|
HC LYMPH NODE NDLE BPSY, DP AX
|
Facility
|
OP
|
$5,644.00
|
|
|
Service Code
|
CPT 38525
|
| Hospital Charge Code |
909000129
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$248.30 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Vantage Medical Group Senior |
$5,035.90
|
| Rate for Payer: Adventist Health Commercial |
$1,128.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,553.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,539.49
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5,035.90
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,716.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,574.78
|
| Rate for Payer: Blue Shield of California Commercial |
$3,897.87
|
| Rate for Payer: Cash Price |
$2,539.80
|
| Rate for Payer: Cash Price |
$2,539.80
|
| Rate for Payer: Cash Price |
$2,539.80
|
| Rate for Payer: Cigna of CA HMO |
$3,612.16
|
| Rate for Payer: Cigna of CA PPO |
$4,176.56
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,553.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,539.49
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5,035.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,950.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,309.24
|
| Rate for Payer: EPIC Health Plan Senior |
$5,539.49
|
| Rate for Payer: Galaxy Health WC |
$4,797.40
|
| Rate for Payer: Global Benefits Group Commercial |
$3,386.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$8,258.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$248.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5,035.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,583.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$280.82
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7,050.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,354.56
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,345.23
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,748.11
|
| Rate for Payer: Multiplan Commercial |
$4,515.20
|
| Rate for Payer: Multiplan WC |
$7,752.28
|
| Rate for Payer: Networks By Design Commercial |
$3,668.60
|
| Rate for Payer: Prime Health Services Commercial |
$4,797.40
|
| Rate for Payer: Prime Health Services WC |
$7,673.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,386.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,822.00
|
| Rate for Payer: United Healthcare All Other HMO |
$16,122.00
|
| Rate for Payer: United Healthcare HMO Rider |
$10,165.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9,312.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$5,035.90
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,553.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,539.49
|
|
|
HC LYMPH NODE NDLE BPSY, DP AX
|
Facility
|
IP
|
$5,644.00
|
|
|
Service Code
|
CPT 38525
|
| Hospital Charge Code |
909000129
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,128.80 |
| Max. Negotiated Rate |
$4,797.40 |
| Rate for Payer: Adventist Health Commercial |
$1,128.80
|
| Rate for Payer: Cash Price |
$2,539.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,950.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,257.60
|
| Rate for Payer: EPIC Health Plan Senior |
$2,257.60
|
| Rate for Payer: Galaxy Health WC |
$4,797.40
|
| Rate for Payer: Global Benefits Group Commercial |
$3,386.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,583.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,329.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,354.56
|
| Rate for Payer: Multiplan Commercial |
$4,515.20
|
| Rate for Payer: Networks By Design Commercial |
$3,668.60
|
| Rate for Payer: Prime Health Services Commercial |
$4,797.40
|
|
|
HC LYMPH NODE NDLE BPSY, DP CE
|
Facility
|
IP
|
$8,340.00
|
|
|
Service Code
|
CPT 38510
|
| Hospital Charge Code |
909000128
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,668.00 |
| Max. Negotiated Rate |
$7,089.00 |
| Rate for Payer: Adventist Health Commercial |
$1,668.00
|
| Rate for Payer: Cash Price |
$3,753.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,838.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,336.00
|
| Rate for Payer: EPIC Health Plan Senior |
$3,336.00
|
| Rate for Payer: Galaxy Health WC |
$7,089.00
|
| Rate for Payer: Global Benefits Group Commercial |
$5,004.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,295.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,920.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,001.60
|
| Rate for Payer: Multiplan Commercial |
$6,672.00
|
| Rate for Payer: Networks By Design Commercial |
$5,421.00
|
| Rate for Payer: Prime Health Services Commercial |
$7,089.00
|
|
|
HC LYMPH NODE NDLE BPSY, DP CE
|
Facility
|
OP
|
$8,340.00
|
|
|
Service Code
|
CPT 38510
|
| Hospital Charge Code |
909000128
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$242.68 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$1,668.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,553.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,539.49
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5,035.90
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,716.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,574.78
|
| Rate for Payer: Blue Shield of California Commercial |
$3,897.87
|
| Rate for Payer: Cash Price |
$3,753.00
|
| Rate for Payer: Cash Price |
$3,753.00
|
| Rate for Payer: Cash Price |
$3,753.00
|
| Rate for Payer: Cigna of CA HMO |
$5,337.60
|
| Rate for Payer: Cigna of CA PPO |
$6,171.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,553.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,539.49
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5,035.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,838.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,309.24
|
| Rate for Payer: EPIC Health Plan Senior |
$5,539.49
|
| Rate for Payer: Galaxy Health WC |
$7,089.00
|
| Rate for Payer: Global Benefits Group Commercial |
$5,004.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$8,258.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$242.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5,035.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,295.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$274.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7,050.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,001.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,345.23
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,748.11
|
| Rate for Payer: Multiplan Commercial |
$6,672.00
|
| Rate for Payer: Multiplan WC |
$7,752.28
|
| Rate for Payer: Networks By Design Commercial |
$5,421.00
|
| Rate for Payer: Prime Health Services Commercial |
$7,089.00
|
| Rate for Payer: Prime Health Services WC |
$7,673.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,004.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,170.00
|
| Rate for Payer: United Healthcare All Other HMO |
$16,122.00
|
| Rate for Payer: United Healthcare HMO Rider |
$10,165.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9,312.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$5,035.90
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,553.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,539.49
|
| Rate for Payer: Vantage Medical Group Senior |
$5,035.90
|
|
|
HC LYMPH NODE NDLE BPSY, INT M
|
Facility
|
OP
|
$8,656.00
|
|
|
Service Code
|
CPT 38530
|
| Hospital Charge Code |
909000130
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$99.46 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$1,731.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,553.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,539.49
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5,035.90
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,716.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,574.78
|
| Rate for Payer: Blue Shield of California Commercial |
$3,897.87
|
| Rate for Payer: Cash Price |
$3,895.20
|
| Rate for Payer: Cash Price |
$3,895.20
|
| Rate for Payer: Cash Price |
$3,895.20
|
| Rate for Payer: Cigna of CA HMO |
$5,539.84
|
| Rate for Payer: Cigna of CA PPO |
$6,405.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,553.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,539.49
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5,035.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,059.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,309.24
|
| Rate for Payer: EPIC Health Plan Senior |
$5,539.49
|
| Rate for Payer: Galaxy Health WC |
$7,357.60
|
| Rate for Payer: Global Benefits Group Commercial |
$5,193.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$8,258.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$99.46
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5,035.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,496.56
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$112.48
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7,050.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,077.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,345.23
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,748.11
|
| Rate for Payer: Multiplan Commercial |
$6,924.80
|
| Rate for Payer: Multiplan WC |
$7,752.28
|
| Rate for Payer: Networks By Design Commercial |
$5,626.40
|
| Rate for Payer: Prime Health Services Commercial |
$7,357.60
|
| Rate for Payer: Prime Health Services WC |
$7,673.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,193.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,328.00
|
| Rate for Payer: United Healthcare All Other HMO |
$16,122.00
|
| Rate for Payer: United Healthcare HMO Rider |
$10,165.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9,312.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$5,035.90
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,553.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,539.49
|
| Rate for Payer: Vantage Medical Group Senior |
$5,035.90
|
|
|
HC LYMPH NODE NDLE BPSY, INT M
|
Facility
|
IP
|
$8,656.00
|
|
|
Service Code
|
CPT 38530
|
| Hospital Charge Code |
909000130
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,731.20 |
| Max. Negotiated Rate |
$7,357.60 |
| Rate for Payer: Adventist Health Commercial |
$1,731.20
|
| Rate for Payer: Cash Price |
$3,895.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,059.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,462.40
|
| Rate for Payer: EPIC Health Plan Senior |
$3,462.40
|
| Rate for Payer: Galaxy Health WC |
$7,357.60
|
| Rate for Payer: Global Benefits Group Commercial |
$5,193.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,496.56
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,107.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,077.44
|
| Rate for Payer: Multiplan Commercial |
$6,924.80
|
| Rate for Payer: Networks By Design Commercial |
$5,626.40
|
| Rate for Payer: Prime Health Services Commercial |
$7,357.60
|
|
|
HC LYMPH NODE NDLE BPSY,SUPFCL
|
Facility
|
OP
|
$3,714.00
|
|
|
Service Code
|
CPT 38505
|
| Hospital Charge Code |
909000127
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$118.84 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$742.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,186.34
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,336.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,124.23
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,924.01
|
| Rate for Payer: Blue Shield of California Commercial |
$2,912.69
|
| Rate for Payer: Cash Price |
$1,671.30
|
| Rate for Payer: Cash Price |
$1,671.30
|
| Rate for Payer: Cash Price |
$1,671.30
|
| Rate for Payer: Cigna of CA HMO |
$2,376.96
|
| Rate for Payer: Cigna of CA PPO |
$2,748.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,186.34
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,336.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,124.23
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,599.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,504.98
|
| Rate for Payer: EPIC Health Plan Senior |
$2,336.65
|
| Rate for Payer: Galaxy Health WC |
$3,156.90
|
| Rate for Payer: Global Benefits Group Commercial |
$2,228.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,483.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$118.84
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,124.23
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,358.39
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$134.41
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,973.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$891.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,676.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,846.47
|
| Rate for Payer: Multiplan Commercial |
$2,971.20
|
| Rate for Payer: Multiplan WC |
$3,280.13
|
| Rate for Payer: Networks By Design Commercial |
$2,414.10
|
| Rate for Payer: Prime Health Services Commercial |
$3,156.90
|
| Rate for Payer: Prime Health Services WC |
$3,246.66
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,228.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,857.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,124.23
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,186.34
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,336.65
|
| Rate for Payer: Vantage Medical Group Senior |
$2,124.23
|
|
|
HC LYMPH NODE NDLE BPSY,SUPFCL
|
Facility
|
IP
|
$3,714.00
|
|
|
Service Code
|
CPT 38505
|
| Hospital Charge Code |
909000127
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$742.80 |
| Max. Negotiated Rate |
$3,156.90 |
| Rate for Payer: Adventist Health Commercial |
$742.80
|
| Rate for Payer: Cash Price |
$1,671.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,599.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,485.60
|
| Rate for Payer: EPIC Health Plan Senior |
$1,485.60
|
| Rate for Payer: Galaxy Health WC |
$3,156.90
|
| Rate for Payer: Global Benefits Group Commercial |
$2,228.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,358.39
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,191.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$891.36
|
| Rate for Payer: Multiplan Commercial |
$2,971.20
|
| Rate for Payer: Networks By Design Commercial |
$2,414.10
|
| Rate for Payer: Prime Health Services Commercial |
$3,156.90
|
|
|
HC LYMPHOCYTE SUBSET, EA CELL MAR
|
Facility
|
IP
|
$527.00
|
|
|
Service Code
|
CPT 88184
|
| Hospital Charge Code |
903901952
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$105.40 |
| Max. Negotiated Rate |
$447.95 |
| Rate for Payer: Adventist Health Commercial |
$105.40
|
| Rate for Payer: Cash Price |
$237.15
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$368.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$210.80
|
| Rate for Payer: EPIC Health Plan Senior |
$210.80
|
| Rate for Payer: Galaxy Health WC |
$447.95
|
| Rate for Payer: Global Benefits Group Commercial |
$316.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$334.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$310.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$126.48
|
| Rate for Payer: Multiplan Commercial |
$421.60
|
| Rate for Payer: Networks By Design Commercial |
$342.55
|
| Rate for Payer: Prime Health Services Commercial |
$447.95
|
|
|
HC LYMPHOCYTE SUBSET, EA CELL MAR
|
Facility
|
OP
|
$527.00
|
|
|
Service Code
|
CPT 88184
|
| Hospital Charge Code |
903901952
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$70.86 |
| Max. Negotiated Rate |
$760.68 |
| Rate for Payer: Adventist Health Commercial |
$105.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$604.01
|
| 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 |
$402.62
|
| Rate for Payer: Blue Shield of California Commercial |
$242.95
|
| Rate for Payer: Blue Shield of California Commercial |
$367.32
|
| Rate for Payer: Cash Price |
$237.15
|
| Rate for Payer: Cash Price |
$237.15
|
| Rate for Payer: Cigna of CA HMO |
$337.28
|
| Rate for Payer: Cigna of CA PPO |
$389.98
|
| 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 |
$368.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$760.68
|
| Rate for Payer: EPIC Health Plan Senior |
$507.12
|
| Rate for Payer: Galaxy Health WC |
$447.95
|
| Rate for Payer: Global Benefits Group Commercial |
$316.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$756.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$70.86
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$461.02
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$334.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$80.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$645.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$126.48
|
| 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 |
$421.60
|
| Rate for Payer: Networks By Design Commercial |
$342.55
|
| Rate for Payer: Prime Health Services Commercial |
$447.95
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$316.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$316.20
|
| 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
|
|
|
HC LYSIS OF LABIAL ADHESIONS
|
Facility
|
OP
|
$7,759.00
|
|
|
Service Code
|
CPT 56441
|
| Hospital Charge Code |
902400744
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$321.10 |
| Max. Negotiated Rate |
$6,869.74 |
| Rate for Payer: Adventist Health Commercial |
$1,551.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,245.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,579.83
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,163.48
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Cash Price |
$3,491.55
|
| Rate for Payer: Cash Price |
$3,491.55
|
| Rate for Payer: Cash Price |
$3,491.55
|
| Rate for Payer: Cigna of CA HMO |
$4,965.76
|
| Rate for Payer: Cigna of CA PPO |
$5,741.66
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,245.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,579.83
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,163.48
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,431.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,869.74
|
| Rate for Payer: EPIC Health Plan Senior |
$4,579.83
|
| Rate for Payer: Galaxy Health WC |
$6,595.15
|
| Rate for Payer: Global Benefits Group Commercial |
$4,655.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,828.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,163.48
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,926.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$321.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,475.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,862.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,245.98
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,579.06
|
| Rate for Payer: Multiplan Commercial |
$6,207.20
|
| Rate for Payer: Multiplan WC |
$6,436.87
|
| Rate for Payer: Networks By Design Commercial |
$5,043.35
|
| Rate for Payer: Prime Health Services Commercial |
$6,595.15
|
| Rate for Payer: Prime Health Services WC |
$6,371.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,655.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,879.50
|
| Rate for Payer: United Healthcare All Other HMO |
$3,879.50
|
| Rate for Payer: United Healthcare HMO Rider |
$3,879.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,879.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,163.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,245.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,579.83
|
| Rate for Payer: Vantage Medical Group Senior |
$4,163.48
|
|
|
HC LYSIS OF LABIAL ADHESIONS
|
Facility
|
IP
|
$7,759.00
|
|
|
Service Code
|
CPT 56441
|
| Hospital Charge Code |
902400744
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,551.80 |
| Max. Negotiated Rate |
$6,595.15 |
| Rate for Payer: Adventist Health Commercial |
$1,551.80
|
| Rate for Payer: Cash Price |
$3,491.55
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,431.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,103.60
|
| Rate for Payer: EPIC Health Plan Senior |
$3,103.60
|
| Rate for Payer: Galaxy Health WC |
$6,595.15
|
| Rate for Payer: Global Benefits Group Commercial |
$4,655.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,926.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,577.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,862.16
|
| Rate for Payer: Multiplan Commercial |
$6,207.20
|
| Rate for Payer: Networks By Design Commercial |
$5,043.35
|
| Rate for Payer: Prime Health Services Commercial |
$6,595.15
|
|
|
HC LYSIS OF LABIAL ADHESIONS
|
Facility
|
IP
|
$7,759.00
|
|
|
Service Code
|
CPT 56441
|
| Hospital Charge Code |
902400744
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$1,551.80 |
| Max. Negotiated Rate |
$6,595.15 |
| Rate for Payer: Adventist Health Commercial |
$1,551.80
|
| Rate for Payer: Cash Price |
$3,491.55
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,431.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,103.60
|
| Rate for Payer: EPIC Health Plan Senior |
$3,103.60
|
| Rate for Payer: Galaxy Health WC |
$6,595.15
|
| Rate for Payer: Global Benefits Group Commercial |
$4,655.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,926.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,577.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,862.16
|
| Rate for Payer: Multiplan Commercial |
$6,207.20
|
| Rate for Payer: Networks By Design Commercial |
$5,043.35
|
| Rate for Payer: Prime Health Services Commercial |
$6,595.15
|
|
|
HC LYSIS OF LABIAL ADHESIONS
|
Facility
|
OP
|
$7,759.00
|
|
|
Service Code
|
CPT 56441
|
| Hospital Charge Code |
902400744
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$283.92 |
| Max. Negotiated Rate |
$6,869.74 |
| Rate for Payer: Adventist Health Commercial |
$1,551.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$997.50
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,245.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,579.83
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,163.48
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Cash Price |
$3,491.55
|
| Rate for Payer: Cash Price |
$3,491.55
|
| Rate for Payer: Cash Price |
$3,491.55
|
| Rate for Payer: Cash Price |
$3,491.55
|
| Rate for Payer: Cigna of CA HMO |
$4,965.76
|
| Rate for Payer: Cigna of CA PPO |
$5,741.66
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,245.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,579.83
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,163.48
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,431.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,869.74
|
| Rate for Payer: EPIC Health Plan Senior |
$4,579.83
|
| Rate for Payer: Galaxy Health WC |
$6,595.15
|
| Rate for Payer: Global Benefits Group Commercial |
$4,655.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,828.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$283.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,163.48
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,926.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$321.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,828.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,862.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,245.98
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,579.06
|
| Rate for Payer: Multiplan Commercial |
$6,207.20
|
| Rate for Payer: Networks By Design Commercial |
$5,043.35
|
| Rate for Payer: Prime Health Services Commercial |
$6,595.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,655.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,655.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,091.00
|
| Rate for Payer: United Healthcare All Other HMO |
$839.00
|
| Rate for Payer: United Healthcare HMO Rider |
$635.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$581.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,163.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,245.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,579.83
|
| Rate for Payer: Vantage Medical Group Senior |
$4,163.48
|
|
|
HC MAGNESIUM
|
Facility
|
IP
|
$152.00
|
|
|
Service Code
|
CPT 83735
|
| Hospital Charge Code |
900910230
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$30.40 |
| Max. Negotiated Rate |
$129.20 |
| Rate for Payer: Adventist Health Commercial |
$30.40
|
| Rate for Payer: Cash Price |
$68.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$106.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$60.80
|
| Rate for Payer: EPIC Health Plan Senior |
$60.80
|
| Rate for Payer: Galaxy Health WC |
$129.20
|
| Rate for Payer: Global Benefits Group Commercial |
$91.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$96.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$89.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$36.48
|
| Rate for Payer: Multiplan Commercial |
$121.60
|
| Rate for Payer: Networks By Design Commercial |
$98.80
|
| Rate for Payer: Prime Health Services Commercial |
$129.20
|
|
|
HC MAGNESIUM
|
Facility
|
OP
|
$152.00
|
|
|
Service Code
|
CPT 83735
|
| Hospital Charge Code |
900910230
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.43 |
| Max. Negotiated Rate |
$129.20 |
| Rate for Payer: Adventist Health Commercial |
$30.40
|
| Rate for Payer: Adventist Health Commercial |
$8.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$55.76
|
| Rate for Payer: Aetna of CA HMO/PPO |
$55.76
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10.05
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.37
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.37
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$68.72
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$68.72
|
| Rate for Payer: Blue Shield of California Commercial |
$18.44
|
| Rate for Payer: Blue Shield of California Commercial |
$105.94
|
| Rate for Payer: Blue Shield of California Commercial |
$27.88
|
| Rate for Payer: Blue Shield of California Commercial |
$70.07
|
| Rate for Payer: Cash Price |
$18.00
|
| Rate for Payer: Cash Price |
$18.00
|
| Rate for Payer: Cash Price |
$68.40
|
| Rate for Payer: Cash Price |
$68.40
|
| Rate for Payer: Cigna of CA HMO |
$25.60
|
| Rate for Payer: Cigna of CA HMO |
$97.28
|
| Rate for Payer: Cigna of CA PPO |
$112.48
|
| Rate for Payer: Cigna of CA PPO |
$29.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.05
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.37
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.37
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$106.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$28.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.05
|
| Rate for Payer: EPIC Health Plan Senior |
$7.37
|
| Rate for Payer: EPIC Health Plan Senior |
$7.37
|
| Rate for Payer: Galaxy Health WC |
$129.20
|
| Rate for Payer: Galaxy Health WC |
$34.00
|
| Rate for Payer: Global Benefits Group Commercial |
$91.20
|
| Rate for Payer: Global Benefits Group Commercial |
$24.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$10.99
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$10.99
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$10.01
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$10.01
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$96.52
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$25.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$11.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$11.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$36.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8.44
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8.98
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8.98
|
| Rate for Payer: Multiplan Commercial |
$32.00
|
| Rate for Payer: Multiplan Commercial |
$121.60
|
| Rate for Payer: Networks By Design Commercial |
$26.00
|
| Rate for Payer: Networks By Design Commercial |
$98.80
|
| Rate for Payer: Prime Health Services Commercial |
$129.20
|
| Rate for Payer: Prime Health Services Commercial |
$34.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$91.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$24.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$91.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$24.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.43
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.43
|
| Rate for Payer: United Healthcare All Other HMO |
$5.43
|
| Rate for Payer: United Healthcare All Other HMO |
$5.43
|
| Rate for Payer: United Healthcare HMO Rider |
$5.43
|
| Rate for Payer: United Healthcare HMO Rider |
$5.43
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.43
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.43
|
| Rate for Payer: Upland Medical Group Pediatric |
$6.70
|
| Rate for Payer: Upland Medical Group Pediatric |
$6.70
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.37
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.37
|
| Rate for Payer: Vantage Medical Group Senior |
$6.70
|
| Rate for Payer: Vantage Medical Group Senior |
$6.70
|
|
|
HC MALARIA QUANTITAT
|
Facility
|
OP
|
$196.00
|
|
|
Service Code
|
CPT 87207
|
| Hospital Charge Code |
900911640
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$4.85 |
| Max. Negotiated Rate |
$166.60 |
| Rate for Payer: Adventist Health Commercial |
$39.20
|
| Rate for Payer: Adventist Health Commercial |
$8.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$49.85
|
| Rate for Payer: Aetna of CA HMO/PPO |
$49.85
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$8.98
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$8.98
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6.59
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6.59
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.99
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.99
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$61.85
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$61.85
|
| Rate for Payer: Blue Shield of California Commercial |
$19.36
|
| Rate for Payer: Blue Shield of California Commercial |
$136.61
|
| Rate for Payer: Blue Shield of California Commercial |
$29.27
|
| Rate for Payer: Blue Shield of California Commercial |
$90.36
|
| Rate for Payer: Cash Price |
$18.90
|
| Rate for Payer: Cash Price |
$18.90
|
| Rate for Payer: Cash Price |
$88.20
|
| Rate for Payer: Cash Price |
$88.20
|
| Rate for Payer: Cigna of CA HMO |
$26.88
|
| Rate for Payer: Cigna of CA HMO |
$125.44
|
| Rate for Payer: Cigna of CA PPO |
$145.04
|
| Rate for Payer: Cigna of CA PPO |
$31.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8.98
|
| Rate for Payer: Dignity Health Medi-Cal |
$6.59
|
| Rate for Payer: Dignity Health Medi-Cal |
$6.59
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.99
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.99
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$137.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$29.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.88
|
| Rate for Payer: EPIC Health Plan Senior |
$6.59
|
| Rate for Payer: EPIC Health Plan Senior |
$6.59
|
| Rate for Payer: Galaxy Health WC |
$166.60
|
| Rate for Payer: Galaxy Health WC |
$35.70
|
| Rate for Payer: Global Benefits Group Commercial |
$117.60
|
| Rate for Payer: Global Benefits Group Commercial |
$25.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$9.82
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$9.82
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$8.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$8.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.99
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.99
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$124.46
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$26.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$10.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$10.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8.39
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$47.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.08
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$7.55
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$7.55
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8.03
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8.03
|
| Rate for Payer: Multiplan Commercial |
$33.60
|
| Rate for Payer: Multiplan Commercial |
$156.80
|
| Rate for Payer: Networks By Design Commercial |
$27.30
|
| Rate for Payer: Networks By Design Commercial |
$127.40
|
| Rate for Payer: Prime Health Services Commercial |
$166.60
|
| Rate for Payer: Prime Health Services Commercial |
$35.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$117.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$25.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$117.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$25.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.85
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.85
|
| Rate for Payer: United Healthcare All Other HMO |
$4.85
|
| Rate for Payer: United Healthcare All Other HMO |
$4.85
|
| Rate for Payer: United Healthcare HMO Rider |
$4.85
|
| Rate for Payer: United Healthcare HMO Rider |
$4.85
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.85
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.85
|
| Rate for Payer: Upland Medical Group Pediatric |
$5.99
|
| Rate for Payer: Upland Medical Group Pediatric |
$5.99
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$8.98
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$8.98
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6.59
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6.59
|
| Rate for Payer: Vantage Medical Group Senior |
$5.99
|
| Rate for Payer: Vantage Medical Group Senior |
$5.99
|
|
|
HC MALARIA QUANTITAT
|
Facility
|
IP
|
$196.00
|
|
|
Service Code
|
CPT 87207
|
| Hospital Charge Code |
900911640
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$39.20 |
| Max. Negotiated Rate |
$166.60 |
| Rate for Payer: EPIC Health Plan Commercial |
$78.40
|
| Rate for Payer: EPIC Health Plan Senior |
$78.40
|
| Rate for Payer: Galaxy Health WC |
$166.60
|
| Rate for Payer: Adventist Health Commercial |
$39.20
|
| Rate for Payer: Cash Price |
$88.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$137.20
|
| Rate for Payer: Global Benefits Group Commercial |
$117.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$124.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$115.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$47.04
|
| Rate for Payer: Multiplan Commercial |
$156.80
|
| Rate for Payer: Networks By Design Commercial |
$127.40
|
| Rate for Payer: Prime Health Services Commercial |
$166.60
|
|
|
HC MALARIA SCREEN AG TEST
|
Facility
|
OP
|
$196.00
|
|
|
Service Code
|
CPT 87899
|
| Hospital Charge Code |
900912441
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$8.18 |
| Max. Negotiated Rate |
$166.60 |
| Rate for Payer: Adventist Health Commercial |
$39.20
|
| Rate for Payer: Adventist Health Commercial |
$7.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$77.24
|
| Rate for Payer: Aetna of CA HMO/PPO |
$77.24
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$24.11
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$24.11
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$17.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$17.68
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$16.07
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$16.07
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$92.77
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$92.77
|
| Rate for Payer: Blue Shield of California Commercial |
$17.52
|
| Rate for Payer: Blue Shield of California Commercial |
$136.61
|
| Rate for Payer: Blue Shield of California Commercial |
$26.49
|
| Rate for Payer: Blue Shield of California Commercial |
$90.36
|
| Rate for Payer: Cash Price |
$17.10
|
| Rate for Payer: Cash Price |
$17.10
|
| Rate for Payer: Cash Price |
$88.20
|
| Rate for Payer: Cash Price |
$88.20
|
| Rate for Payer: Cigna of CA HMO |
$24.32
|
| Rate for Payer: Cigna of CA HMO |
$125.44
|
| Rate for Payer: Cigna of CA PPO |
$145.04
|
| Rate for Payer: Cigna of CA PPO |
$28.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$24.11
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$24.11
|
| Rate for Payer: Dignity Health Medi-Cal |
$17.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$17.68
|
| Rate for Payer: Dignity Health Medicare Advantage |
$16.07
|
| Rate for Payer: Dignity Health Medicare Advantage |
$16.07
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$137.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$26.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.52
|
| Rate for Payer: EPIC Health Plan Senior |
$17.68
|
| Rate for Payer: EPIC Health Plan Senior |
$17.68
|
| Rate for Payer: Galaxy Health WC |
$166.60
|
| Rate for Payer: Galaxy Health WC |
$32.30
|
| Rate for Payer: Global Benefits Group Commercial |
$117.60
|
| Rate for Payer: Global Benefits Group Commercial |
$22.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$26.35
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$26.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$8.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$8.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$16.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$16.07
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$124.46
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$24.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$9.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$9.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$22.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$22.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$47.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$20.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$20.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$21.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$21.53
|
| Rate for Payer: Multiplan Commercial |
$30.40
|
| Rate for Payer: Multiplan Commercial |
$156.80
|
| Rate for Payer: Networks By Design Commercial |
$24.70
|
| Rate for Payer: Networks By Design Commercial |
$127.40
|
| Rate for Payer: Prime Health Services Commercial |
$166.60
|
| Rate for Payer: Prime Health Services Commercial |
$32.30
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$117.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$22.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$117.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$22.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$13.01
|
| Rate for Payer: United Healthcare All Other Commercial |
$13.01
|
| Rate for Payer: United Healthcare All Other HMO |
$13.01
|
| Rate for Payer: United Healthcare All Other HMO |
$13.01
|
| Rate for Payer: United Healthcare HMO Rider |
$13.01
|
| Rate for Payer: United Healthcare HMO Rider |
$13.01
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$13.01
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$13.01
|
| Rate for Payer: Upland Medical Group Pediatric |
$16.07
|
| Rate for Payer: Upland Medical Group Pediatric |
$16.07
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$24.11
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$24.11
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$17.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$17.68
|
| Rate for Payer: Vantage Medical Group Senior |
$16.07
|
| Rate for Payer: Vantage Medical Group Senior |
$16.07
|
|
|
HC MALARIA SCREEN AG TEST
|
Facility
|
IP
|
$196.00
|
|
|
Service Code
|
CPT 87899
|
| Hospital Charge Code |
900912441
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$39.20 |
| Max. Negotiated Rate |
$166.60 |
| Rate for Payer: Adventist Health Commercial |
$39.20
|
| Rate for Payer: Cash Price |
$88.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$137.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$78.40
|
| Rate for Payer: EPIC Health Plan Senior |
$78.40
|
| Rate for Payer: Galaxy Health WC |
$166.60
|
| Rate for Payer: Global Benefits Group Commercial |
$117.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$124.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$115.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$47.04
|
| Rate for Payer: Multiplan Commercial |
$156.80
|
| Rate for Payer: Networks By Design Commercial |
$127.40
|
| Rate for Payer: Prime Health Services Commercial |
$166.60
|
|
|
HC MALARIA SMEARS
|
Facility
|
IP
|
$196.00
|
|
|
Service Code
|
CPT 87207
|
| Hospital Charge Code |
900911686
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$39.20 |
| Max. Negotiated Rate |
$166.60 |
| Rate for Payer: Cash Price |
$88.20
|
| Rate for Payer: Adventist Health Commercial |
$39.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$137.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$78.40
|
| Rate for Payer: EPIC Health Plan Senior |
$78.40
|
| Rate for Payer: Galaxy Health WC |
$166.60
|
| Rate for Payer: Global Benefits Group Commercial |
$117.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$124.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$115.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$47.04
|
| Rate for Payer: Multiplan Commercial |
$156.80
|
| Rate for Payer: Networks By Design Commercial |
$127.40
|
| Rate for Payer: Prime Health Services Commercial |
$166.60
|
|
|
HC MALARIA SMEARS
|
Facility
|
OP
|
$196.00
|
|
|
Service Code
|
CPT 87207
|
| Hospital Charge Code |
900911686
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$4.85 |
| Max. Negotiated Rate |
$166.60 |
| Rate for Payer: Adventist Health Commercial |
$39.20
|
| Rate for Payer: Adventist Health Commercial |
$8.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$49.85
|
| Rate for Payer: Aetna of CA HMO/PPO |
$49.85
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$8.98
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$8.98
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6.59
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6.59
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.99
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.99
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$61.85
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$61.85
|
| Rate for Payer: Blue Shield of California Commercial |
$19.36
|
| Rate for Payer: Blue Shield of California Commercial |
$136.61
|
| Rate for Payer: Blue Shield of California Commercial |
$29.27
|
| Rate for Payer: Blue Shield of California Commercial |
$90.36
|
| Rate for Payer: Cash Price |
$18.90
|
| Rate for Payer: Cash Price |
$18.90
|
| Rate for Payer: Cash Price |
$88.20
|
| Rate for Payer: Cash Price |
$88.20
|
| Rate for Payer: Cigna of CA HMO |
$26.88
|
| Rate for Payer: Cigna of CA HMO |
$125.44
|
| Rate for Payer: Cigna of CA PPO |
$145.04
|
| Rate for Payer: Cigna of CA PPO |
$31.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8.98
|
| Rate for Payer: Dignity Health Medi-Cal |
$6.59
|
| Rate for Payer: Dignity Health Medi-Cal |
$6.59
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.99
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.99
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$137.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$29.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.88
|
| Rate for Payer: EPIC Health Plan Senior |
$6.59
|
| Rate for Payer: EPIC Health Plan Senior |
$6.59
|
| Rate for Payer: Galaxy Health WC |
$166.60
|
| Rate for Payer: Galaxy Health WC |
$35.70
|
| Rate for Payer: Global Benefits Group Commercial |
$117.60
|
| Rate for Payer: Global Benefits Group Commercial |
$25.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$9.82
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$9.82
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$8.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$8.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.99
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.99
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$124.46
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$26.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$10.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$10.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8.39
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$47.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.08
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$7.55
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$7.55
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8.03
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8.03
|
| Rate for Payer: Multiplan Commercial |
$33.60
|
| Rate for Payer: Multiplan Commercial |
$156.80
|
| Rate for Payer: Networks By Design Commercial |
$27.30
|
| Rate for Payer: Networks By Design Commercial |
$127.40
|
| Rate for Payer: Prime Health Services Commercial |
$166.60
|
| Rate for Payer: Prime Health Services Commercial |
$35.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$117.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$25.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$117.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$25.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.85
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.85
|
| Rate for Payer: United Healthcare All Other HMO |
$4.85
|
| Rate for Payer: United Healthcare All Other HMO |
$4.85
|
| Rate for Payer: United Healthcare HMO Rider |
$4.85
|
| Rate for Payer: United Healthcare HMO Rider |
$4.85
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.85
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.85
|
| Rate for Payer: Upland Medical Group Pediatric |
$5.99
|
| Rate for Payer: Upland Medical Group Pediatric |
$5.99
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$8.98
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$8.98
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6.59
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6.59
|
| Rate for Payer: Vantage Medical Group Senior |
$5.99
|
| Rate for Payer: Vantage Medical Group Senior |
$5.99
|
|
|
HC MAMMARY DUCTOGRAM
|
Facility
|
IP
|
$554.00
|
|
|
Service Code
|
CPT 19030
|
| Hospital Charge Code |
909000103
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$110.80 |
| Max. Negotiated Rate |
$470.90 |
| Rate for Payer: Galaxy Health WC |
$470.90
|
| Rate for Payer: Adventist Health Commercial |
$110.80
|
| Rate for Payer: Cash Price |
$249.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$387.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$221.60
|
| Rate for Payer: EPIC Health Plan Senior |
$221.60
|
| Rate for Payer: Global Benefits Group Commercial |
$332.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$351.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$326.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$132.96
|
| Rate for Payer: Multiplan Commercial |
$443.20
|
| Rate for Payer: Networks By Design Commercial |
$360.10
|
| Rate for Payer: Prime Health Services Commercial |
$470.90
|
|
|
HC MAMMARY DUCTOGRAM
|
Facility
|
OP
|
$554.00
|
|
|
Service Code
|
CPT 19030
|
| Hospital Charge Code |
909000103
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$110.80 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$110.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$470.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$304.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$415.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Blue Shield of California Commercial |
$7,196.06
|
| Rate for Payer: Blue Shield of California Commercial |
$4,753.44
|
| Rate for Payer: Cash Price |
$249.30
|
| Rate for Payer: Cash Price |
$249.30
|
| Rate for Payer: Cash Price |
$249.30
|
| Rate for Payer: Cigna of CA HMO |
$354.56
|
| Rate for Payer: Cigna of CA PPO |
$409.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$470.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$470.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$470.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$387.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$221.60
|
| Rate for Payer: EPIC Health Plan Senior |
$221.60
|
| Rate for Payer: Galaxy Health WC |
$470.90
|
| Rate for Payer: Global Benefits Group Commercial |
$332.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$325.25
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$351.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$367.84
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$326.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$132.96
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$387.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$387.80
|
| Rate for Payer: Multiplan Commercial |
$443.20
|
| Rate for Payer: Networks By Design Commercial |
$360.10
|
| Rate for Payer: Prime Health Services Commercial |
$470.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$332.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$277.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$470.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$470.90
|
| Rate for Payer: Vantage Medical Group Senior |
$470.90
|
|
|
HC MAMMOGRAPHY DIGITAL BILAT
|
Facility
|
OP
|
$850.00
|
|
|
Service Code
|
CPT 77066
|
| Hospital Charge Code |
909002011
|
|
Hospital Revenue Code
|
401
|
| Min. Negotiated Rate |
$170.00 |
| Max. Negotiated Rate |
$839.69 |
| Rate for Payer: Adventist Health Commercial |
$170.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$839.69
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$722.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$467.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$637.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$545.45
|
| Rate for Payer: Blue Shield of California Commercial |
$542.30
|
| Rate for Payer: Blue Shield of California Commercial |
$357.85
|
| Rate for Payer: Cash Price |
$382.50
|
| Rate for Payer: Cash Price |
$382.50
|
| Rate for Payer: Cigna of CA HMO |
$544.00
|
| Rate for Payer: Cigna of CA PPO |
$629.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$722.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$722.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$722.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$595.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$340.00
|
| Rate for Payer: EPIC Health Plan Senior |
$340.00
|
| Rate for Payer: Galaxy Health WC |
$722.50
|
| Rate for Payer: Global Benefits Group Commercial |
$510.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$248.69
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$539.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$281.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$501.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$204.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$595.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$595.00
|
| Rate for Payer: Multiplan Commercial |
$680.00
|
| Rate for Payer: Networks By Design Commercial |
$552.50
|
| Rate for Payer: Prime Health Services Commercial |
$722.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$510.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$510.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$321.54
|
| Rate for Payer: United Healthcare All Other HMO |
$321.54
|
| Rate for Payer: United Healthcare HMO Rider |
$321.54
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$321.54
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$722.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$722.50
|
| Rate for Payer: Vantage Medical Group Senior |
$722.50
|
|
