|
HC IMMUNE ADMIN ORAL/NASAL ADDL
|
Facility
|
IP
|
$64.00
|
|
|
Service Code
|
CPT 90474
|
| Hospital Charge Code |
908710589
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$12.80 |
| Max. Negotiated Rate |
$54.40 |
| Rate for Payer: Adventist Health Commercial |
$12.80
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$44.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$25.60
|
| Rate for Payer: EPIC Health Plan Senior |
$25.60
|
| Rate for Payer: Galaxy Health WC |
$54.40
|
| Rate for Payer: Global Benefits Group Commercial |
$38.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$40.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$37.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.36
|
| Rate for Payer: Multiplan Commercial |
$51.20
|
| Rate for Payer: Networks By Design Commercial |
$41.60
|
| Rate for Payer: Prime Health Services Commercial |
$54.40
|
|
|
HC IMMUNE ADMIN ORAL/NASAL ADDL
|
Facility
|
OP
|
$64.00
|
|
|
Service Code
|
CPT 90474
|
| Hospital Charge Code |
908710589
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$12.80 |
| Max. Negotiated Rate |
$54.40 |
| Rate for Payer: Adventist Health Commercial |
$12.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$20.86
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$54.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$35.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$48.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$41.07
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Cigna of CA HMO |
$40.96
|
| Rate for Payer: Cigna of CA PPO |
$47.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$54.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$54.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$54.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$44.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$25.60
|
| Rate for Payer: EPIC Health Plan Senior |
$25.60
|
| Rate for Payer: Galaxy Health WC |
$54.40
|
| Rate for Payer: Global Benefits Group Commercial |
$38.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$40.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$23.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$37.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$44.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$44.80
|
| Rate for Payer: Multiplan Commercial |
$51.20
|
| Rate for Payer: Networks By Design Commercial |
$41.60
|
| Rate for Payer: Prime Health Services Commercial |
$54.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$38.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$38.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$32.00
|
| Rate for Payer: United Healthcare All Other HMO |
$32.00
|
| Rate for Payer: United Healthcare HMO Rider |
$32.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$32.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$54.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$54.40
|
| Rate for Payer: Vantage Medical Group Senior |
$54.40
|
|
|
HC IMMUNE CELL LUMINESCENCE DET
|
Facility
|
OP
|
$178.00
|
|
|
Service Code
|
CPT 82397
|
| Hospital Charge Code |
900912314
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.44 |
| Max. Negotiated Rate |
$151.30 |
| Rate for Payer: Adventist Health Commercial |
$35.60
|
| Rate for Payer: Adventist Health Commercial |
$43.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$117.49
|
| Rate for Payer: Aetna of CA HMO/PPO |
$117.49
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21.18
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15.53
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15.53
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$145.86
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$145.86
|
| Rate for Payer: Blue Shield of California Commercial |
$149.85
|
| Rate for Payer: Blue Shield of California Commercial |
$124.07
|
| Rate for Payer: Blue Shield of California Commercial |
$99.11
|
| Rate for Payer: Blue Shield of California Commercial |
$82.06
|
| Rate for Payer: Cash Price |
$96.75
|
| Rate for Payer: Cash Price |
$96.75
|
| Rate for Payer: Cash Price |
$80.10
|
| Rate for Payer: Cash Price |
$80.10
|
| Rate for Payer: Cigna of CA HMO |
$137.60
|
| Rate for Payer: Cigna of CA HMO |
$113.92
|
| Rate for Payer: Cigna of CA PPO |
$131.72
|
| Rate for Payer: Cigna of CA PPO |
$159.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$15.53
|
| Rate for Payer: Dignity Health Medi-Cal |
$15.53
|
| Rate for Payer: Dignity Health Medicare Advantage |
$14.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$14.12
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$124.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$150.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$23.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$23.30
|
| Rate for Payer: EPIC Health Plan Senior |
$15.53
|
| Rate for Payer: EPIC Health Plan Senior |
$15.53
|
| Rate for Payer: Galaxy Health WC |
$151.30
|
| Rate for Payer: Galaxy Health WC |
$182.75
|
| Rate for Payer: Global Benefits Group Commercial |
$106.80
|
| Rate for Payer: Global Benefits Group Commercial |
$129.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$23.16
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$23.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$21.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$21.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$14.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$14.12
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$113.03
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$136.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$23.84
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$23.84
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$19.77
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$19.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$42.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$51.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17.79
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17.79
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18.92
|
| Rate for Payer: Multiplan Commercial |
$172.00
|
| Rate for Payer: Multiplan Commercial |
$142.40
|
| Rate for Payer: Networks By Design Commercial |
$139.75
|
| Rate for Payer: Networks By Design Commercial |
$115.70
|
| Rate for Payer: Prime Health Services Commercial |
$151.30
|
| Rate for Payer: Prime Health Services Commercial |
$182.75
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$106.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$129.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$106.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$129.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$11.44
|
| Rate for Payer: United Healthcare All Other Commercial |
$11.44
|
| Rate for Payer: United Healthcare All Other HMO |
$11.44
|
| Rate for Payer: United Healthcare All Other HMO |
$11.44
|
| Rate for Payer: United Healthcare HMO Rider |
$11.44
|
| Rate for Payer: United Healthcare HMO Rider |
$11.44
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.44
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.44
|
| Rate for Payer: Upland Medical Group Pediatric |
$14.12
|
| Rate for Payer: Upland Medical Group Pediatric |
$14.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21.18
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15.53
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15.53
|
| Rate for Payer: Vantage Medical Group Senior |
$14.12
|
| Rate for Payer: Vantage Medical Group Senior |
$14.12
|
|
|
HC IMMUNE CELL LUMINESCENCE DET
|
Facility
|
IP
|
$215.00
|
|
|
Service Code
|
CPT 82397
|
| Hospital Charge Code |
900912314
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$43.00 |
| Max. Negotiated Rate |
$182.75 |
| Rate for Payer: Adventist Health Commercial |
$43.00
|
| Rate for Payer: Cash Price |
$96.75
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$150.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$86.00
|
| Rate for Payer: EPIC Health Plan Senior |
$86.00
|
| Rate for Payer: Galaxy Health WC |
$182.75
|
| Rate for Payer: Global Benefits Group Commercial |
$129.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$136.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$126.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$51.60
|
| Rate for Payer: Multiplan Commercial |
$172.00
|
| Rate for Payer: Networks By Design Commercial |
$139.75
|
| Rate for Payer: Prime Health Services Commercial |
$182.75
|
|
|
HC IMMUNE CELL MITOGEN STIM
|
Facility
|
IP
|
$314.00
|
|
|
Service Code
|
CPT 86353
|
| Hospital Charge Code |
900912313
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$62.80 |
| Max. Negotiated Rate |
$266.90 |
| Rate for Payer: Adventist Health Commercial |
$62.80
|
| Rate for Payer: Cash Price |
$141.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$219.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$125.60
|
| Rate for Payer: EPIC Health Plan Senior |
$125.60
|
| Rate for Payer: Galaxy Health WC |
$266.90
|
| Rate for Payer: Global Benefits Group Commercial |
$188.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$199.39
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$185.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$75.36
|
| Rate for Payer: Multiplan Commercial |
$251.20
|
| Rate for Payer: Networks By Design Commercial |
$204.10
|
| Rate for Payer: Prime Health Services Commercial |
$266.90
|
|
|
HC IMMUNE CELL MITOGEN STIM
|
Facility
|
OP
|
$259.00
|
|
|
Service Code
|
CPT 86353
|
| Hospital Charge Code |
900912313
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$39.72 |
| Max. Negotiated Rate |
$505.95 |
| Rate for Payer: Adventist Health Commercial |
$51.80
|
| Rate for Payer: Adventist Health Commercial |
$62.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$407.68
|
| Rate for Payer: Aetna of CA HMO/PPO |
$407.68
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$73.55
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$73.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$53.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$53.93
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$49.03
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$49.03
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$505.95
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$505.95
|
| Rate for Payer: Blue Shield of California Commercial |
$144.75
|
| Rate for Payer: Blue Shield of California Commercial |
$119.40
|
| Rate for Payer: Blue Shield of California Commercial |
$218.86
|
| Rate for Payer: Blue Shield of California Commercial |
$180.52
|
| Rate for Payer: Cash Price |
$141.30
|
| Rate for Payer: Cash Price |
$141.30
|
| Rate for Payer: Cash Price |
$116.55
|
| Rate for Payer: Cash Price |
$116.55
|
| Rate for Payer: Cigna of CA HMO |
$200.96
|
| Rate for Payer: Cigna of CA HMO |
$165.76
|
| Rate for Payer: Cigna of CA PPO |
$191.66
|
| Rate for Payer: Cigna of CA PPO |
$232.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$73.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$73.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$53.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$53.93
|
| Rate for Payer: Dignity Health Medicare Advantage |
$49.03
|
| Rate for Payer: Dignity Health Medicare Advantage |
$49.03
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$181.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$219.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$80.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$80.90
|
| Rate for Payer: EPIC Health Plan Senior |
$53.93
|
| Rate for Payer: EPIC Health Plan Senior |
$53.93
|
| Rate for Payer: Galaxy Health WC |
$220.15
|
| Rate for Payer: Galaxy Health WC |
$266.90
|
| Rate for Payer: Global Benefits Group Commercial |
$155.40
|
| Rate for Payer: Global Benefits Group Commercial |
$188.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$80.41
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$80.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$73.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$73.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$49.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$49.03
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$164.47
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$199.39
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$82.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$82.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$68.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$68.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$62.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$75.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$61.78
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$61.78
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$65.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$65.70
|
| Rate for Payer: Multiplan Commercial |
$251.20
|
| Rate for Payer: Multiplan Commercial |
$207.20
|
| Rate for Payer: Networks By Design Commercial |
$204.10
|
| Rate for Payer: Networks By Design Commercial |
$168.35
|
| Rate for Payer: Prime Health Services Commercial |
$220.15
|
| Rate for Payer: Prime Health Services Commercial |
$266.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$155.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$188.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$155.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$188.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$39.72
|
| Rate for Payer: United Healthcare All Other Commercial |
$39.72
|
| Rate for Payer: United Healthcare All Other HMO |
$39.72
|
| Rate for Payer: United Healthcare All Other HMO |
$39.72
|
| Rate for Payer: United Healthcare HMO Rider |
$39.72
|
| Rate for Payer: United Healthcare HMO Rider |
$39.72
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$39.72
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$39.72
|
| Rate for Payer: Upland Medical Group Pediatric |
$49.03
|
| Rate for Payer: Upland Medical Group Pediatric |
$49.03
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$73.55
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$73.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$53.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$53.93
|
| Rate for Payer: Vantage Medical Group Senior |
$49.03
|
| Rate for Payer: Vantage Medical Group Senior |
$49.03
|
|
|
HC IMMUNOASSAY QUAN CA 125
|
Facility
|
IP
|
$331.00
|
|
|
Service Code
|
CPT 86304
|
| Hospital Charge Code |
900912122
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$66.20 |
| Max. Negotiated Rate |
$281.35 |
| Rate for Payer: Adventist Health Commercial |
$66.20
|
| Rate for Payer: Cash Price |
$148.95
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$231.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$132.40
|
| Rate for Payer: EPIC Health Plan Senior |
$132.40
|
| Rate for Payer: Galaxy Health WC |
$281.35
|
| Rate for Payer: Global Benefits Group Commercial |
$198.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$210.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$195.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$79.44
|
| Rate for Payer: Multiplan Commercial |
$264.80
|
| Rate for Payer: Networks By Design Commercial |
$215.15
|
| Rate for Payer: Prime Health Services Commercial |
$281.35
|
|
|
HC IMMUNOASSAY QUAN CA 125
|
Facility
|
OP
|
$166.00
|
|
|
Service Code
|
CPT 86304
|
| Hospital Charge Code |
900912122
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$16.86 |
| Max. Negotiated Rate |
$214.65 |
| Rate for Payer: Adventist Health Commercial |
$33.20
|
| Rate for Payer: Adventist Health Commercial |
$66.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$173.11
|
| Rate for Payer: Aetna of CA HMO/PPO |
$173.11
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$31.21
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$31.21
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$22.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$22.89
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$20.81
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$20.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$214.65
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$214.65
|
| Rate for Payer: Blue Shield of California Commercial |
$152.59
|
| Rate for Payer: Blue Shield of California Commercial |
$115.70
|
| Rate for Payer: Blue Shield of California Commercial |
$230.71
|
| Rate for Payer: Blue Shield of California Commercial |
$76.53
|
| Rate for Payer: Cash Price |
$148.95
|
| Rate for Payer: Cash Price |
$148.95
|
| Rate for Payer: Cash Price |
$74.70
|
| Rate for Payer: Cash Price |
$74.70
|
| Rate for Payer: Cigna of CA HMO |
$211.84
|
| Rate for Payer: Cigna of CA HMO |
$106.24
|
| Rate for Payer: Cigna of CA PPO |
$122.84
|
| Rate for Payer: Cigna of CA PPO |
$244.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$31.21
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$31.21
|
| Rate for Payer: Dignity Health Medi-Cal |
$22.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$22.89
|
| Rate for Payer: Dignity Health Medicare Advantage |
$20.81
|
| Rate for Payer: Dignity Health Medicare Advantage |
$20.81
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$116.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$231.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$34.34
|
| Rate for Payer: EPIC Health Plan Commercial |
$34.34
|
| Rate for Payer: EPIC Health Plan Senior |
$22.89
|
| Rate for Payer: EPIC Health Plan Senior |
$22.89
|
| Rate for Payer: Galaxy Health WC |
$141.10
|
| Rate for Payer: Galaxy Health WC |
$281.35
|
| Rate for Payer: Global Benefits Group Commercial |
$99.60
|
| Rate for Payer: Global Benefits Group Commercial |
$198.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$34.13
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$34.13
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$31.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$31.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$20.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$20.81
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$105.41
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$210.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$35.15
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$35.15
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$29.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$29.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$39.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$79.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$26.22
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$26.22
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$27.89
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$27.89
|
| Rate for Payer: Multiplan Commercial |
$264.80
|
| Rate for Payer: Multiplan Commercial |
$132.80
|
| Rate for Payer: Networks By Design Commercial |
$215.15
|
| Rate for Payer: Networks By Design Commercial |
$107.90
|
| Rate for Payer: Prime Health Services Commercial |
$141.10
|
| Rate for Payer: Prime Health Services Commercial |
$281.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$99.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$198.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$99.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$198.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$16.86
|
| Rate for Payer: United Healthcare All Other Commercial |
$16.86
|
| Rate for Payer: United Healthcare All Other HMO |
$16.86
|
| Rate for Payer: United Healthcare All Other HMO |
$16.86
|
| Rate for Payer: United Healthcare HMO Rider |
$16.86
|
| Rate for Payer: United Healthcare HMO Rider |
$16.86
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16.86
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16.86
|
| Rate for Payer: Upland Medical Group Pediatric |
$20.81
|
| Rate for Payer: Upland Medical Group Pediatric |
$20.81
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$31.21
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$31.21
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$22.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$22.89
|
| Rate for Payer: Vantage Medical Group Senior |
$20.81
|
| Rate for Payer: Vantage Medical Group Senior |
$20.81
|
|
|
HC IMMUNOASSAY QUAN CA 15-3
|
Facility
|
IP
|
$170.00
|
|
|
Service Code
|
CPT 86300
|
| Hospital Charge Code |
900912123
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$34.00 |
| Max. Negotiated Rate |
$144.50 |
| Rate for Payer: Adventist Health Commercial |
$34.00
|
| Rate for Payer: Cash Price |
$76.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$119.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$68.00
|
| Rate for Payer: EPIC Health Plan Senior |
$68.00
|
| Rate for Payer: Galaxy Health WC |
$144.50
|
| Rate for Payer: Global Benefits Group Commercial |
$102.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$107.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$100.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$40.80
|
| Rate for Payer: Multiplan Commercial |
$136.00
|
| Rate for Payer: Networks By Design Commercial |
$110.50
|
| Rate for Payer: Prime Health Services Commercial |
$144.50
|
|
|
HC IMMUNOASSAY QUAN CA 15-3
|
Facility
|
OP
|
$170.00
|
|
|
Service Code
|
CPT 86300
|
| Hospital Charge Code |
900912123
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$16.86 |
| Max. Negotiated Rate |
$214.65 |
| Rate for Payer: Adventist Health Commercial |
$34.00
|
| Rate for Payer: Adventist Health Commercial |
$19.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$173.11
|
| Rate for Payer: Aetna of CA HMO/PPO |
$173.11
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$31.21
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$31.21
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$22.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$22.89
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$20.81
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$20.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$214.65
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$214.65
|
| Rate for Payer: Blue Shield of California Commercial |
$43.80
|
| Rate for Payer: Blue Shield of California Commercial |
$118.49
|
| Rate for Payer: Blue Shield of California Commercial |
$66.22
|
| Rate for Payer: Blue Shield of California Commercial |
$78.37
|
| Rate for Payer: Cash Price |
$42.75
|
| Rate for Payer: Cash Price |
$42.75
|
| Rate for Payer: Cash Price |
$76.50
|
| Rate for Payer: Cash Price |
$76.50
|
| Rate for Payer: Cigna of CA HMO |
$60.80
|
| Rate for Payer: Cigna of CA HMO |
$108.80
|
| Rate for Payer: Cigna of CA PPO |
$125.80
|
| Rate for Payer: Cigna of CA PPO |
$70.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$31.21
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$31.21
|
| Rate for Payer: Dignity Health Medi-Cal |
$22.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$22.89
|
| Rate for Payer: Dignity Health Medicare Advantage |
$20.81
|
| Rate for Payer: Dignity Health Medicare Advantage |
$20.81
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$119.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$66.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$34.34
|
| Rate for Payer: EPIC Health Plan Commercial |
$34.34
|
| Rate for Payer: EPIC Health Plan Senior |
$22.89
|
| Rate for Payer: EPIC Health Plan Senior |
$22.89
|
| Rate for Payer: Galaxy Health WC |
$144.50
|
| Rate for Payer: Galaxy Health WC |
$80.75
|
| Rate for Payer: Global Benefits Group Commercial |
$102.00
|
| Rate for Payer: Global Benefits Group Commercial |
$57.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$34.13
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$34.13
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$31.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$31.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$20.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$20.81
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$107.95
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$60.33
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$35.15
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$35.15
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$29.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$29.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$40.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$26.22
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$26.22
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$27.89
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$27.89
|
| Rate for Payer: Multiplan Commercial |
$76.00
|
| Rate for Payer: Multiplan Commercial |
$136.00
|
| Rate for Payer: Networks By Design Commercial |
$61.75
|
| Rate for Payer: Networks By Design Commercial |
$110.50
|
| Rate for Payer: Prime Health Services Commercial |
$144.50
|
| Rate for Payer: Prime Health Services Commercial |
$80.75
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$102.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$57.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$102.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$57.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$16.86
|
| Rate for Payer: United Healthcare All Other Commercial |
$16.86
|
| Rate for Payer: United Healthcare All Other HMO |
$16.86
|
| Rate for Payer: United Healthcare All Other HMO |
$16.86
|
| Rate for Payer: United Healthcare HMO Rider |
$16.86
|
| Rate for Payer: United Healthcare HMO Rider |
$16.86
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16.86
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16.86
|
| Rate for Payer: Upland Medical Group Pediatric |
$20.81
|
| Rate for Payer: Upland Medical Group Pediatric |
$20.81
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$31.21
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$31.21
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$22.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$22.89
|
| Rate for Payer: Vantage Medical Group Senior |
$20.81
|
| Rate for Payer: Vantage Medical Group Senior |
$20.81
|
|
|
HC IMMUNOASSAY QUAN CA 19-9
|
Facility
|
OP
|
$166.00
|
|
|
Service Code
|
CPT 86301
|
| Hospital Charge Code |
900912124
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$16.86 |
| Max. Negotiated Rate |
$214.65 |
| Rate for Payer: Adventist Health Commercial |
$33.20
|
| Rate for Payer: Adventist Health Commercial |
$66.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$173.11
|
| Rate for Payer: Aetna of CA HMO/PPO |
$173.11
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$31.21
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$31.21
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$22.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$22.89
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$20.81
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$20.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$214.65
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$214.65
|
| Rate for Payer: Blue Shield of California Commercial |
$152.59
|
| Rate for Payer: Blue Shield of California Commercial |
$115.70
|
| Rate for Payer: Blue Shield of California Commercial |
$230.71
|
| Rate for Payer: Blue Shield of California Commercial |
$76.53
|
| Rate for Payer: Cash Price |
$148.95
|
| Rate for Payer: Cash Price |
$148.95
|
| Rate for Payer: Cash Price |
$74.70
|
| Rate for Payer: Cash Price |
$74.70
|
| Rate for Payer: Cigna of CA HMO |
$211.84
|
| Rate for Payer: Cigna of CA HMO |
$106.24
|
| Rate for Payer: Cigna of CA PPO |
$122.84
|
| Rate for Payer: Cigna of CA PPO |
$244.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$31.21
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$31.21
|
| Rate for Payer: Dignity Health Medi-Cal |
$22.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$22.89
|
| Rate for Payer: Dignity Health Medicare Advantage |
$20.81
|
| Rate for Payer: Dignity Health Medicare Advantage |
$20.81
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$116.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$231.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$34.34
|
| Rate for Payer: EPIC Health Plan Commercial |
$34.34
|
| Rate for Payer: EPIC Health Plan Senior |
$22.89
|
| Rate for Payer: EPIC Health Plan Senior |
$22.89
|
| Rate for Payer: Galaxy Health WC |
$141.10
|
| Rate for Payer: Galaxy Health WC |
$281.35
|
| Rate for Payer: Global Benefits Group Commercial |
$99.60
|
| Rate for Payer: Global Benefits Group Commercial |
$198.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$34.13
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$34.13
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$31.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$31.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$20.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$20.81
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$105.41
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$210.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$35.15
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$35.15
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$29.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$29.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$39.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$79.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$26.22
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$26.22
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$27.89
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$27.89
|
| Rate for Payer: Multiplan Commercial |
$264.80
|
| Rate for Payer: Multiplan Commercial |
$132.80
|
| Rate for Payer: Networks By Design Commercial |
$215.15
|
| Rate for Payer: Networks By Design Commercial |
$107.90
|
| Rate for Payer: Prime Health Services Commercial |
$141.10
|
| Rate for Payer: Prime Health Services Commercial |
$281.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$99.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$198.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$99.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$198.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$16.86
|
| Rate for Payer: United Healthcare All Other Commercial |
$16.86
|
| Rate for Payer: United Healthcare All Other HMO |
$16.86
|
| Rate for Payer: United Healthcare All Other HMO |
$16.86
|
| Rate for Payer: United Healthcare HMO Rider |
$16.86
|
| Rate for Payer: United Healthcare HMO Rider |
$16.86
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16.86
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16.86
|
| Rate for Payer: Upland Medical Group Pediatric |
$20.81
|
| Rate for Payer: Upland Medical Group Pediatric |
$20.81
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$31.21
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$31.21
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$22.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$22.89
|
| Rate for Payer: Vantage Medical Group Senior |
$20.81
|
| Rate for Payer: Vantage Medical Group Senior |
$20.81
|
|
|
HC IMMUNOASSAY QUAN CA 19-9
|
Facility
|
IP
|
$331.00
|
|
|
Service Code
|
CPT 86301
|
| Hospital Charge Code |
900912124
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$66.20 |
| Max. Negotiated Rate |
$281.35 |
| Rate for Payer: Adventist Health Commercial |
$66.20
|
| Rate for Payer: Cash Price |
$148.95
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$231.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$132.40
|
| Rate for Payer: EPIC Health Plan Senior |
$132.40
|
| Rate for Payer: Galaxy Health WC |
$281.35
|
| Rate for Payer: Global Benefits Group Commercial |
$198.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$210.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$195.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$79.44
|
| Rate for Payer: Multiplan Commercial |
$264.80
|
| Rate for Payer: Networks By Design Commercial |
$215.15
|
| Rate for Payer: Prime Health Services Commercial |
$281.35
|
|
|
HC IMMUNOFLUORESCENCE STAIN EA AB
|
Facility
|
OP
|
$205.00
|
|
|
Service Code
|
CPT 88346
|
| Hospital Charge Code |
903800037
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$41.00 |
| Max. Negotiated Rate |
$437.43 |
| Rate for Payer: Adventist Health Commercial |
$41.00
|
| Rate for Payer: Adventist Health Commercial |
$149.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$437.43
|
| Rate for Payer: Aetna of CA HMO/PPO |
$437.43
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$328.68
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$328.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$241.03
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$241.03
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$219.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$219.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$77.90
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$77.90
|
| Rate for Payer: Blue Shield of California Commercial |
$343.91
|
| Rate for Payer: Blue Shield of California Commercial |
$142.88
|
| Rate for Payer: Blue Shield of California Commercial |
$519.96
|
| Rate for Payer: Blue Shield of California Commercial |
$94.50
|
| Rate for Payer: Cash Price |
$335.70
|
| Rate for Payer: Cash Price |
$335.70
|
| Rate for Payer: Cash Price |
$92.25
|
| Rate for Payer: Cash Price |
$92.25
|
| Rate for Payer: Cigna of CA HMO |
$477.44
|
| Rate for Payer: Cigna of CA HMO |
$131.20
|
| Rate for Payer: Cigna of CA PPO |
$151.70
|
| Rate for Payer: Cigna of CA PPO |
$552.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$328.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$328.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$241.03
|
| Rate for Payer: Dignity Health Medi-Cal |
$241.03
|
| Rate for Payer: Dignity Health Medicare Advantage |
$219.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$219.12
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$143.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$522.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$361.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$361.55
|
| Rate for Payer: EPIC Health Plan Senior |
$241.03
|
| Rate for Payer: EPIC Health Plan Senior |
$241.03
|
| Rate for Payer: Galaxy Health WC |
$174.25
|
| Rate for Payer: Galaxy Health WC |
$634.10
|
| Rate for Payer: Global Benefits Group Commercial |
$123.00
|
| Rate for Payer: Global Benefits Group Commercial |
$447.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$359.36
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$359.36
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$94.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$94.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$219.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$219.12
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$130.18
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$473.71
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$106.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$106.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$306.77
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$306.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$49.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$179.04
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$276.09
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$276.09
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$293.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$293.62
|
| Rate for Payer: Multiplan Commercial |
$596.80
|
| Rate for Payer: Multiplan Commercial |
$164.00
|
| Rate for Payer: Networks By Design Commercial |
$484.90
|
| Rate for Payer: Networks By Design Commercial |
$133.25
|
| Rate for Payer: Prime Health Services Commercial |
$174.25
|
| Rate for Payer: Prime Health Services Commercial |
$634.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$123.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$447.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$123.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$447.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$240.94
|
| Rate for Payer: United Healthcare All Other Commercial |
$240.94
|
| Rate for Payer: United Healthcare All Other HMO |
$240.94
|
| Rate for Payer: United Healthcare All Other HMO |
$240.94
|
| Rate for Payer: United Healthcare HMO Rider |
$240.94
|
| Rate for Payer: United Healthcare HMO Rider |
$240.94
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$240.94
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$240.94
|
| Rate for Payer: Upland Medical Group Pediatric |
$219.12
|
| Rate for Payer: Upland Medical Group Pediatric |
$219.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$328.68
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$328.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$241.03
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$241.03
|
| Rate for Payer: Vantage Medical Group Senior |
$219.12
|
| Rate for Payer: Vantage Medical Group Senior |
$219.12
|
|
|
HC IMMUNOFLUORESCENCE STAIN EA AB
|
Facility
|
IP
|
$746.00
|
|
|
Service Code
|
CPT 88346
|
| Hospital Charge Code |
903800037
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$149.20 |
| Max. Negotiated Rate |
$634.10 |
| Rate for Payer: Adventist Health Commercial |
$149.20
|
| Rate for Payer: Cash Price |
$335.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$522.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$298.40
|
| Rate for Payer: EPIC Health Plan Senior |
$298.40
|
| Rate for Payer: Galaxy Health WC |
$634.10
|
| Rate for Payer: Global Benefits Group Commercial |
$447.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$473.71
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$440.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$179.04
|
| Rate for Payer: Multiplan Commercial |
$596.80
|
| Rate for Payer: Networks By Design Commercial |
$484.90
|
| Rate for Payer: Prime Health Services Commercial |
$634.10
|
|
|
HC IMMUNOFLUORES STAIN EA ADDL
|
Facility
|
OP
|
$649.00
|
|
|
Service Code
|
CPT 88350
|
| Hospital Charge Code |
903800289
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$73.72 |
| Max. Negotiated Rate |
$572.80 |
| Rate for Payer: Adventist Health Commercial |
$129.80
|
| Rate for Payer: Adventist Health Commercial |
$82.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$299.71
|
| Rate for Payer: Aetna of CA HMO/PPO |
$299.71
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$348.50
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$551.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$225.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$356.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$307.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$486.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$572.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$572.80
|
| Rate for Payer: Blue Shield of California Commercial |
$452.35
|
| Rate for Payer: Blue Shield of California Commercial |
$285.77
|
| Rate for Payer: Blue Shield of California Commercial |
$189.01
|
| Rate for Payer: Blue Shield of California Commercial |
$299.19
|
| Rate for Payer: Cash Price |
$292.05
|
| Rate for Payer: Cash Price |
$184.50
|
| Rate for Payer: Cash Price |
$292.05
|
| Rate for Payer: Cash Price |
$184.50
|
| Rate for Payer: Cigna of CA HMO |
$415.36
|
| Rate for Payer: Cigna of CA HMO |
$262.40
|
| Rate for Payer: Cigna of CA PPO |
$303.40
|
| Rate for Payer: Cigna of CA PPO |
$480.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$348.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$551.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$348.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$551.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$348.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$551.65
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$454.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$287.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$259.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$164.00
|
| Rate for Payer: EPIC Health Plan Senior |
$259.60
|
| Rate for Payer: EPIC Health Plan Senior |
$164.00
|
| Rate for Payer: Galaxy Health WC |
$551.65
|
| Rate for Payer: Galaxy Health WC |
$348.50
|
| Rate for Payer: Global Benefits Group Commercial |
$246.00
|
| Rate for Payer: Global Benefits Group Commercial |
$389.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$108.63
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$108.63
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$412.12
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$260.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$122.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$122.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$241.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$382.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$98.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$155.76
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$454.30
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$287.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$454.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$287.00
|
| Rate for Payer: Multiplan Commercial |
$519.20
|
| Rate for Payer: Multiplan Commercial |
$328.00
|
| Rate for Payer: Networks By Design Commercial |
$266.50
|
| Rate for Payer: Networks By Design Commercial |
$421.85
|
| Rate for Payer: Prime Health Services Commercial |
$551.65
|
| Rate for Payer: Prime Health Services Commercial |
$348.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$246.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$389.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$389.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$246.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$73.72
|
| Rate for Payer: United Healthcare All Other Commercial |
$73.72
|
| Rate for Payer: United Healthcare All Other HMO |
$73.72
|
| Rate for Payer: United Healthcare All Other HMO |
$73.72
|
| Rate for Payer: United Healthcare HMO Rider |
$73.72
|
| Rate for Payer: United Healthcare HMO Rider |
$73.72
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$73.72
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$73.72
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$551.65
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$348.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$348.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$551.65
|
| Rate for Payer: Vantage Medical Group Senior |
$551.65
|
| Rate for Payer: Vantage Medical Group Senior |
$348.50
|
|
|
HC IMMUNOFLUORES STAIN EA ADDL
|
Facility
|
IP
|
$649.00
|
|
|
Service Code
|
CPT 88350
|
| Hospital Charge Code |
903800289
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$129.80 |
| Max. Negotiated Rate |
$551.65 |
| Rate for Payer: Adventist Health Commercial |
$129.80
|
| Rate for Payer: Cash Price |
$292.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$454.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$259.60
|
| Rate for Payer: EPIC Health Plan Senior |
$259.60
|
| Rate for Payer: Galaxy Health WC |
$551.65
|
| Rate for Payer: Global Benefits Group Commercial |
$389.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$412.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$382.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$155.76
|
| Rate for Payer: Multiplan Commercial |
$519.20
|
| Rate for Payer: Networks By Design Commercial |
$421.85
|
| Rate for Payer: Prime Health Services Commercial |
$551.65
|
|
|
HC IMMUNOGLOBULIN E
|
Facility
|
OP
|
$179.00
|
|
|
Service Code
|
CPT 82785
|
| Hospital Charge Code |
900912129
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.33 |
| Max. Negotiated Rate |
$169.97 |
| Rate for Payer: Vantage Medical Group Medi-Cal |
$18.11
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$18.11
|
| Rate for Payer: Vantage Medical Group Senior |
$16.46
|
| Rate for Payer: Vantage Medical Group Senior |
$16.46
|
| Rate for Payer: Adventist Health Commercial |
$35.80
|
| Rate for Payer: Adventist Health Commercial |
$19.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$136.96
|
| Rate for Payer: Aetna of CA HMO/PPO |
$136.96
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$24.69
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$24.69
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$18.11
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$18.11
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$16.46
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$16.46
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$169.97
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$169.97
|
| Rate for Payer: Blue Shield of California Commercial |
$45.18
|
| Rate for Payer: Blue Shield of California Commercial |
$124.76
|
| Rate for Payer: Blue Shield of California Commercial |
$68.31
|
| Rate for Payer: Blue Shield of California Commercial |
$82.52
|
| Rate for Payer: Cash Price |
$44.10
|
| Rate for Payer: Cash Price |
$44.10
|
| Rate for Payer: Cash Price |
$80.55
|
| Rate for Payer: Cash Price |
$80.55
|
| Rate for Payer: Cigna of CA HMO |
$62.72
|
| Rate for Payer: Cigna of CA HMO |
$114.56
|
| Rate for Payer: Cigna of CA PPO |
$132.46
|
| Rate for Payer: Cigna of CA PPO |
$72.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$24.69
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$24.69
|
| Rate for Payer: Dignity Health Medi-Cal |
$18.11
|
| Rate for Payer: Dignity Health Medi-Cal |
$18.11
|
| Rate for Payer: Dignity Health Medicare Advantage |
$16.46
|
| Rate for Payer: Dignity Health Medicare Advantage |
$16.46
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$125.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$68.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$27.16
|
| Rate for Payer: EPIC Health Plan Commercial |
$27.16
|
| Rate for Payer: EPIC Health Plan Senior |
$18.11
|
| Rate for Payer: EPIC Health Plan Senior |
$18.11
|
| Rate for Payer: Galaxy Health WC |
$152.15
|
| Rate for Payer: Galaxy Health WC |
$83.30
|
| Rate for Payer: Global Benefits Group Commercial |
$107.40
|
| Rate for Payer: Global Benefits Group Commercial |
$58.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$26.99
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$26.99
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$24.53
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$24.53
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$16.46
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$16.46
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$113.67
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$62.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$27.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$27.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$23.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$23.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$42.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23.52
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$20.74
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$20.74
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$22.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$22.06
|
| Rate for Payer: Multiplan Commercial |
$78.40
|
| Rate for Payer: Multiplan Commercial |
$143.20
|
| Rate for Payer: Networks By Design Commercial |
$63.70
|
| Rate for Payer: Networks By Design Commercial |
$116.35
|
| Rate for Payer: Prime Health Services Commercial |
$152.15
|
| Rate for Payer: Prime Health Services Commercial |
$83.30
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$107.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$58.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$107.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$58.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$13.33
|
| Rate for Payer: United Healthcare All Other Commercial |
$13.33
|
| Rate for Payer: United Healthcare All Other HMO |
$13.33
|
| Rate for Payer: United Healthcare All Other HMO |
$13.33
|
| Rate for Payer: United Healthcare HMO Rider |
$13.33
|
| Rate for Payer: United Healthcare HMO Rider |
$13.33
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$13.33
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$13.33
|
| Rate for Payer: Upland Medical Group Pediatric |
$16.46
|
| Rate for Payer: Upland Medical Group Pediatric |
$16.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$24.69
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$24.69
|
|
|
HC IMMUNOGLOBULIN E
|
Facility
|
IP
|
$179.00
|
|
|
Service Code
|
CPT 82785
|
| Hospital Charge Code |
900912129
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$35.80 |
| Max. Negotiated Rate |
$152.15 |
| Rate for Payer: Adventist Health Commercial |
$35.80
|
| Rate for Payer: Cash Price |
$80.55
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$125.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$71.60
|
| Rate for Payer: EPIC Health Plan Senior |
$71.60
|
| Rate for Payer: Galaxy Health WC |
$152.15
|
| Rate for Payer: Global Benefits Group Commercial |
$107.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$113.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$105.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$42.96
|
| Rate for Payer: Multiplan Commercial |
$143.20
|
| Rate for Payer: Networks By Design Commercial |
$116.35
|
| Rate for Payer: Prime Health Services Commercial |
$152.15
|
|
|
HC IMMUNOGLOBULINS IGA
|
Facility
|
OP
|
$210.00
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
900910855
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.53 |
| Max. Negotiated Rate |
$178.50 |
| Rate for Payer: Adventist Health Commercial |
$42.00
|
| Rate for Payer: Adventist Health Commercial |
$15.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$54.51
|
| Rate for Payer: Aetna of CA HMO/PPO |
$54.51
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13.95
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10.23
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9.30
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9.30
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$79.98
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$79.98
|
| Rate for Payer: Blue Shield of California Commercial |
$35.96
|
| Rate for Payer: Blue Shield of California Commercial |
$146.37
|
| Rate for Payer: Blue Shield of California Commercial |
$54.37
|
| Rate for Payer: Blue Shield of California Commercial |
$96.81
|
| Rate for Payer: Cash Price |
$35.10
|
| Rate for Payer: Cash Price |
$35.10
|
| Rate for Payer: Cash Price |
$94.50
|
| Rate for Payer: Cash Price |
$94.50
|
| Rate for Payer: Cigna of CA HMO |
$49.92
|
| Rate for Payer: Cigna of CA HMO |
$134.40
|
| Rate for Payer: Cigna of CA PPO |
$155.40
|
| Rate for Payer: Cigna of CA PPO |
$57.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13.95
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$10.23
|
| Rate for Payer: Dignity Health Medi-Cal |
$10.23
|
| Rate for Payer: Dignity Health Medicare Advantage |
$9.30
|
| Rate for Payer: Dignity Health Medicare Advantage |
$9.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$147.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$54.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.35
|
| Rate for Payer: EPIC Health Plan Senior |
$10.23
|
| Rate for Payer: EPIC Health Plan Senior |
$10.23
|
| Rate for Payer: Galaxy Health WC |
$178.50
|
| Rate for Payer: Galaxy Health WC |
$66.30
|
| Rate for Payer: Global Benefits Group Commercial |
$126.00
|
| Rate for Payer: Global Benefits Group Commercial |
$46.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$15.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$15.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$10.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$10.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$9.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$9.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$133.35
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$49.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$11.55
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$11.55
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$13.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$13.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$50.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18.72
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11.72
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11.72
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$12.46
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$12.46
|
| Rate for Payer: Multiplan Commercial |
$62.40
|
| Rate for Payer: Multiplan Commercial |
$168.00
|
| Rate for Payer: Networks By Design Commercial |
$50.70
|
| Rate for Payer: Networks By Design Commercial |
$136.50
|
| Rate for Payer: Prime Health Services Commercial |
$178.50
|
| Rate for Payer: Prime Health Services Commercial |
$66.30
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$126.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$46.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$126.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$46.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.53
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.53
|
| Rate for Payer: United Healthcare All Other HMO |
$7.53
|
| Rate for Payer: United Healthcare All Other HMO |
$7.53
|
| Rate for Payer: United Healthcare HMO Rider |
$7.53
|
| Rate for Payer: United Healthcare HMO Rider |
$7.53
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.53
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.53
|
| Rate for Payer: Upland Medical Group Pediatric |
$9.30
|
| Rate for Payer: Upland Medical Group Pediatric |
$9.30
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13.95
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.23
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.23
|
| Rate for Payer: Vantage Medical Group Senior |
$9.30
|
| Rate for Payer: Vantage Medical Group Senior |
$9.30
|
|
|
HC IMMUNOGLOBULINS IGA
|
Facility
|
IP
|
$210.00
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
900910855
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$42.00 |
| Max. Negotiated Rate |
$178.50 |
| Rate for Payer: Adventist Health Commercial |
$42.00
|
| Rate for Payer: Cash Price |
$94.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$147.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$84.00
|
| Rate for Payer: EPIC Health Plan Senior |
$84.00
|
| Rate for Payer: Galaxy Health WC |
$178.50
|
| Rate for Payer: Global Benefits Group Commercial |
$126.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$133.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$123.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$50.40
|
| Rate for Payer: Multiplan Commercial |
$168.00
|
| Rate for Payer: Networks By Design Commercial |
$136.50
|
| Rate for Payer: Prime Health Services Commercial |
$178.50
|
|
|
HC IMMUNOGLOBULINS IGG
|
Facility
|
OP
|
$178.00
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
900910857
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.53 |
| Max. Negotiated Rate |
$151.30 |
| Rate for Payer: Adventist Health Commercial |
$35.60
|
| Rate for Payer: Adventist Health Commercial |
$15.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$54.51
|
| Rate for Payer: Aetna of CA HMO/PPO |
$54.51
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13.95
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10.23
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9.30
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9.30
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$79.98
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$79.98
|
| Rate for Payer: Blue Shield of California Commercial |
$35.96
|
| Rate for Payer: Blue Shield of California Commercial |
$124.07
|
| Rate for Payer: Blue Shield of California Commercial |
$54.37
|
| Rate for Payer: Blue Shield of California Commercial |
$82.06
|
| Rate for Payer: Cash Price |
$35.10
|
| Rate for Payer: Cash Price |
$35.10
|
| Rate for Payer: Cash Price |
$80.10
|
| Rate for Payer: Cash Price |
$80.10
|
| Rate for Payer: Cigna of CA HMO |
$49.92
|
| Rate for Payer: Cigna of CA HMO |
$113.92
|
| Rate for Payer: Cigna of CA PPO |
$131.72
|
| Rate for Payer: Cigna of CA PPO |
$57.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13.95
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$10.23
|
| Rate for Payer: Dignity Health Medi-Cal |
$10.23
|
| Rate for Payer: Dignity Health Medicare Advantage |
$9.30
|
| Rate for Payer: Dignity Health Medicare Advantage |
$9.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$124.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$54.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.35
|
| Rate for Payer: EPIC Health Plan Senior |
$10.23
|
| Rate for Payer: EPIC Health Plan Senior |
$10.23
|
| Rate for Payer: Galaxy Health WC |
$151.30
|
| Rate for Payer: Galaxy Health WC |
$66.30
|
| Rate for Payer: Global Benefits Group Commercial |
$106.80
|
| Rate for Payer: Global Benefits Group Commercial |
$46.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$15.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$15.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$10.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$10.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$9.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$9.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$113.03
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$49.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$11.55
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$11.55
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$13.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$13.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$42.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18.72
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11.72
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11.72
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$12.46
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$12.46
|
| Rate for Payer: Multiplan Commercial |
$62.40
|
| Rate for Payer: Multiplan Commercial |
$142.40
|
| Rate for Payer: Networks By Design Commercial |
$50.70
|
| Rate for Payer: Networks By Design Commercial |
$115.70
|
| Rate for Payer: Prime Health Services Commercial |
$151.30
|
| Rate for Payer: Prime Health Services Commercial |
$66.30
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$106.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$46.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$106.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$46.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.53
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.53
|
| Rate for Payer: United Healthcare All Other HMO |
$7.53
|
| Rate for Payer: United Healthcare All Other HMO |
$7.53
|
| Rate for Payer: United Healthcare HMO Rider |
$7.53
|
| Rate for Payer: United Healthcare HMO Rider |
$7.53
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.53
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.53
|
| Rate for Payer: Upland Medical Group Pediatric |
$9.30
|
| Rate for Payer: Upland Medical Group Pediatric |
$9.30
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13.95
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.23
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.23
|
| Rate for Payer: Vantage Medical Group Senior |
$9.30
|
| Rate for Payer: Vantage Medical Group Senior |
$9.30
|
|
|
HC IMMUNOGLOBULINS IGG
|
Facility
|
IP
|
$178.00
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
900910857
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$35.60 |
| Max. Negotiated Rate |
$151.30 |
| Rate for Payer: Adventist Health Commercial |
$35.60
|
| Rate for Payer: Cash Price |
$80.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$124.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$71.20
|
| Rate for Payer: EPIC Health Plan Senior |
$71.20
|
| Rate for Payer: Galaxy Health WC |
$151.30
|
| Rate for Payer: Global Benefits Group Commercial |
$106.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$113.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$105.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$42.72
|
| Rate for Payer: Multiplan Commercial |
$142.40
|
| Rate for Payer: Networks By Design Commercial |
$115.70
|
| Rate for Payer: Prime Health Services Commercial |
$151.30
|
|
|
HC IMMUNOGLOBULINS IGM
|
Facility
|
IP
|
$210.00
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
900910856
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$42.00 |
| Max. Negotiated Rate |
$178.50 |
| Rate for Payer: Adventist Health Commercial |
$42.00
|
| Rate for Payer: Cash Price |
$94.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$147.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$84.00
|
| Rate for Payer: EPIC Health Plan Senior |
$84.00
|
| Rate for Payer: Galaxy Health WC |
$178.50
|
| Rate for Payer: Global Benefits Group Commercial |
$126.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$133.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$123.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$50.40
|
| Rate for Payer: Multiplan Commercial |
$168.00
|
| Rate for Payer: Networks By Design Commercial |
$136.50
|
| Rate for Payer: Prime Health Services Commercial |
$178.50
|
|
|
HC IMMUNOGLOBULINS IGM
|
Facility
|
OP
|
$210.00
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
900910856
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.53 |
| Max. Negotiated Rate |
$178.50 |
| Rate for Payer: Adventist Health Commercial |
$42.00
|
| Rate for Payer: Adventist Health Commercial |
$15.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$54.51
|
| Rate for Payer: Aetna of CA HMO/PPO |
$54.51
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13.95
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10.23
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9.30
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9.30
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$79.98
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$79.98
|
| Rate for Payer: Blue Shield of California Commercial |
$35.96
|
| Rate for Payer: Blue Shield of California Commercial |
$146.37
|
| Rate for Payer: Blue Shield of California Commercial |
$54.37
|
| Rate for Payer: Blue Shield of California Commercial |
$96.81
|
| Rate for Payer: Cash Price |
$35.10
|
| Rate for Payer: Cash Price |
$35.10
|
| Rate for Payer: Cash Price |
$94.50
|
| Rate for Payer: Cash Price |
$94.50
|
| Rate for Payer: Cigna of CA HMO |
$49.92
|
| Rate for Payer: Cigna of CA HMO |
$134.40
|
| Rate for Payer: Cigna of CA PPO |
$155.40
|
| Rate for Payer: Cigna of CA PPO |
$57.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13.95
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$10.23
|
| Rate for Payer: Dignity Health Medi-Cal |
$10.23
|
| Rate for Payer: Dignity Health Medicare Advantage |
$9.30
|
| Rate for Payer: Dignity Health Medicare Advantage |
$9.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$147.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$54.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.35
|
| Rate for Payer: EPIC Health Plan Senior |
$10.23
|
| Rate for Payer: EPIC Health Plan Senior |
$10.23
|
| Rate for Payer: Galaxy Health WC |
$178.50
|
| Rate for Payer: Galaxy Health WC |
$66.30
|
| Rate for Payer: Global Benefits Group Commercial |
$126.00
|
| Rate for Payer: Global Benefits Group Commercial |
$46.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$15.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$15.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$10.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$10.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$9.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$9.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$133.35
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$49.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$11.55
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$11.55
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$13.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$13.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$50.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18.72
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11.72
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11.72
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$12.46
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$12.46
|
| Rate for Payer: Multiplan Commercial |
$62.40
|
| Rate for Payer: Multiplan Commercial |
$168.00
|
| Rate for Payer: Networks By Design Commercial |
$50.70
|
| Rate for Payer: Networks By Design Commercial |
$136.50
|
| Rate for Payer: Prime Health Services Commercial |
$178.50
|
| Rate for Payer: Prime Health Services Commercial |
$66.30
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$126.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$46.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$126.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$46.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.53
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.53
|
| Rate for Payer: United Healthcare All Other HMO |
$7.53
|
| Rate for Payer: United Healthcare All Other HMO |
$7.53
|
| Rate for Payer: United Healthcare HMO Rider |
$7.53
|
| Rate for Payer: United Healthcare HMO Rider |
$7.53
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.53
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.53
|
| Rate for Payer: Upland Medical Group Pediatric |
$9.30
|
| Rate for Payer: Upland Medical Group Pediatric |
$9.30
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13.95
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.23
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.23
|
| Rate for Payer: Vantage Medical Group Senior |
$9.30
|
| Rate for Payer: Vantage Medical Group Senior |
$9.30
|
|
|
HC IMMUNOHISTO ANTIBOD ADD SLID
|
Facility
|
IP
|
$724.00
|
|
|
Service Code
|
CPT 88344
|
| Hospital Charge Code |
903800241
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$144.80 |
| Max. Negotiated Rate |
$615.40 |
| Rate for Payer: Adventist Health Commercial |
$144.80
|
| Rate for Payer: Cash Price |
$325.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$506.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$289.60
|
| Rate for Payer: EPIC Health Plan Senior |
$289.60
|
| Rate for Payer: Galaxy Health WC |
$615.40
|
| Rate for Payer: Global Benefits Group Commercial |
$434.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$459.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$427.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$173.76
|
| Rate for Payer: Multiplan Commercial |
$579.20
|
| Rate for Payer: Networks By Design Commercial |
$470.60
|
| Rate for Payer: Prime Health Services Commercial |
$615.40
|
|
