|
HC LAB REF HPA ANTIBODIES
|
Facility
|
IP
|
$29.00
|
|
|
Service Code
|
CPT 86022
|
| Hospital Charge Code |
900911214
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.80 |
| Max. Negotiated Rate |
$24.65 |
| Rate for Payer: Adventist Health Commercial |
$5.80
|
| Rate for Payer: Cash Price |
$13.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.60
|
| Rate for Payer: EPIC Health Plan Senior |
$11.60
|
| Rate for Payer: Galaxy Health WC |
$24.65
|
| Rate for Payer: Global Benefits Group Commercial |
$17.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$19.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.05
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$17.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.96
|
| Rate for Payer: Multiplan Commercial |
$23.20
|
| Rate for Payer: Networks By Design Commercial |
$18.85
|
| Rate for Payer: Prime Health Services Commercial |
$24.65
|
|
|
HC LAB REF HPA ANTIBODIES
|
Facility
|
OP
|
$29.00
|
|
|
Service Code
|
CPT 86022
|
| Hospital Charge Code |
900911214
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.80 |
| Max. Negotiated Rate |
$153.94 |
| Rate for Payer: Adventist Health Commercial |
$5.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$19.02
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$27.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$20.21
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$18.37
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$153.94
|
| Rate for Payer: Blue Shield of California Commercial |
$19.40
|
| Rate for Payer: Blue Shield of California EPN |
$12.82
|
| Rate for Payer: Cash Price |
$13.05
|
| Rate for Payer: Cash Price |
$13.05
|
| Rate for Payer: Cigna of CA HMO |
$18.56
|
| Rate for Payer: Cigna of CA PPO |
$21.46
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$27.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$20.21
|
| Rate for Payer: Dignity Health Medicare Advantage |
$18.37
|
| Rate for Payer: EPIC Health Plan Commercial |
$24.80
|
| Rate for Payer: EPIC Health Plan Senior |
$18.37
|
| Rate for Payer: Galaxy Health WC |
$24.65
|
| Rate for Payer: Global Benefits Group Commercial |
$17.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$30.13
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$27.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$18.37
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$19.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$31.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.96
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$23.15
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$24.62
|
| Rate for Payer: Multiplan Commercial |
$23.20
|
| Rate for Payer: Networks By Design Commercial |
$18.85
|
| Rate for Payer: Prime Health Services Commercial |
$24.65
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$17.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$17.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.88
|
| Rate for Payer: United Healthcare All Other HMO |
$14.88
|
| Rate for Payer: United Healthcare HMO Rider |
$14.88
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.88
|
| Rate for Payer: Upland Medical Group Pediatric |
$18.37
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$27.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$20.21
|
| Rate for Payer: Vantage Medical Group Senior |
$18.37
|
|
|
HC LAB REF HSV 1/2 IGM CSF
|
Facility
|
IP
|
$119.00
|
|
| Hospital Charge Code |
900911351
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$23.80 |
| Max. Negotiated Rate |
$101.15 |
| Rate for Payer: Adventist Health Commercial |
$23.80
|
| Rate for Payer: Cash Price |
$53.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$47.60
|
| Rate for Payer: EPIC Health Plan Senior |
$47.60
|
| Rate for Payer: Galaxy Health WC |
$101.15
|
| Rate for Payer: Global Benefits Group Commercial |
$71.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$79.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$45.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$73.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$28.56
|
| Rate for Payer: Multiplan Commercial |
$95.20
|
| Rate for Payer: Networks By Design Commercial |
$77.35
|
| Rate for Payer: Prime Health Services Commercial |
$101.15
|
|
|
HC LAB REF HSV 1/2 IGM CSF
|
Facility
|
OP
|
$119.00
|
|
| Hospital Charge Code |
900911351
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$23.80 |
| Max. Negotiated Rate |
$101.15 |
| Rate for Payer: Adventist Health Commercial |
$23.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$78.05
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$101.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$65.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$89.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$73.08
|
| Rate for Payer: Blue Shield of California Commercial |
$79.61
|
| Rate for Payer: Blue Shield of California EPN |
$52.60
|
| Rate for Payer: Cash Price |
$53.55
|
| Rate for Payer: Cigna of CA HMO |
$76.16
|
| Rate for Payer: Cigna of CA PPO |
$88.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$101.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$101.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$101.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$47.60
|
| Rate for Payer: EPIC Health Plan Senior |
$47.60
|
| Rate for Payer: Galaxy Health WC |
$101.15
|
| Rate for Payer: Global Benefits Group Commercial |
$71.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$79.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$45.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$73.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$28.56
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$83.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$83.30
|
| Rate for Payer: Multiplan Commercial |
$95.20
|
| Rate for Payer: Networks By Design Commercial |
$77.35
|
| Rate for Payer: Prime Health Services Commercial |
$101.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$71.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$71.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$59.50
|
| Rate for Payer: United Healthcare All Other HMO |
$59.50
|
| Rate for Payer: United Healthcare HMO Rider |
$59.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$59.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$101.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$101.15
|
| Rate for Payer: Vantage Medical Group Senior |
$101.15
|
|
|
HC LAB REF HSV 1 IGG
|
Facility
|
OP
|
$16.00
|
|
|
Service Code
|
CPT 86695
|
| Hospital Charge Code |
900911468
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.20 |
| Max. Negotiated Rate |
$130.27 |
| Rate for Payer: Adventist Health Commercial |
$3.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10.49
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19.79
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.51
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13.19
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$130.27
|
| Rate for Payer: Blue Shield of California Commercial |
$10.70
|
| Rate for Payer: Blue Shield of California EPN |
$7.07
|
| Rate for Payer: Cash Price |
$7.20
|
| Rate for Payer: Cash Price |
$7.20
|
| Rate for Payer: Cigna of CA HMO |
$10.24
|
| Rate for Payer: Cigna of CA PPO |
$11.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.79
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.51
|
| Rate for Payer: Dignity Health Medicare Advantage |
$13.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$17.81
|
| Rate for Payer: EPIC Health Plan Senior |
$13.19
|
| Rate for Payer: Galaxy Health WC |
$13.60
|
| Rate for Payer: Global Benefits Group Commercial |
$9.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$21.63
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$19.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13.19
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$22.27
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.84
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17.67
|
| Rate for Payer: Multiplan Commercial |
$12.80
|
| Rate for Payer: Networks By Design Commercial |
$10.40
|
| Rate for Payer: Prime Health Services Commercial |
$13.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.68
|
| Rate for Payer: United Healthcare All Other HMO |
$10.68
|
| Rate for Payer: United Healthcare HMO Rider |
$10.68
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.68
|
| Rate for Payer: Upland Medical Group Pediatric |
$13.19
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.79
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.51
|
| Rate for Payer: Vantage Medical Group Senior |
$13.19
|
|
|
HC LAB REF HSV 1 IGG
|
Facility
|
IP
|
$16.00
|
|
|
Service Code
|
CPT 86695
|
| Hospital Charge Code |
900911468
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.20 |
| Max. Negotiated Rate |
$13.60 |
| Rate for Payer: Adventist Health Commercial |
$3.20
|
| Rate for Payer: Cash Price |
$7.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.40
|
| Rate for Payer: EPIC Health Plan Senior |
$6.40
|
| Rate for Payer: Galaxy Health WC |
$13.60
|
| Rate for Payer: Global Benefits Group Commercial |
$9.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.84
|
| Rate for Payer: Multiplan Commercial |
$12.80
|
| Rate for Payer: Networks By Design Commercial |
$10.40
|
| Rate for Payer: Prime Health Services Commercial |
$13.60
|
|
|
HC LAB REF HSV 2 IGG
|
Facility
|
IP
|
$16.00
|
|
|
Service Code
|
CPT 86696
|
| Hospital Charge Code |
900911469
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$3.20 |
| Max. Negotiated Rate |
$13.60 |
| Rate for Payer: Adventist Health Commercial |
$3.20
|
| Rate for Payer: Cash Price |
$7.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.40
|
| Rate for Payer: EPIC Health Plan Senior |
$6.40
|
| Rate for Payer: Galaxy Health WC |
$13.60
|
| Rate for Payer: Global Benefits Group Commercial |
$9.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.84
|
| Rate for Payer: Multiplan Commercial |
$12.80
|
| Rate for Payer: Networks By Design Commercial |
$10.40
|
| Rate for Payer: Prime Health Services Commercial |
$13.60
|
|
|
HC LAB REF HSV 2 IGG
|
Facility
|
OP
|
$16.00
|
|
|
Service Code
|
CPT 86696
|
| Hospital Charge Code |
900911469
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$3.20 |
| Max. Negotiated Rate |
$191.05 |
| Rate for Payer: Adventist Health Commercial |
$3.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10.49
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$29.02
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$21.29
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$19.35
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$191.05
|
| Rate for Payer: Blue Shield of California Commercial |
$10.70
|
| Rate for Payer: Blue Shield of California EPN |
$7.07
|
| Rate for Payer: Cash Price |
$7.20
|
| Rate for Payer: Cash Price |
$7.20
|
| Rate for Payer: Cigna of CA HMO |
$10.24
|
| Rate for Payer: Cigna of CA PPO |
$11.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$29.02
|
| Rate for Payer: Dignity Health Medi-Cal |
$21.29
|
| Rate for Payer: Dignity Health Medicare Advantage |
$19.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.12
|
| Rate for Payer: EPIC Health Plan Senior |
$19.35
|
| Rate for Payer: Galaxy Health WC |
$13.60
|
| Rate for Payer: Global Benefits Group Commercial |
$9.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$31.73
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$28.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$19.35
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$32.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$19.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.84
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$24.38
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$25.93
|
| Rate for Payer: Multiplan Commercial |
$12.80
|
| Rate for Payer: Networks By Design Commercial |
$10.40
|
| Rate for Payer: Prime Health Services Commercial |
$13.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$15.68
|
| Rate for Payer: United Healthcare All Other HMO |
$15.68
|
| Rate for Payer: United Healthcare HMO Rider |
$15.68
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15.68
|
| Rate for Payer: Upland Medical Group Pediatric |
$19.35
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$29.02
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$21.29
|
| Rate for Payer: Vantage Medical Group Senior |
$19.35
|
|
|
HC LAB REF HSV PCR
|
Facility
|
IP
|
$218.00
|
|
|
Service Code
|
CPT 87529
|
| Hospital Charge Code |
900910770
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$43.60 |
| Max. Negotiated Rate |
$185.30 |
| Rate for Payer: Adventist Health Commercial |
$43.60
|
| Rate for Payer: Cash Price |
$98.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$87.20
|
| Rate for Payer: EPIC Health Plan Senior |
$87.20
|
| Rate for Payer: Galaxy Health WC |
$185.30
|
| Rate for Payer: Global Benefits Group Commercial |
$130.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$145.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$83.06
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$134.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$52.32
|
| Rate for Payer: Multiplan Commercial |
$174.40
|
| Rate for Payer: Networks By Design Commercial |
$141.70
|
| Rate for Payer: Prime Health Services Commercial |
$185.30
|
|
|
HC LAB REF HSV PCR
|
Facility
|
OP
|
$218.00
|
|
|
Service Code
|
CPT 87529
|
| Hospital Charge Code |
900910770
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$28.42 |
| Max. Negotiated Rate |
$335.41 |
| Rate for Payer: Adventist Health Commercial |
$43.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$142.99
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$52.63
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$38.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$35.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$335.41
|
| Rate for Payer: Blue Shield of California Commercial |
$145.84
|
| Rate for Payer: Blue Shield of California EPN |
$96.36
|
| Rate for Payer: Cash Price |
$98.10
|
| Rate for Payer: Cash Price |
$98.10
|
| Rate for Payer: Cigna of CA HMO |
$139.52
|
| Rate for Payer: Cigna of CA PPO |
$161.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$52.63
|
| Rate for Payer: Dignity Health Medi-Cal |
$38.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$35.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$47.37
|
| Rate for Payer: EPIC Health Plan Senior |
$35.09
|
| Rate for Payer: Galaxy Health WC |
$185.30
|
| Rate for Payer: Global Benefits Group Commercial |
$130.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$57.55
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$41.26
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$35.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$145.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$46.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$35.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$52.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$44.21
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$47.02
|
| Rate for Payer: Multiplan Commercial |
$174.40
|
| Rate for Payer: Networks By Design Commercial |
$141.70
|
| Rate for Payer: Prime Health Services Commercial |
$185.30
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$130.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$130.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$28.42
|
| Rate for Payer: United Healthcare All Other HMO |
$28.42
|
| Rate for Payer: United Healthcare HMO Rider |
$28.42
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$28.42
|
| Rate for Payer: Upland Medical Group Pediatric |
$35.09
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$52.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$38.60
|
| Rate for Payer: Vantage Medical Group Senior |
$35.09
|
|
|
HC LAB REF IGF-BP2
|
Facility
|
OP
|
$67.00
|
|
|
Service Code
|
CPT 83519
|
| Hospital Charge Code |
900911427
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.40 |
| Max. Negotiated Rate |
$133.46 |
| Rate for Payer: Adventist Health Commercial |
$13.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$43.95
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$27.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$20.24
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$18.40
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$133.46
|
| Rate for Payer: Blue Shield of California Commercial |
$44.82
|
| Rate for Payer: Blue Shield of California EPN |
$29.61
|
| Rate for Payer: Cash Price |
$30.15
|
| Rate for Payer: Cash Price |
$30.15
|
| Rate for Payer: Cigna of CA HMO |
$42.88
|
| Rate for Payer: Cigna of CA PPO |
$49.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$27.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$20.24
|
| Rate for Payer: Dignity Health Medicare Advantage |
$18.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$24.84
|
| Rate for Payer: EPIC Health Plan Senior |
$18.40
|
| Rate for Payer: Galaxy Health WC |
$56.95
|
| Rate for Payer: Global Benefits Group Commercial |
$40.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$30.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$20.61
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$18.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$44.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$23.31
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.08
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$23.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$24.66
|
| Rate for Payer: Multiplan Commercial |
$53.60
|
| Rate for Payer: Networks By Design Commercial |
$43.55
|
| Rate for Payer: Prime Health Services Commercial |
$56.95
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$40.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$40.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.90
|
| Rate for Payer: United Healthcare All Other HMO |
$14.90
|
| Rate for Payer: United Healthcare HMO Rider |
$14.90
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.90
|
| Rate for Payer: Upland Medical Group Pediatric |
$18.40
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$27.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$20.24
|
| Rate for Payer: Vantage Medical Group Senior |
$18.40
|
|
|
HC LAB REF IGF-BP2
|
Facility
|
IP
|
$67.00
|
|
|
Service Code
|
CPT 83519
|
| Hospital Charge Code |
900911427
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.40 |
| Max. Negotiated Rate |
$56.95 |
| Rate for Payer: Adventist Health Commercial |
$13.40
|
| Rate for Payer: Cash Price |
$30.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.80
|
| Rate for Payer: EPIC Health Plan Senior |
$26.80
|
| Rate for Payer: Galaxy Health WC |
$56.95
|
| Rate for Payer: Global Benefits Group Commercial |
$40.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$44.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$25.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$41.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.08
|
| Rate for Payer: Multiplan Commercial |
$53.60
|
| Rate for Payer: Networks By Design Commercial |
$43.55
|
| Rate for Payer: Prime Health Services Commercial |
$56.95
|
|
|
HC LAB REF IMMUNE COMPLEX PANEL C1Q
|
Facility
|
OP
|
$81.00
|
|
|
Service Code
|
CPT 86332
|
| Hospital Charge Code |
900912836
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.20 |
| Max. Negotiated Rate |
$240.72 |
| Rate for Payer: Adventist Health Commercial |
$16.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$53.13
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$36.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$26.81
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$24.37
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$240.72
|
| Rate for Payer: Blue Shield of California Commercial |
$54.19
|
| Rate for Payer: Blue Shield of California EPN |
$35.80
|
| Rate for Payer: Cash Price |
$36.45
|
| Rate for Payer: Cash Price |
$36.45
|
| Rate for Payer: Cigna of CA HMO |
$51.84
|
| Rate for Payer: Cigna of CA PPO |
$59.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$36.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$26.81
|
| Rate for Payer: Dignity Health Medicare Advantage |
$24.37
|
| Rate for Payer: EPIC Health Plan Commercial |
$32.90
|
| Rate for Payer: EPIC Health Plan Senior |
$24.37
|
| Rate for Payer: Galaxy Health WC |
$68.85
|
| Rate for Payer: Global Benefits Group Commercial |
$48.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$39.97
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$36.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$24.37
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$54.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$41.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$24.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$30.71
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$32.66
|
| Rate for Payer: Multiplan Commercial |
$64.80
|
| Rate for Payer: Networks By Design Commercial |
$52.65
|
| Rate for Payer: Prime Health Services Commercial |
$68.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$48.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$48.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$19.74
|
| Rate for Payer: United Healthcare All Other HMO |
$19.74
|
| Rate for Payer: United Healthcare HMO Rider |
$19.74
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$19.74
|
| Rate for Payer: Upland Medical Group Pediatric |
$24.37
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$36.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$26.81
|
| Rate for Payer: Vantage Medical Group Senior |
$24.37
|
|
|
HC LAB REF IMMUNE COMPLEX PANEL C1Q
|
Facility
|
IP
|
$81.00
|
|
|
Service Code
|
CPT 86332
|
| Hospital Charge Code |
900912836
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.20 |
| Max. Negotiated Rate |
$68.85 |
| Rate for Payer: Adventist Health Commercial |
$16.20
|
| Rate for Payer: Cash Price |
$36.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$32.40
|
| Rate for Payer: EPIC Health Plan Senior |
$32.40
|
| Rate for Payer: Galaxy Health WC |
$68.85
|
| Rate for Payer: Global Benefits Group Commercial |
$48.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$54.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$30.86
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$50.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.44
|
| Rate for Payer: Multiplan Commercial |
$64.80
|
| Rate for Payer: Networks By Design Commercial |
$52.65
|
| Rate for Payer: Prime Health Services Commercial |
$68.85
|
|
|
HC LAB REF IMMUNE COMPLEX PANEL C3D
|
Facility
|
OP
|
$81.00
|
|
|
Service Code
|
CPT 86332
|
| Hospital Charge Code |
900912837
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.20 |
| Max. Negotiated Rate |
$240.72 |
| Rate for Payer: Adventist Health Commercial |
$16.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$53.13
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$36.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$26.81
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$24.37
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$240.72
|
| Rate for Payer: Blue Shield of California Commercial |
$54.19
|
| Rate for Payer: Blue Shield of California EPN |
$35.80
|
| Rate for Payer: Cash Price |
$36.45
|
| Rate for Payer: Cash Price |
$36.45
|
| Rate for Payer: Cigna of CA HMO |
$51.84
|
| Rate for Payer: Cigna of CA PPO |
$59.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$36.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$26.81
|
| Rate for Payer: Dignity Health Medicare Advantage |
$24.37
|
| Rate for Payer: EPIC Health Plan Commercial |
$32.90
|
| Rate for Payer: EPIC Health Plan Senior |
$24.37
|
| Rate for Payer: Galaxy Health WC |
$68.85
|
| Rate for Payer: Global Benefits Group Commercial |
$48.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$39.97
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$36.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$24.37
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$54.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$41.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$24.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$30.71
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$32.66
|
| Rate for Payer: Multiplan Commercial |
$64.80
|
| Rate for Payer: Networks By Design Commercial |
$52.65
|
| Rate for Payer: Prime Health Services Commercial |
$68.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$48.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$48.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$19.74
|
| Rate for Payer: United Healthcare All Other HMO |
$19.74
|
| Rate for Payer: United Healthcare HMO Rider |
$19.74
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$19.74
|
| Rate for Payer: Upland Medical Group Pediatric |
$24.37
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$36.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$26.81
|
| Rate for Payer: Vantage Medical Group Senior |
$24.37
|
|
|
HC LAB REF IMMUNE COMPLEX PANEL C3D
|
Facility
|
IP
|
$81.00
|
|
|
Service Code
|
CPT 86332
|
| Hospital Charge Code |
900912837
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.20 |
| Max. Negotiated Rate |
$68.85 |
| Rate for Payer: Adventist Health Commercial |
$16.20
|
| Rate for Payer: Cash Price |
$36.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$32.40
|
| Rate for Payer: EPIC Health Plan Senior |
$32.40
|
| Rate for Payer: Galaxy Health WC |
$68.85
|
| Rate for Payer: Global Benefits Group Commercial |
$48.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$54.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$30.86
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$50.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.44
|
| Rate for Payer: Multiplan Commercial |
$64.80
|
| Rate for Payer: Networks By Design Commercial |
$52.65
|
| Rate for Payer: Prime Health Services Commercial |
$68.85
|
|
|
HC LAB REF IMMUNE COMPLEX PANEL PEG
|
Facility
|
IP
|
$81.00
|
|
|
Service Code
|
CPT 86332
|
| Hospital Charge Code |
900911375
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.20 |
| Max. Negotiated Rate |
$68.85 |
| Rate for Payer: Adventist Health Commercial |
$16.20
|
| Rate for Payer: Cash Price |
$36.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$32.40
|
| Rate for Payer: EPIC Health Plan Senior |
$32.40
|
| Rate for Payer: Galaxy Health WC |
$68.85
|
| Rate for Payer: Global Benefits Group Commercial |
$48.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$54.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$30.86
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$50.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.44
|
| Rate for Payer: Multiplan Commercial |
$64.80
|
| Rate for Payer: Networks By Design Commercial |
$52.65
|
| Rate for Payer: Prime Health Services Commercial |
$68.85
|
|
|
HC LAB REF IMMUNE COMPLEX PANEL PEG
|
Facility
|
OP
|
$81.00
|
|
|
Service Code
|
CPT 86332
|
| Hospital Charge Code |
900911375
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.20 |
| Max. Negotiated Rate |
$240.72 |
| Rate for Payer: Adventist Health Commercial |
$16.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$53.13
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$36.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$26.81
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$24.37
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$240.72
|
| Rate for Payer: Blue Shield of California Commercial |
$54.19
|
| Rate for Payer: Blue Shield of California EPN |
$35.80
|
| Rate for Payer: Cash Price |
$36.45
|
| Rate for Payer: Cash Price |
$36.45
|
| Rate for Payer: Cigna of CA HMO |
$51.84
|
| Rate for Payer: Cigna of CA PPO |
$59.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$36.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$26.81
|
| Rate for Payer: Dignity Health Medicare Advantage |
$24.37
|
| Rate for Payer: EPIC Health Plan Commercial |
$32.90
|
| Rate for Payer: EPIC Health Plan Senior |
$24.37
|
| Rate for Payer: Galaxy Health WC |
$68.85
|
| Rate for Payer: Global Benefits Group Commercial |
$48.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$39.97
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$36.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$24.37
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$54.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$41.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$24.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$30.71
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$32.66
|
| Rate for Payer: Multiplan Commercial |
$64.80
|
| Rate for Payer: Networks By Design Commercial |
$52.65
|
| Rate for Payer: Prime Health Services Commercial |
$68.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$48.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$48.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$19.74
|
| Rate for Payer: United Healthcare All Other HMO |
$19.74
|
| Rate for Payer: United Healthcare HMO Rider |
$19.74
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$19.74
|
| Rate for Payer: Upland Medical Group Pediatric |
$24.37
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$36.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$26.81
|
| Rate for Payer: Vantage Medical Group Senior |
$24.37
|
|
|
HC LAB REF IMMUNO FIXATION ELECTROPHORESI
|
Facility
|
IP
|
$179.00
|
|
|
Service Code
|
CPT 86334
|
| Hospital Charge Code |
900912722
|
|
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: 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 Permanente of CA Commercial/Self Funded |
$119.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$68.20
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$110.80
|
| 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 LAB REF IMMUNO FIXATION ELECTROPHORESI
|
Facility
|
OP
|
$179.00
|
|
|
Service Code
|
CPT 86334
|
| Hospital Charge Code |
900912722
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$18.10 |
| Max. Negotiated Rate |
$220.64 |
| Rate for Payer: Adventist Health Commercial |
$35.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$117.41
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$33.51
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$24.57
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$22.34
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$220.64
|
| Rate for Payer: Blue Shield of California Commercial |
$119.75
|
| Rate for Payer: Blue Shield of California EPN |
$79.12
|
| Rate for Payer: Cash Price |
$80.55
|
| Rate for Payer: Cash Price |
$80.55
|
| Rate for Payer: Cigna of CA HMO |
$114.56
|
| Rate for Payer: Cigna of CA PPO |
$132.46
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$33.51
|
| Rate for Payer: Dignity Health Medi-Cal |
$24.57
|
| Rate for Payer: Dignity Health Medicare Advantage |
$22.34
|
| Rate for Payer: EPIC Health Plan Commercial |
$30.16
|
| Rate for Payer: EPIC Health Plan Senior |
$22.34
|
| Rate for Payer: Galaxy Health WC |
$152.15
|
| Rate for Payer: Global Benefits Group Commercial |
$107.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$36.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$33.36
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$22.34
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$119.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$37.73
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$42.96
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$28.15
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$29.94
|
| 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
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$107.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$107.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$18.10
|
| Rate for Payer: United Healthcare All Other HMO |
$18.10
|
| Rate for Payer: United Healthcare HMO Rider |
$18.10
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$18.10
|
| Rate for Payer: Upland Medical Group Pediatric |
$22.34
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$33.51
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$24.57
|
| Rate for Payer: Vantage Medical Group Senior |
$22.34
|
|
|
HC LAB REF IMMUNO FIXATION ELECTRO UR
|
Facility
|
IP
|
$47.00
|
|
|
Service Code
|
CPT 86335
|
| Hospital Charge Code |
900912719
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.40 |
| Max. Negotiated Rate |
$39.95 |
| Rate for Payer: Adventist Health Commercial |
$9.40
|
| Rate for Payer: Cash Price |
$21.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$18.80
|
| Rate for Payer: EPIC Health Plan Senior |
$18.80
|
| Rate for Payer: Galaxy Health WC |
$39.95
|
| Rate for Payer: Global Benefits Group Commercial |
$28.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$31.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$17.91
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.28
|
| Rate for Payer: Multiplan Commercial |
$37.60
|
| Rate for Payer: Networks By Design Commercial |
$30.55
|
| Rate for Payer: Prime Health Services Commercial |
$39.95
|
|
|
HC LAB REF IMMUNO FIXATION ELECTRO UR
|
Facility
|
OP
|
$47.00
|
|
|
Service Code
|
CPT 86335
|
| Hospital Charge Code |
900912719
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.40 |
| Max. Negotiated Rate |
$137.45 |
| Rate for Payer: Adventist Health Commercial |
$9.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$30.83
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$44.02
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$32.28
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$29.35
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$137.45
|
| Rate for Payer: Blue Shield of California Commercial |
$31.44
|
| Rate for Payer: Blue Shield of California EPN |
$20.77
|
| Rate for Payer: Cash Price |
$21.15
|
| Rate for Payer: Cash Price |
$21.15
|
| Rate for Payer: Cigna of CA HMO |
$30.08
|
| Rate for Payer: Cigna of CA PPO |
$34.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$44.02
|
| Rate for Payer: Dignity Health Medi-Cal |
$32.28
|
| Rate for Payer: Dignity Health Medicare Advantage |
$29.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$39.62
|
| Rate for Payer: EPIC Health Plan Senior |
$29.35
|
| Rate for Payer: Galaxy Health WC |
$39.95
|
| Rate for Payer: Global Benefits Group Commercial |
$28.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$48.13
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$43.83
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$29.35
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$31.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$49.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$36.98
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$39.33
|
| Rate for Payer: Multiplan Commercial |
$37.60
|
| Rate for Payer: Networks By Design Commercial |
$30.55
|
| Rate for Payer: Prime Health Services Commercial |
$39.95
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$28.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$28.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$23.78
|
| Rate for Payer: United Healthcare All Other HMO |
$23.78
|
| Rate for Payer: United Healthcare HMO Rider |
$23.78
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$23.78
|
| Rate for Payer: Upland Medical Group Pediatric |
$29.35
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$44.02
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$32.28
|
| Rate for Payer: Vantage Medical Group Senior |
$29.35
|
|
|
HC LAB REF IMMUNOGLOBULINS IGA SALIVARY
|
Facility
|
OP
|
$111.00
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
900911376
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.53 |
| Max. Negotiated Rate |
$94.35 |
| Rate for Payer: Adventist Health Commercial |
$22.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$72.80
|
| 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 Medicare Advantage/Dual Product |
$9.30
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$76.54
|
| Rate for Payer: Blue Shield of California Commercial |
$74.26
|
| Rate for Payer: Blue Shield of California EPN |
$49.06
|
| Rate for Payer: Cash Price |
$49.95
|
| Rate for Payer: Cash Price |
$49.95
|
| Rate for Payer: Cigna of CA HMO |
$71.04
|
| Rate for Payer: Cigna of CA PPO |
$82.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$10.23
|
| Rate for Payer: Dignity Health Medicare Advantage |
$9.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.55
|
| Rate for Payer: EPIC Health Plan Senior |
$9.30
|
| Rate for Payer: Galaxy Health WC |
$94.35
|
| Rate for Payer: Global Benefits Group Commercial |
$66.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$15.25
|
| 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: Kaiser Permanente of CA Commercial/Self Funded |
$74.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.55
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$26.64
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11.72
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$12.46
|
| Rate for Payer: Multiplan Commercial |
$88.80
|
| Rate for Payer: Networks By Design Commercial |
$72.15
|
| Rate for Payer: Prime Health Services Commercial |
$94.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$66.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$66.60
|
| 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 HMO Rider |
$7.53
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.53
|
| 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 Medi-Cal |
$10.23
|
| Rate for Payer: Vantage Medical Group Senior |
$9.30
|
|
|
HC LAB REF IMMUNOGLOBULINS IGA SALIVARY
|
Facility
|
IP
|
$111.00
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
900911376
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$22.20 |
| Max. Negotiated Rate |
$94.35 |
| Rate for Payer: Adventist Health Commercial |
$22.20
|
| Rate for Payer: Cash Price |
$49.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$44.40
|
| Rate for Payer: EPIC Health Plan Senior |
$44.40
|
| Rate for Payer: Galaxy Health WC |
$94.35
|
| Rate for Payer: Global Benefits Group Commercial |
$66.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$74.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$42.29
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$68.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$26.64
|
| Rate for Payer: Multiplan Commercial |
$88.80
|
| Rate for Payer: Networks By Design Commercial |
$72.15
|
| Rate for Payer: Prime Health Services Commercial |
$94.35
|
|
|
HC LAB REF INFLUENZA A AB IGM
|
Facility
|
OP
|
$17.00
|
|
|
Service Code
|
CPT 86710
|
| Hospital Charge Code |
900912806
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.40 |
| Max. Negotiated Rate |
$136.45 |
| Rate for Payer: Adventist Health Commercial |
$3.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$11.15
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20.32
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$136.45
|
| Rate for Payer: Blue Shield of California Commercial |
$11.37
|
| Rate for Payer: Blue Shield of California EPN |
$7.51
|
| 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 |
$20.32
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$13.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$18.29
|
| Rate for Payer: EPIC Health Plan Senior |
$13.55
|
| Rate for Payer: Galaxy Health WC |
$14.45
|
| Rate for Payer: Global Benefits Group Commercial |
$10.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$22.22
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$20.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$22.89
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.08
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17.07
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18.16
|
| 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: 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 |
$10.98
|
| Rate for Payer: United Healthcare All Other HMO |
$10.98
|
| Rate for Payer: United Healthcare HMO Rider |
$10.98
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.98
|
| Rate for Payer: Upland Medical Group Pediatric |
$13.55
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.90
|
| Rate for Payer: Vantage Medical Group Senior |
$13.55
|
|
