate for Payer: Networks By Design Commercial |
$798.20
|
| Rate for Payer: Prime Health Services Commercial |
$1,043.80
|
|
|
HC US GUID CHOR VILUS SAMPLING
|
Facility
OP
|
$1,228.00
|
|
|
Service Code
|
CPT 76945
|
| Hospital Charge Code |
910400115
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$294.72 |
| Max. Negotiated Rate |
$1,043.80 |
| Rate for Payer: Aetna of CA HMO/PPO |
$375.63
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,043.80
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$675.40
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$675.40
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$731.64
|
| Rate for Payer: BCBS Transplant Transplant |
$736.80
|
| Rate for Payer: Blue Shield of California Commercial |
$725.75
|
| Rate for Payer: Blue Shield of California EPN |
$575.93
|
| Rate for Payer: Cash Price |
$552.60
|
| Rate for Payer: Cash Price |
$552.60
|
| Rate for Payer: Cigna of CA HMO |
$785.92
|
| Rate for Payer: Cigna of CA PPO |
$908.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,043.80
|
| Rate for Payer: Dignity Health Media |
$1,043.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,043.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$491.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$491.20
|
| Rate for Payer: Galaxy Health WC |
$1,043.80
|
| Rate for Payer: Global Benefits Group Commercial |
$736.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$921.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$819.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$467.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$294.72
|
| Rate for Payer: Multiplan Commercial |
$982.40
|
| Rate for Payer: Networks By Design Commercial |
$798.20
|
| Rate for Payer: Prime Health Services Commercial |
$1,043.80
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$736.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$736.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$736.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$614.00
|
| Rate for Payer: United Healthcare All Other HMO |
$614.00
|
| Rate for Payer: United Healthcare HMO Rider |
$614.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$614.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,043.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,043.80
|
| Rate for Payer: Vantage Medical Group Senior |
$1,043.80
|
|
|
HC US GUID CHOR VILUS SAMP TWIN
|
Facility
IP
|
$1,228.00
|
|
|
Service Code
|
CPT 76945
|
| Hospital Charge Code |
910400116
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$294.72 |
| Max. Negotiated Rate |
$1,043.80 |
| Rate for Payer: Cash Price |
$552.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$491.20
|
| Rate for Payer: Galaxy Health WC |
$1,043.80
|
| Rate for Payer: Global Benefits Group Commercial |
$736.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$819.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$467.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$294.72
|
| Rate for Payer: Multiplan Commercial |
$982.40
|
| Rate for Payer: Networks By Design Commercial |
$798.20
|
| Rate for Payer: Prime Health Services Commercial |
$1,043.80
|
|
|
HC US GUID CHOR VILUS SAMP TWIN
|
Facility
OP
|
$1,228.00
|
|
|
Service Code
|
CPT 76945
|
| Hospital Charge Code |
910400116
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$294.72 |
| Max. Negotiated Rate |
$1,043.80 |
| Rate for Payer: Aetna of CA HMO/PPO |
$375.63
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,043.80
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$675.40
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$675.40
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$731.64
|
| Rate for Payer: BCBS Transplant Transplant |
$736.80
|
| Rate for Payer: Blue Shield of California Commercial |
$725.75
|
| Rate for Payer: Blue Shield of California EPN |
$575.93
|
| Rate for Payer: Cash Price |
$552.60
|
| Rate for Payer: Cash Price |
$552.60
|
| Rate for Payer: Cigna of CA HMO |
$785.92
|
| Rate for Payer: Cigna of CA PPO |
$908.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,043.80
|
| Rate for Payer: Dignity Health Media |
$1,043.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,043.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$491.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$491.20
|
| Rate for Payer: Galaxy Health WC |
$1,043.80
|
| Rate for Payer: Global Benefits Group Commercial |
$736.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$921.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$819.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$467.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$294.72
|
| Rate for Payer: Multiplan Commercial |
$982.40
|
| Rate for Payer: Networks By Design Commercial |
$798.20
|
| Rate for Payer: Prime Health Services Commercial |
$1,043.80
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$736.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$736.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$736.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$614.00
|
| Rate for Payer: United Healthcare All Other HMO |
$614.00
|
| Rate for Payer: United Healthcare HMO Rider |
$614.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$614.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,043.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,043.80
|
| Rate for Payer: Vantage Medical Group Senior |
$1,043.80
|
|
