|
HC LAB REF LCM IGM
|
Facility
|
OP
|
$44.00
|
|
|
Service Code
|
CPT 86727
|
| Hospital Charge Code |
900912723
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.80 |
| Max. Negotiated Rate |
$132.86 |
| Rate for Payer: Adventist Health Commercial |
$8.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$106.99
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12.87
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$132.86
|
| Rate for Payer: Blue Shield of California Commercial |
$20.28
|
| Rate for Payer: Blue Shield of California Commercial |
$30.67
|
| Rate for Payer: Cash Price |
$19.80
|
| Rate for Payer: Cash Price |
$19.80
|
| Rate for Payer: Cigna of CA HMO |
$28.16
|
| Rate for Payer: Cigna of CA PPO |
$32.56
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.16
|
| Rate for Payer: Dignity Health Medicare Advantage |
$12.87
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$30.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$21.24
|
| Rate for Payer: EPIC Health Plan Senior |
$14.16
|
| Rate for Payer: Galaxy Health WC |
$37.40
|
| Rate for Payer: Global Benefits Group Commercial |
$26.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$21.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$19.22
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$12.87
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$27.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$21.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$18.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.56
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16.22
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17.25
|
| Rate for Payer: Multiplan Commercial |
$35.20
|
| Rate for Payer: Networks By Design Commercial |
$28.60
|
| Rate for Payer: Prime Health Services Commercial |
$37.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$26.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$26.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.42
|
| Rate for Payer: United Healthcare All Other HMO |
$10.42
|
| Rate for Payer: United Healthcare HMO Rider |
$10.42
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.42
|
| Rate for Payer: Upland Medical Group Pediatric |
$12.87
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.16
|
| Rate for Payer: Vantage Medical Group Senior |
$12.87
|
|
|
HC LAB REF LEUCINE AMINOPEPTIDASE
|
Facility
|
IP
|
$78.00
|
|
|
Service Code
|
CPT 83670
|
| Hospital Charge Code |
900911220
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.60 |
| Max. Negotiated Rate |
$66.30 |
| Rate for Payer: Adventist Health Commercial |
$15.60
|
| Rate for Payer: Cash Price |
$35.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$54.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$31.20
|
| Rate for Payer: EPIC Health Plan Senior |
$31.20
|
| Rate for Payer: Galaxy Health WC |
$66.30
|
| Rate for Payer: Global Benefits Group Commercial |
$46.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$49.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$46.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18.72
|
| Rate for Payer: Multiplan Commercial |
$62.40
|
| Rate for Payer: Networks By Design Commercial |
$50.70
|
| Rate for Payer: Prime Health Services Commercial |
$66.30
|
|
|
HC LAB REF LEUCINE AMINOPEPTIDASE
|
Facility
|
OP
|
$78.00
|
|
|
Service Code
|
CPT 83670
|
| Hospital Charge Code |
900911220
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.95 |
| Max. Negotiated Rate |
$94.23 |
| Rate for Payer: Adventist Health Commercial |
$15.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$76.27
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$14.71
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10.79
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$94.23
|
| Rate for Payer: Blue Shield of California Commercial |
$35.96
|
| Rate for Payer: Blue Shield of California Commercial |
$54.37
|
| Rate for Payer: Cash Price |
$35.10
|
| Rate for Payer: Cash Price |
$35.10
|
| Rate for Payer: Cigna of CA HMO |
$49.92
|
| Rate for Payer: Cigna of CA PPO |
$57.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$14.71
|
| Rate for Payer: Dignity Health Medi-Cal |
$10.79
|
| Rate for Payer: Dignity Health Medicare Advantage |
$9.81
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$54.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.19
|
| Rate for Payer: EPIC Health Plan Senior |
$10.79
|
| Rate for Payer: Galaxy Health WC |
$66.30
|
| Rate for Payer: Global Benefits Group Commercial |
$46.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$16.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$13.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$9.81
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$49.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$15.48
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$13.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18.72
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$12.36
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$13.15
|
| Rate for Payer: Multiplan Commercial |
$62.40
|
| Rate for Payer: Networks By Design Commercial |
$50.70
|
| Rate for Payer: Prime Health Services Commercial |
$66.30
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$46.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$46.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.95
|
| Rate for Payer: United Healthcare All Other HMO |
$7.95
|
| Rate for Payer: United Healthcare HMO Rider |
$7.95
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.95
|
| Rate for Payer: Upland Medical Group Pediatric |
$9.81
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$14.71
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.79
|
| Rate for Payer: Vantage Medical Group Senior |
$9.81
|
|
|
HC LAB REF LIDOCAINE
|
Facility
|
IP
|
$18.00
|
|
|
Service Code
|
CPT 80176
|
| Hospital Charge Code |
900910404
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.60 |
| Max. Negotiated Rate |
$15.30 |
| Rate for Payer: Adventist Health Commercial |
$3.60
|
| Rate for Payer: Cash Price |
$8.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$12.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.20
|
| Rate for Payer: EPIC Health Plan Senior |
$7.20
|
| Rate for Payer: Galaxy Health WC |
$15.30
|
| Rate for Payer: Global Benefits Group Commercial |
$10.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$11.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.32
|
| Rate for Payer: Multiplan Commercial |
$14.40
|
| Rate for Payer: Networks By Design Commercial |
$11.70
|
| Rate for Payer: Prime Health Services Commercial |
$15.30
|
|
|
HC LAB REF LIDOCAINE
|
Facility
|
OP
|
$18.00
|
|
|
Service Code
|
CPT 80176
|
| Hospital Charge Code |
900910404
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.60 |
| Max. Negotiated Rate |
$151.56 |
| Rate for Payer: Adventist Health Commercial |
$3.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$122.15
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$22.04
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$16.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14.69
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$151.56
|
| Rate for Payer: Blue Shield of California Commercial |
$12.55
|
| Rate for Payer: Blue Shield of California Commercial |
$8.30
|
| Rate for Payer: Cash Price |
$8.10
|
| Rate for Payer: Cash Price |
$8.10
|
| Rate for Payer: Cigna of CA HMO |
$11.52
|
| Rate for Payer: Cigna of CA PPO |
$13.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$22.04
|
| Rate for Payer: Dignity Health Medi-Cal |
$16.16
|
| Rate for Payer: Dignity Health Medicare Advantage |
$14.69
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$12.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$24.24
|
| Rate for Payer: EPIC Health Plan Senior |
$16.16
|
| Rate for Payer: Galaxy Health WC |
$15.30
|
| Rate for Payer: Global Benefits Group Commercial |
$10.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$24.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$21.94
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$14.69
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$11.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$24.81
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$20.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18.51
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$19.68
|
| Rate for Payer: Multiplan Commercial |
$14.40
|
| Rate for Payer: Networks By Design Commercial |
$11.70
|
| Rate for Payer: Prime Health Services Commercial |
$15.30
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$10.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$11.90
|
| Rate for Payer: United Healthcare All Other HMO |
$11.90
|
| Rate for Payer: United Healthcare HMO Rider |
$11.90
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.90
|
| Rate for Payer: Upland Medical Group Pediatric |
$14.69
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$22.04
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$16.16
|
| Rate for Payer: Vantage Medical Group Senior |
$14.69
|
|
|
HC LAB REF LIPID PANEL, CARDIAC
|
Facility
|
OP
|
$22.00
|
|
|
Service Code
|
CPT 80061
|
| Hospital Charge Code |
900912578
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.40 |
| Max. Negotiated Rate |
$138.21 |
| Rate for Payer: Dignity Health Medi-Cal |
$14.73
|
| Rate for Payer: Adventist Health Commercial |
$4.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$111.37
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20.09
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.73
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13.39
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$138.21
|
| Rate for Payer: Blue Shield of California Commercial |
$10.14
|
| Rate for Payer: Blue Shield of California Commercial |
$15.33
|
| Rate for Payer: Cash Price |
$9.90
|
| Rate for Payer: Cash Price |
$9.90
|
| Rate for Payer: Cigna of CA HMO |
$14.08
|
| Rate for Payer: Cigna of CA PPO |
$16.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20.09
|
| Rate for Payer: Dignity Health Medicare Advantage |
$13.39
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$15.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$22.09
|
| Rate for Payer: EPIC Health Plan Senior |
$14.73
|
| Rate for Payer: Galaxy Health WC |
$18.70
|
| Rate for Payer: Global Benefits Group Commercial |
$13.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$21.96
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$19.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13.39
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$13.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$21.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$18.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16.87
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17.94
|
| Rate for Payer: Multiplan Commercial |
$17.60
|
| Rate for Payer: Networks By Design Commercial |
$14.30
|
| Rate for Payer: Prime Health Services Commercial |
$18.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$13.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$13.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.85
|
| Rate for Payer: United Healthcare All Other HMO |
$10.85
|
| Rate for Payer: United Healthcare HMO Rider |
$10.85
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.85
|
| Rate for Payer: Upland Medical Group Pediatric |
$13.39
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20.09
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.73
|
| Rate for Payer: Vantage Medical Group Senior |
$13.39
|
|
|
HC LAB REF LISTERIA AB
|
Facility
|
IP
|
$110.00
|
|
|
Service Code
|
CPT 86609
|
| Hospital Charge Code |
900911391
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$22.00 |
| Max. Negotiated Rate |
$93.50 |
| Rate for Payer: Adventist Health Commercial |
$22.00
|
| Rate for Payer: Cash Price |
$49.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$77.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$44.00
|
| Rate for Payer: EPIC Health Plan Senior |
$44.00
|
| Rate for Payer: Galaxy Health WC |
$93.50
|
| Rate for Payer: Global Benefits Group Commercial |
$66.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$69.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$64.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$26.40
|
| Rate for Payer: Multiplan Commercial |
$88.00
|
| Rate for Payer: Networks By Design Commercial |
$71.50
|
| Rate for Payer: Prime Health Services Commercial |
$93.50
|
|
|
HC LAB REF LISTERIA AB
|
Facility
|
OP
|
$110.00
|
|
|
Service Code
|
CPT 86609
|
| Hospital Charge Code |
900911391
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.43 |
| Max. Negotiated Rate |
$133.00 |
| Rate for Payer: Cigna of CA PPO |
$81.40
|
| Rate for Payer: Adventist Health Commercial |
$22.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$107.13
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19.32
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.17
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$133.00
|
| Rate for Payer: Blue Shield of California Commercial |
$50.71
|
| Rate for Payer: Blue Shield of California Commercial |
$76.67
|
| Rate for Payer: Cash Price |
$49.50
|
| Rate for Payer: Cash Price |
$49.50
|
| Rate for Payer: Cigna of CA HMO |
$70.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.32
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.17
|
| Rate for Payer: Dignity Health Medicare Advantage |
$12.88
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$77.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$21.25
|
| Rate for Payer: EPIC Health Plan Senior |
$14.17
|
| Rate for Payer: Galaxy Health WC |
$93.50
|
| Rate for Payer: Global Benefits Group Commercial |
$66.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$21.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$19.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$12.88
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$69.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$21.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$18.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$26.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16.23
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17.26
|
| Rate for Payer: Multiplan Commercial |
$88.00
|
| Rate for Payer: Networks By Design Commercial |
$71.50
|
| Rate for Payer: Prime Health Services Commercial |
$93.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$66.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$66.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.43
|
| Rate for Payer: United Healthcare All Other HMO |
$10.43
|
| Rate for Payer: United Healthcare HMO Rider |
$10.43
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.43
|
| Rate for Payer: Upland Medical Group Pediatric |
$12.88
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.17
|
| Rate for Payer: Vantage Medical Group Senior |
$12.88
|
|
|
HC LAB REF METHEMALBUMIN
|
Facility
|
OP
|
$115.00
|
|
|
Service Code
|
CPT 83857
|
| Hospital Charge Code |
900911067
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.70 |
| Max. Negotiated Rate |
$110.83 |
| Rate for Payer: United Healthcare HMO Rider |
$8.70
|
| Rate for Payer: Adventist Health Commercial |
$23.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$89.34
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$16.11
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11.81
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10.74
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$110.83
|
| Rate for Payer: Blue Shield of California Commercial |
$53.02
|
| Rate for Payer: Blue Shield of California Commercial |
$80.16
|
| Rate for Payer: Cash Price |
$51.75
|
| Rate for Payer: Cash Price |
$51.75
|
| Rate for Payer: Cigna of CA HMO |
$73.60
|
| Rate for Payer: Cigna of CA PPO |
$85.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$16.11
|
| Rate for Payer: Dignity Health Medi-Cal |
$11.81
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10.74
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$80.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$17.72
|
| Rate for Payer: EPIC Health Plan Senior |
$11.81
|
| Rate for Payer: Galaxy Health WC |
$97.75
|
| Rate for Payer: Global Benefits Group Commercial |
$69.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$17.61
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$16.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10.74
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$73.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$18.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$15.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$13.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14.39
|
| Rate for Payer: Multiplan Commercial |
$92.00
|
| Rate for Payer: Networks By Design Commercial |
$74.75
|
| Rate for Payer: Prime Health Services Commercial |
$97.75
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$69.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$69.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$8.70
|
| Rate for Payer: United Healthcare All Other HMO |
$8.70
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8.70
|
| Rate for Payer: Upland Medical Group Pediatric |
$10.74
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$16.11
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11.81
|
| Rate for Payer: Vantage Medical Group Senior |
$10.74
|
|
|
HC LAB REF METHEMALBUMIN
|
Facility
|
IP
|
$115.00
|
|
|
Service Code
|
CPT 83857
|
| Hospital Charge Code |
900911067
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$23.00 |
| Max. Negotiated Rate |
$97.75 |
| Rate for Payer: Adventist Health Commercial |
$23.00
|
| Rate for Payer: Cash Price |
$51.75
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$80.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$46.00
|
| Rate for Payer: EPIC Health Plan Senior |
$46.00
|
| Rate for Payer: Galaxy Health WC |
$97.75
|
| Rate for Payer: Global Benefits Group Commercial |
$69.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$73.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$67.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27.60
|
| Rate for Payer: Multiplan Commercial |
$92.00
|
| Rate for Payer: Networks By Design Commercial |
$74.75
|
| Rate for Payer: Prime Health Services Commercial |
$97.75
|
|
|
HC LAB REF METHEMOGLOBIN
|
Facility
|
OP
|
$10.00
|
|
|
Service Code
|
CPT 83050
|
| Hospital Charge Code |
900910295
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.00 |
| Max. Negotiated Rate |
$75.60 |
| Rate for Payer: Adventist Health Commercial |
$2.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$60.90
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9.02
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.20
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$75.60
|
| Rate for Payer: Blue Shield of California Commercial |
$4.61
|
| Rate for Payer: Blue Shield of California Commercial |
$6.97
|
| Rate for Payer: Cash Price |
$4.50
|
| Rate for Payer: Cash Price |
$4.50
|
| Rate for Payer: Cigna of CA HMO |
$6.40
|
| Rate for Payer: Cigna of CA PPO |
$7.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.02
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.53
|
| Rate for Payer: EPIC Health Plan Senior |
$9.02
|
| Rate for Payer: Galaxy Health WC |
$8.50
|
| Rate for Payer: Global Benefits Group Commercial |
$6.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$13.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$10.65
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$12.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$11.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.33
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10.99
|
| Rate for Payer: Multiplan Commercial |
$8.00
|
| Rate for Payer: Networks By Design Commercial |
$6.50
|
| Rate for Payer: Prime Health Services Commercial |
$8.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.64
|
| Rate for Payer: United Healthcare All Other HMO |
$6.64
|
| Rate for Payer: United Healthcare HMO Rider |
$6.64
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.64
|
| Rate for Payer: Upland Medical Group Pediatric |
$8.20
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.02
|
| Rate for Payer: Vantage Medical Group Senior |
$8.20
|
|
|
HC LAB REF METHEMOGLOBIN
|
Facility
|
IP
|
$10.00
|
|
|
Service Code
|
CPT 83050
|
| Hospital Charge Code |
900910295
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.00 |
| Max. Negotiated Rate |
$8.50 |
| Rate for Payer: Adventist Health Commercial |
$2.00
|
| Rate for Payer: Cash Price |
$4.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.00
|
| Rate for Payer: EPIC Health Plan Senior |
$4.00
|
| Rate for Payer: Galaxy Health WC |
$8.50
|
| Rate for Payer: Global Benefits Group Commercial |
$6.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.40
|
| Rate for Payer: Multiplan Commercial |
$8.00
|
| Rate for Payer: Networks By Design Commercial |
$6.50
|
| Rate for Payer: Prime Health Services Commercial |
$8.50
|
|
|
HC LAB REF MITOCHONDRIAL DNA
|
Facility
|
IP
|
$1,316.00
|
|
|
Service Code
|
CPT 84999
|
| Hospital Charge Code |
900911407
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$263.20 |
| Max. Negotiated Rate |
$1,118.60 |
| Rate for Payer: Adventist Health Commercial |
$263.20
|
| Rate for Payer: Cash Price |
$592.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$921.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$526.40
|
| Rate for Payer: EPIC Health Plan Senior |
$526.40
|
| Rate for Payer: Galaxy Health WC |
$1,118.60
|
| Rate for Payer: Global Benefits Group Commercial |
$789.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$835.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$776.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$315.84
|
| Rate for Payer: Multiplan Commercial |
$1,052.80
|
| Rate for Payer: Networks By Design Commercial |
$855.40
|
| Rate for Payer: Prime Health Services Commercial |
$1,118.60
|
|
|
HC LAB REF MITOCHONDRIAL DNA
|
Facility
|
OP
|
$1,316.00
|
|
|
Service Code
|
CPT 84999
|
| Hospital Charge Code |
900911407
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$263.20 |
| Max. Negotiated Rate |
$1,118.60 |
| Rate for Payer: Adventist Health Commercial |
$263.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$863.16
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,118.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$723.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$987.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$844.48
|
| Rate for Payer: Blue Shield of California Commercial |
$606.68
|
| Rate for Payer: Blue Shield of California Commercial |
$917.25
|
| Rate for Payer: Cash Price |
$592.20
|
| Rate for Payer: Cigna of CA HMO |
$842.24
|
| Rate for Payer: Cigna of CA PPO |
$973.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,118.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,118.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,118.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$921.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$526.40
|
| Rate for Payer: EPIC Health Plan Senior |
$526.40
|
| Rate for Payer: Galaxy Health WC |
$1,118.60
|
| Rate for Payer: Global Benefits Group Commercial |
$789.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$835.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$776.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$315.84
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$921.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$921.20
|
| Rate for Payer: Multiplan Commercial |
$1,052.80
|
| Rate for Payer: Networks By Design Commercial |
$855.40
|
| Rate for Payer: Prime Health Services Commercial |
$1,118.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$789.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$789.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$658.00
|
| Rate for Payer: United Healthcare All Other HMO |
$658.00
|
| Rate for Payer: United Healthcare HMO Rider |
$658.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$658.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,118.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,118.60
|
| Rate for Payer: Vantage Medical Group Senior |
$1,118.60
|
|
|
HC LAB REF MMR MUMPS IGG IFA
|
Facility
|
IP
|
$54.00
|
|
|
Service Code
|
CPT 86735
|
| Hospital Charge Code |
900912870
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.80 |
| Max. Negotiated Rate |
$45.90 |
| Rate for Payer: Adventist Health Commercial |
$10.80
|
| Rate for Payer: Cash Price |
$24.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$37.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$21.60
|
| Rate for Payer: EPIC Health Plan Senior |
$21.60
|
| Rate for Payer: Galaxy Health WC |
$45.90
|
| Rate for Payer: Global Benefits Group Commercial |
$32.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$34.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$31.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.96
|
| Rate for Payer: Multiplan Commercial |
$43.20
|
| Rate for Payer: Networks By Design Commercial |
$35.10
|
| Rate for Payer: Prime Health Services Commercial |
$45.90
|
|
|
HC LAB REF MMR MUMPS IGG IFA
|
Facility
|
OP
|
$54.00
|
|
|
Service Code
|
CPT 86735
|
| Hospital Charge Code |
900912870
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.57 |
| Max. Negotiated Rate |
$136.13 |
| Rate for Payer: Adventist Health Commercial |
$10.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$108.52
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.36
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$136.13
|
| Rate for Payer: Blue Shield of California Commercial |
$24.89
|
| Rate for Payer: Blue Shield of California Commercial |
$37.64
|
| Rate for Payer: Cash Price |
$24.30
|
| Rate for Payer: Cash Price |
$24.30
|
| Rate for Payer: Cigna of CA HMO |
$34.56
|
| Rate for Payer: Cigna of CA PPO |
$39.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.57
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.36
|
| Rate for Payer: Dignity Health Medicare Advantage |
$13.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$37.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$21.53
|
| Rate for Payer: EPIC Health Plan Senior |
$14.36
|
| Rate for Payer: Galaxy Health WC |
$45.90
|
| Rate for Payer: Global Benefits Group Commercial |
$32.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$21.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$19.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$34.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$22.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$18.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.96
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16.44
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17.49
|
| Rate for Payer: Multiplan Commercial |
$43.20
|
| Rate for Payer: Networks By Design Commercial |
$35.10
|
| Rate for Payer: Prime Health Services Commercial |
$45.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$32.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$32.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.57
|
| Rate for Payer: United Healthcare All Other HMO |
$10.57
|
| Rate for Payer: United Healthcare HMO Rider |
$10.57
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.57
|
| Rate for Payer: Upland Medical Group Pediatric |
$13.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.36
|
| Rate for Payer: Vantage Medical Group Senior |
$13.05
|
|
|
HC LAB REF MMR RUBELLA IGG ELISA
|
Facility
|
IP
|
$60.00
|
|
|
Service Code
|
CPT 86762
|
| Hospital Charge Code |
900912871
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.00 |
| Max. Negotiated Rate |
$51.00 |
| Rate for Payer: Adventist Health Commercial |
$12.00
|
| Rate for Payer: Cash Price |
$27.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$42.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$24.00
|
| Rate for Payer: EPIC Health Plan Senior |
$24.00
|
| Rate for Payer: Galaxy Health WC |
$51.00
|
| Rate for Payer: Global Benefits Group Commercial |
$36.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$38.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$35.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.40
|
| Rate for Payer: Multiplan Commercial |
$48.00
|
| Rate for Payer: Networks By Design Commercial |
$39.00
|
| Rate for Payer: Prime Health Services Commercial |
$51.00
|
|
|
HC LAB REF MMR RUBELLA IGG ELISA
|
Facility
|
OP
|
$60.00
|
|
|
Service Code
|
CPT 86762
|
| Hospital Charge Code |
900912871
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.65 |
| Max. Negotiated Rate |
$148.08 |
| Rate for Payer: Adventist Health Commercial |
$12.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$119.65
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21.59
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15.83
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14.39
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$148.08
|
| Rate for Payer: Blue Shield of California Commercial |
$27.66
|
| Rate for Payer: Blue Shield of California Commercial |
$41.82
|
| Rate for Payer: Cash Price |
$27.00
|
| Rate for Payer: Cash Price |
$27.00
|
| Rate for Payer: Cigna of CA HMO |
$38.40
|
| Rate for Payer: Cigna of CA PPO |
$44.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21.59
|
| Rate for Payer: Dignity Health Medi-Cal |
$15.83
|
| Rate for Payer: Dignity Health Medicare Advantage |
$14.39
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$42.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$23.74
|
| Rate for Payer: EPIC Health Plan Senior |
$15.83
|
| Rate for Payer: Galaxy Health WC |
$51.00
|
| Rate for Payer: Global Benefits Group Commercial |
$36.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$23.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$21.49
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$14.39
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$38.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$24.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$20.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18.13
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$19.28
|
| Rate for Payer: Multiplan Commercial |
$48.00
|
| Rate for Payer: Networks By Design Commercial |
$39.00
|
| Rate for Payer: Prime Health Services Commercial |
$51.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$36.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$36.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$11.65
|
| Rate for Payer: United Healthcare All Other HMO |
$11.65
|
| Rate for Payer: United Healthcare HMO Rider |
$11.65
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.65
|
| Rate for Payer: Upland Medical Group Pediatric |
$14.39
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21.59
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15.83
|
| Rate for Payer: Vantage Medical Group Senior |
$14.39
|
|
|
HC LAB REF MMR RUBEOLA IGG IFA
|
Facility
|
OP
|
$53.00
|
|
|
Service Code
|
CPT 86765
|
| Hospital Charge Code |
900912869
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.43 |
| Max. Negotiated Rate |
$133.00 |
| Rate for Payer: Cigna of CA PPO |
$39.22
|
| Rate for Payer: Adventist Health Commercial |
$10.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$107.13
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19.32
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.17
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$133.00
|
| Rate for Payer: Blue Shield of California Commercial |
$24.43
|
| Rate for Payer: Blue Shield of California Commercial |
$36.94
|
| Rate for Payer: Cash Price |
$23.85
|
| Rate for Payer: Cash Price |
$23.85
|
| Rate for Payer: Cigna of CA HMO |
$33.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.32
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.17
|
| Rate for Payer: Dignity Health Medicare Advantage |
$12.88
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$37.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$21.25
|
| Rate for Payer: EPIC Health Plan Senior |
$14.17
|
| Rate for Payer: Galaxy Health WC |
$45.05
|
| Rate for Payer: Global Benefits Group Commercial |
$31.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$21.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$19.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$12.88
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$33.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$21.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$18.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.72
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16.23
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17.26
|
| Rate for Payer: Multiplan Commercial |
$42.40
|
| Rate for Payer: Networks By Design Commercial |
$34.45
|
| Rate for Payer: Prime Health Services Commercial |
$45.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$31.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$31.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.43
|
| Rate for Payer: United Healthcare All Other HMO |
$10.43
|
| Rate for Payer: United Healthcare HMO Rider |
$10.43
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.43
|
| Rate for Payer: Upland Medical Group Pediatric |
$12.88
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.17
|
| Rate for Payer: Vantage Medical Group Senior |
$12.88
|
|
|
HC LAB REF MMR RUBEOLA IGG IFA
|
Facility
|
IP
|
$53.00
|
|
|
Service Code
|
CPT 86765
|
| Hospital Charge Code |
900912869
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.60 |
| Max. Negotiated Rate |
$45.05 |
| Rate for Payer: Adventist Health Commercial |
$10.60
|
| Rate for Payer: Cash Price |
$23.85
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$37.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$21.20
|
| Rate for Payer: EPIC Health Plan Senior |
$21.20
|
| Rate for Payer: Galaxy Health WC |
$45.05
|
| Rate for Payer: Global Benefits Group Commercial |
$31.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$33.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$31.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.72
|
| Rate for Payer: Multiplan Commercial |
$42.40
|
| Rate for Payer: Networks By Design Commercial |
$34.45
|
| Rate for Payer: Prime Health Services Commercial |
$45.05
|
|
|
HC LAB REF MOLECULAR CYTOGENETICS,DNA PRO
|
Facility
|
OP
|
$34.00
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
900910683
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$6.80 |
| Max. Negotiated Rate |
$1,751.12 |
| Rate for Payer: Adventist Health Commercial |
$6.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$178.12
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$32.13
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$23.56
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$21.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,751.12
|
| Rate for Payer: Blue Shield of California Commercial |
$15.67
|
| Rate for Payer: Blue Shield of California Commercial |
$23.70
|
| Rate for Payer: Cash Price |
$15.30
|
| Rate for Payer: Cash Price |
$15.30
|
| Rate for Payer: Cigna of CA HMO |
$21.76
|
| Rate for Payer: Cigna of CA PPO |
$25.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$32.13
|
| Rate for Payer: Dignity Health Medi-Cal |
$23.56
|
| Rate for Payer: Dignity Health Medicare Advantage |
$21.42
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$23.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$35.34
|
| Rate for Payer: EPIC Health Plan Senior |
$23.56
|
| Rate for Payer: Galaxy Health WC |
$28.90
|
| Rate for Payer: Global Benefits Group Commercial |
$20.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$35.13
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$28.22
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$21.42
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$21.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$31.92
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$29.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$26.99
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$28.70
|
| Rate for Payer: Multiplan Commercial |
$27.20
|
| Rate for Payer: Networks By Design Commercial |
$22.10
|
| Rate for Payer: Prime Health Services Commercial |
$28.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$20.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$20.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$17.35
|
| Rate for Payer: United Healthcare All Other HMO |
$17.35
|
| Rate for Payer: United Healthcare HMO Rider |
$17.35
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$17.35
|
| Rate for Payer: Upland Medical Group Pediatric |
$21.42
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$32.13
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$23.56
|
| Rate for Payer: Vantage Medical Group Senior |
$21.42
|
|
|
HC LAB REF MOLECULAR CYTOGENETICS,DNA PRO
|
Facility
|
IP
|
$34.00
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
900910683
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$6.80 |
| Max. Negotiated Rate |
$28.90 |
| Rate for Payer: Networks By Design Commercial |
$22.10
|
| Rate for Payer: Multiplan Commercial |
$27.20
|
| Rate for Payer: Adventist Health Commercial |
$6.80
|
| Rate for Payer: Cash Price |
$15.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$23.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.60
|
| Rate for Payer: EPIC Health Plan Senior |
$13.60
|
| Rate for Payer: Galaxy Health WC |
$28.90
|
| Rate for Payer: Global Benefits Group Commercial |
$20.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$21.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$20.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.16
|
| Rate for Payer: Prime Health Services Commercial |
$28.90
|
|
|
HC LAB REF MOLECULAR CYTOGENTCS 100-300CE
|
Facility
|
IP
|
$64.00
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
900910679
|
|
Hospital Revenue Code
|
310
|
| 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 LAB REF MOLECULAR CYTOGENTCS 100-300CE
|
Facility
|
OP
|
$64.00
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
900910679
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$12.80 |
| Max. Negotiated Rate |
$2,701.73 |
| Rate for Payer: Adventist Health Commercial |
$12.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$333.91
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$76.78
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$56.31
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$51.19
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,701.73
|
| Rate for Payer: Blue Shield of California Commercial |
$29.50
|
| Rate for Payer: Blue Shield of California Commercial |
$44.61
|
| 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 |
$76.78
|
| Rate for Payer: Dignity Health Medi-Cal |
$56.31
|
| Rate for Payer: Dignity Health Medicare Advantage |
$51.19
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$44.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$84.46
|
| Rate for Payer: EPIC Health Plan Senior |
$56.31
|
| Rate for Payer: Galaxy Health WC |
$54.40
|
| Rate for Payer: Global Benefits Group Commercial |
$38.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$83.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$53.22
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$51.19
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$40.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$60.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$71.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$64.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$68.59
|
| 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 |
$41.46
|
| Rate for Payer: United Healthcare All Other HMO |
$41.46
|
| Rate for Payer: United Healthcare HMO Rider |
$41.46
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$41.46
|
| Rate for Payer: Upland Medical Group Pediatric |
$51.19
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$76.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$56.31
|
| Rate for Payer: Vantage Medical Group Senior |
$51.19
|
|
|
HC LAB REF MORPHOMETRIC ANALYSIS IN SITU
|
Facility
|
OP
|
$73.00
|
|
|
Service Code
|
CPT 88368
|
| Hospital Charge Code |
900912796
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$14.60 |
| Max. Negotiated Rate |
$1,135.57 |
| Rate for Payer: EPIC Health Plan Senior |
$507.12
|
| Rate for Payer: Galaxy Health WC |
$62.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$760.68
|
| Rate for Payer: Adventist Health Commercial |
$14.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,135.57
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$691.53
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$507.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$461.02
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$888.49
|
| Rate for Payer: Blue Shield of California Commercial |
$33.65
|
| Rate for Payer: Blue Shield of California Commercial |
$50.88
|
| Rate for Payer: Cash Price |
$32.85
|
| Rate for Payer: Cash Price |
$32.85
|
| Rate for Payer: Cigna of CA HMO |
$46.72
|
| Rate for Payer: Cigna of CA PPO |
$54.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$691.53
|
| Rate for Payer: Dignity Health Medi-Cal |
$507.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$461.02
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$51.10
|
| Rate for Payer: Global Benefits Group Commercial |
$43.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$756.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$126.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$461.02
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$46.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$143.28
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$645.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$17.52
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$580.89
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$617.77
|
| Rate for Payer: Multiplan Commercial |
$58.40
|
| Rate for Payer: Networks By Design Commercial |
$47.45
|
| Rate for Payer: Prime Health Services Commercial |
$62.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$43.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$43.80
|
| 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 HMO Rider |
$240.94
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$240.94
|
| Rate for Payer: Upland Medical Group Pediatric |
$461.02
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$691.53
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$507.12
|
| Rate for Payer: Vantage Medical Group Senior |
$461.02
|
|
