|
HC MICROCATH SWIFT NINJA
|
Facility
|
IP
|
$4,875.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
909011887
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$975.00 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$975.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$2,193.75
|
| Rate for Payer: Cash Price |
$2,193.75
|
| Rate for Payer: Cigna of CA HMO |
$3,412.50
|
| Rate for Payer: Cigna of CA PPO |
$3,412.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,412.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,950.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,950.00
|
| Rate for Payer: Galaxy Health WC |
$4,143.75
|
| Rate for Payer: Global Benefits Group Commercial |
$2,925.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,095.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,876.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,170.00
|
| Rate for Payer: Multiplan Commercial |
$3,900.00
|
| Rate for Payer: Networks By Design Commercial |
$2,437.50
|
| Rate for Payer: Prime Health Services Commercial |
$4,143.75
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,829.59
|
| Rate for Payer: United Healthcare All Other HMO |
$1,780.84
|
| Rate for Payer: United Healthcare HMO Rider |
$1,742.33
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,596.56
|
|
|
HC MICROCATH TREVO PRO
|
Facility
|
OP
|
$2,828.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
909000026
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$213.43 |
| Max. Negotiated Rate |
$2,403.80 |
| Rate for Payer: Adventist Health Commercial |
$565.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$213.43
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,403.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,555.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,121.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,814.73
|
| Rate for Payer: Cash Price |
$1,272.60
|
| Rate for Payer: Cash Price |
$1,272.60
|
| Rate for Payer: Cigna of CA HMO |
$1,809.92
|
| Rate for Payer: Cigna of CA PPO |
$2,092.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,403.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,403.80
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,403.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,979.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,131.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,131.20
|
| Rate for Payer: Galaxy Health WC |
$2,403.80
|
| Rate for Payer: Global Benefits Group Commercial |
$1,696.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,795.78
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,026.56
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,668.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$678.72
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,979.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,979.60
|
| Rate for Payer: Multiplan Commercial |
$2,262.40
|
| Rate for Payer: Networks By Design Commercial |
$1,838.20
|
| Rate for Payer: Prime Health Services Commercial |
$2,403.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,696.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,696.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,414.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,414.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,414.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,414.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,403.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,403.80
|
| Rate for Payer: Vantage Medical Group Senior |
$2,403.80
|
|
|
HC MICROCATH TREVO PRO
|
Facility
|
IP
|
$2,828.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
909000026
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$565.60 |
| Max. Negotiated Rate |
$2,403.80 |
| Rate for Payer: Adventist Health Commercial |
$565.60
|
| Rate for Payer: Cash Price |
$1,272.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,979.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,131.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,131.20
|
| Rate for Payer: Galaxy Health WC |
$2,403.80
|
| Rate for Payer: Global Benefits Group Commercial |
$1,696.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,795.78
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,668.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$678.72
|
| Rate for Payer: Multiplan Commercial |
$2,262.40
|
| Rate for Payer: Networks By Design Commercial |
$1,838.20
|
| Rate for Payer: Prime Health Services Commercial |
$2,403.80
|
|
|
HC MICRO EXAM/CRYSTALS
|
Facility
|
OP
|
$190.00
|
|
|
Service Code
|
CPT 89060
|
| Hospital Charge Code |
900910153
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.94 |
| Max. Negotiated Rate |
$161.50 |
| Rate for Payer: Adventist Health Commercial |
$38.00
|
| Rate for Payer: Adventist Health Commercial |
$6.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$59.44
|
| Rate for Payer: Aetna of CA HMO/PPO |
$59.44
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10.99
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10.99
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.06
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.06
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7.33
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7.33
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$73.73
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$73.73
|
| Rate for Payer: Blue Shield of California Commercial |
$14.29
|
| Rate for Payer: Blue Shield of California Commercial |
$132.43
|
| Rate for Payer: Blue Shield of California Commercial |
$21.61
|
| Rate for Payer: Blue Shield of California Commercial |
$87.59
|
| Rate for Payer: Cash Price |
$13.95
|
| Rate for Payer: Cash Price |
$13.95
|
| Rate for Payer: Cash Price |
$85.50
|
| Rate for Payer: Cash Price |
$85.50
|
| Rate for Payer: Cigna of CA HMO |
$19.84
|
| Rate for Payer: Cigna of CA HMO |
$121.60
|
| Rate for Payer: Cigna of CA PPO |
$140.60
|
| Rate for Payer: Cigna of CA PPO |
$22.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.99
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$8.06
|
| Rate for Payer: Dignity Health Medi-Cal |
$8.06
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7.33
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7.33
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$133.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$21.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.09
|
| Rate for Payer: EPIC Health Plan Senior |
$8.06
|
| Rate for Payer: EPIC Health Plan Senior |
$8.06
|
| Rate for Payer: Galaxy Health WC |
$161.50
|
| Rate for Payer: Galaxy Health WC |
$26.35
|
| Rate for Payer: Global Benefits Group Commercial |
$114.00
|
| Rate for Payer: Global Benefits Group Commercial |
$18.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$12.02
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$12.02
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$10.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$10.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7.33
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7.33
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$120.65
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$19.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$12.08
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$12.08
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$45.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9.24
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9.82
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9.82
|
| Rate for Payer: Multiplan Commercial |
$24.80
|
| Rate for Payer: Multiplan Commercial |
$152.00
|
| Rate for Payer: Networks By Design Commercial |
$20.15
|
| Rate for Payer: Networks By Design Commercial |
$123.50
|
| Rate for Payer: Prime Health Services Commercial |
$161.50
|
| Rate for Payer: Prime Health Services Commercial |
$26.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$114.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$18.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$114.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$18.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.94
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.94
|
| Rate for Payer: United Healthcare All Other HMO |
$5.94
|
| Rate for Payer: United Healthcare All Other HMO |
$5.94
|
| Rate for Payer: United Healthcare HMO Rider |
$5.94
|
| Rate for Payer: United Healthcare HMO Rider |
$5.94
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.94
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.94
|
| Rate for Payer: Upland Medical Group Pediatric |
$7.33
|
| Rate for Payer: Upland Medical Group Pediatric |
$7.33
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10.99
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10.99
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.06
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.06
|
| Rate for Payer: Vantage Medical Group Senior |
$7.33
|
| Rate for Payer: Vantage Medical Group Senior |
$7.33
|
|
|
HC MICRO EXAM/CRYSTALS
|
Facility
|
IP
|
$190.00
|
|
|
Service Code
|
CPT 89060
|
| Hospital Charge Code |
900910153
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$38.00 |
| Max. Negotiated Rate |
$161.50 |
| Rate for Payer: Adventist Health Commercial |
$38.00
|
| Rate for Payer: Cash Price |
$85.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$133.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$76.00
|
| Rate for Payer: EPIC Health Plan Senior |
$76.00
|
| Rate for Payer: Galaxy Health WC |
$161.50
|
| Rate for Payer: Global Benefits Group Commercial |
$114.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$120.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$112.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$45.60
|
| Rate for Payer: Multiplan Commercial |
$152.00
|
| Rate for Payer: Networks By Design Commercial |
$123.50
|
| Rate for Payer: Prime Health Services Commercial |
$161.50
|
|
|
HC MICRO EXAM/SPERM
|
Facility
|
IP
|
$161.00
|
|
|
Service Code
|
CPT 89321
|
| Hospital Charge Code |
900910155
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$32.20 |
| Max. Negotiated Rate |
$136.85 |
| Rate for Payer: Adventist Health Commercial |
$32.20
|
| Rate for Payer: Cash Price |
$72.45
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$112.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$64.40
|
| Rate for Payer: EPIC Health Plan Senior |
$64.40
|
| Rate for Payer: Galaxy Health WC |
$136.85
|
| Rate for Payer: Global Benefits Group Commercial |
$96.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$102.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$94.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$38.64
|
| Rate for Payer: Multiplan Commercial |
$128.80
|
| Rate for Payer: Networks By Design Commercial |
$104.65
|
| Rate for Payer: Prime Health Services Commercial |
$136.85
|
|
|
HC MICRO EXAM/SPERM
|
Facility
|
OP
|
$161.00
|
|
|
Service Code
|
CPT 89321
|
| Hospital Charge Code |
900910155
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$9.77 |
| Max. Negotiated Rate |
$136.85 |
| Rate for Payer: Adventist Health Commercial |
$32.20
|
| Rate for Payer: Adventist Health Commercial |
$16.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$100.25
|
| Rate for Payer: Aetna of CA HMO/PPO |
$100.25
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$18.07
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$18.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13.26
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$124.32
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$124.32
|
| Rate for Payer: Blue Shield of California Commercial |
$57.15
|
| Rate for Payer: Blue Shield of California Commercial |
$112.22
|
| Rate for Payer: Blue Shield of California Commercial |
$74.22
|
| Rate for Payer: Blue Shield of California Commercial |
$37.80
|
| Rate for Payer: Cash Price |
$36.90
|
| Rate for Payer: Cash Price |
$36.90
|
| Rate for Payer: Cash Price |
$72.45
|
| Rate for Payer: Cash Price |
$72.45
|
| Rate for Payer: Cigna of CA HMO |
$103.04
|
| Rate for Payer: Cigna of CA HMO |
$52.48
|
| Rate for Payer: Cigna of CA PPO |
$60.68
|
| Rate for Payer: Cigna of CA PPO |
$119.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$18.07
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$18.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.26
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.26
|
| Rate for Payer: Dignity Health Medicare Advantage |
$12.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$12.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$57.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$112.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.88
|
| Rate for Payer: EPIC Health Plan Senior |
$13.26
|
| Rate for Payer: EPIC Health Plan Senior |
$13.26
|
| Rate for Payer: Galaxy Health WC |
$136.85
|
| Rate for Payer: Galaxy Health WC |
$69.70
|
| Rate for Payer: Global Benefits Group Commercial |
$96.60
|
| Rate for Payer: Global Benefits Group Commercial |
$49.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$19.76
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$19.76
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$12.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$12.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$52.07
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$102.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$58.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$29.77
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$16.87
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$16.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$38.64
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$15.18
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$15.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16.15
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16.15
|
| Rate for Payer: Multiplan Commercial |
$128.80
|
| Rate for Payer: Multiplan Commercial |
$65.60
|
| Rate for Payer: Networks By Design Commercial |
$53.30
|
| Rate for Payer: Networks By Design Commercial |
$104.65
|
| Rate for Payer: Prime Health Services Commercial |
$136.85
|
| Rate for Payer: Prime Health Services Commercial |
$69.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$96.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$49.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$96.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$49.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.77
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.77
|
| Rate for Payer: United Healthcare All Other HMO |
$9.77
|
| Rate for Payer: United Healthcare All Other HMO |
$9.77
|
| Rate for Payer: United Healthcare HMO Rider |
$9.77
|
| Rate for Payer: United Healthcare HMO Rider |
$9.77
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.77
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.77
|
| Rate for Payer: Upland Medical Group Pediatric |
$12.05
|
| Rate for Payer: Upland Medical Group Pediatric |
$12.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$18.07
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$18.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.26
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.26
|
| Rate for Payer: Vantage Medical Group Senior |
$12.05
|
| Rate for Payer: Vantage Medical Group Senior |
$12.05
|
|
|
HC MICRO EXAM/TRICHOMONAS
|
Facility
|
OP
|
$156.00
|
|
|
Service Code
|
CPT 87210
|
| Hospital Charge Code |
900910156
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$4.72 |
| Max. Negotiated Rate |
$132.60 |
| Rate for Payer: Dignity Health Medi-Cal |
$6.40
|
| Rate for Payer: Adventist Health Commercial |
$31.20
|
| Rate for Payer: Adventist Health Commercial |
$8.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$35.53
|
| Rate for Payer: Aetna of CA HMO/PPO |
$35.53
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$8.73
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$8.73
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.82
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.82
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$44.06
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$44.06
|
| Rate for Payer: Blue Shield of California Commercial |
$18.44
|
| Rate for Payer: Blue Shield of California Commercial |
$108.73
|
| Rate for Payer: Blue Shield of California Commercial |
$27.88
|
| Rate for Payer: Blue Shield of California Commercial |
$71.92
|
| Rate for Payer: Cash Price |
$18.00
|
| Rate for Payer: Cash Price |
$18.00
|
| Rate for Payer: Cash Price |
$70.20
|
| Rate for Payer: Cash Price |
$70.20
|
| Rate for Payer: Cigna of CA HMO |
$25.60
|
| Rate for Payer: Cigna of CA HMO |
$99.84
|
| Rate for Payer: Cigna of CA PPO |
$115.44
|
| Rate for Payer: Cigna of CA PPO |
$29.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8.73
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8.73
|
| Rate for Payer: Dignity Health Medi-Cal |
$6.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.82
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.82
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$109.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$28.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.60
|
| Rate for Payer: EPIC Health Plan Senior |
$6.40
|
| Rate for Payer: EPIC Health Plan Senior |
$6.40
|
| Rate for Payer: Galaxy Health WC |
$132.60
|
| Rate for Payer: Galaxy Health WC |
$34.00
|
| Rate for Payer: Global Benefits Group Commercial |
$93.60
|
| Rate for Payer: Global Benefits Group Commercial |
$24.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$9.54
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$9.54
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$5.98
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$5.98
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.82
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.82
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$99.06
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$25.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$6.76
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$6.76
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8.15
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$37.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$7.33
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$7.33
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$7.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$7.80
|
| Rate for Payer: Multiplan Commercial |
$32.00
|
| Rate for Payer: Multiplan Commercial |
$124.80
|
| Rate for Payer: Networks By Design Commercial |
$26.00
|
| Rate for Payer: Networks By Design Commercial |
$101.40
|
| Rate for Payer: Prime Health Services Commercial |
$132.60
|
| Rate for Payer: Prime Health Services Commercial |
$34.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$93.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$24.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$93.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$24.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.72
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.72
|
| Rate for Payer: United Healthcare All Other HMO |
$4.72
|
| Rate for Payer: United Healthcare All Other HMO |
$4.72
|
| Rate for Payer: United Healthcare HMO Rider |
$4.72
|
| Rate for Payer: United Healthcare HMO Rider |
$4.72
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.72
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.72
|
| Rate for Payer: Upland Medical Group Pediatric |
$5.82
|
| Rate for Payer: Upland Medical Group Pediatric |
$5.82
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$8.73
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$8.73
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6.40
|
| Rate for Payer: Vantage Medical Group Senior |
$5.82
|
| Rate for Payer: Vantage Medical Group Senior |
$5.82
|
|
|
HC MICRO EXAM/TRICHOMONAS
|
Facility
|
IP
|
$156.00
|
|
|
Service Code
|
CPT 87210
|
| Hospital Charge Code |
900910156
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$31.20 |
| Max. Negotiated Rate |
$132.60 |
| Rate for Payer: Adventist Health Commercial |
$31.20
|
| Rate for Payer: Cash Price |
$70.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$109.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$62.40
|
| Rate for Payer: EPIC Health Plan Senior |
$62.40
|
| Rate for Payer: Galaxy Health WC |
$132.60
|
| Rate for Payer: Global Benefits Group Commercial |
$93.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$99.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$92.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$37.44
|
| Rate for Payer: Multiplan Commercial |
$124.80
|
| Rate for Payer: Networks By Design Commercial |
$101.40
|
| Rate for Payer: Prime Health Services Commercial |
$132.60
|
|
|
HC MICROFIL LARVA
|
Facility
|
OP
|
$196.00
|
|
|
Service Code
|
CPT 87207
|
| Hospital Charge Code |
900911659
|
|
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 |
$5.40
|
| 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 |
$12.45
|
| Rate for Payer: Blue Shield of California Commercial |
$136.61
|
| Rate for Payer: Blue Shield of California Commercial |
$18.82
|
| Rate for Payer: Blue Shield of California Commercial |
$90.36
|
| Rate for Payer: Cash Price |
$12.15
|
| Rate for Payer: Cash Price |
$12.15
|
| Rate for Payer: Cash Price |
$88.20
|
| Rate for Payer: Cash Price |
$88.20
|
| Rate for Payer: Cigna of CA HMO |
$17.28
|
| 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 |
$19.98
|
| 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 |
$18.90
|
| 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 |
$22.95
|
| Rate for Payer: Global Benefits Group Commercial |
$117.60
|
| Rate for Payer: Global Benefits Group Commercial |
$16.20
|
| 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 |
$17.14
|
| 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 |
$6.48
|
| 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 |
$21.60
|
| Rate for Payer: Multiplan Commercial |
$156.80
|
| Rate for Payer: Networks By Design Commercial |
$17.55
|
| 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 |
$22.95
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$117.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$16.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$117.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$16.20
|
| 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 MICROFIL LARVA
|
Facility
|
IP
|
$196.00
|
|
|
Service Code
|
CPT 87207
|
| Hospital Charge Code |
900911659
|
|
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 MICROGLOBULIN
|
Facility
|
OP
|
$144.00
|
|
|
Service Code
|
CPT 82232
|
| Hospital Charge Code |
900912121
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.10 |
| Max. Negotiated Rate |
$167.05 |
| Rate for Payer: Aetna of CA HMO/PPO |
$134.53
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$17.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$17.80
|
| Rate for Payer: Vantage Medical Group Senior |
$16.18
|
| Rate for Payer: Vantage Medical Group Senior |
$16.18
|
| Rate for Payer: Adventist Health Commercial |
$28.80
|
| Rate for Payer: Adventist Health Commercial |
$35.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$134.53
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$24.27
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$24.27
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$17.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$17.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$16.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$16.18
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$167.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$167.05
|
| Rate for Payer: Blue Shield of California Commercial |
$124.07
|
| Rate for Payer: Blue Shield of California Commercial |
$100.37
|
| Rate for Payer: Blue Shield of California Commercial |
$82.06
|
| Rate for Payer: Blue Shield of California Commercial |
$66.38
|
| Rate for Payer: Cash Price |
$80.10
|
| Rate for Payer: Cash Price |
$80.10
|
| Rate for Payer: Cash Price |
$64.80
|
| Rate for Payer: Cash Price |
$64.80
|
| Rate for Payer: Cigna of CA HMO |
$113.92
|
| Rate for Payer: Cigna of CA HMO |
$92.16
|
| Rate for Payer: Cigna of CA PPO |
$106.56
|
| Rate for Payer: Cigna of CA PPO |
$131.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$24.27
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$24.27
|
| Rate for Payer: Dignity Health Medi-Cal |
$17.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$17.80
|
| Rate for Payer: Dignity Health Medicare Advantage |
$16.18
|
| Rate for Payer: Dignity Health Medicare Advantage |
$16.18
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$100.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$124.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.70
|
| Rate for Payer: EPIC Health Plan Senior |
$17.80
|
| Rate for Payer: EPIC Health Plan Senior |
$17.80
|
| Rate for Payer: Galaxy Health WC |
$122.40
|
| Rate for Payer: Galaxy Health WC |
$151.30
|
| Rate for Payer: Global Benefits Group Commercial |
$86.40
|
| Rate for Payer: Global Benefits Group Commercial |
$106.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$26.54
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$26.54
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$24.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$24.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$16.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$16.18
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$91.44
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$113.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$27.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$27.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$22.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$22.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$34.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$42.72
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$20.39
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$20.39
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$21.68
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$21.68
|
| Rate for Payer: Multiplan Commercial |
$142.40
|
| Rate for Payer: Multiplan Commercial |
$115.20
|
| Rate for Payer: Networks By Design Commercial |
$115.70
|
| Rate for Payer: Networks By Design Commercial |
$93.60
|
| Rate for Payer: Prime Health Services Commercial |
$122.40
|
| Rate for Payer: Prime Health Services Commercial |
$151.30
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$86.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$106.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$86.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$106.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$13.10
|
| Rate for Payer: United Healthcare All Other Commercial |
$13.10
|
| Rate for Payer: United Healthcare All Other HMO |
$13.10
|
| Rate for Payer: United Healthcare All Other HMO |
$13.10
|
| Rate for Payer: United Healthcare HMO Rider |
$13.10
|
| Rate for Payer: United Healthcare HMO Rider |
$13.10
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$13.10
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$13.10
|
| Rate for Payer: Upland Medical Group Pediatric |
$16.18
|
| Rate for Payer: Upland Medical Group Pediatric |
$16.18
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$24.27
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$24.27
|
|
|
HC MICROGLOBULIN
|
Facility
|
IP
|
$178.00
|
|
|
Service Code
|
CPT 82232
|
| Hospital Charge Code |
900912121
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$35.60 |
| Max. Negotiated Rate |
$151.30 |
| Rate for Payer: Adventist Health Commercial |
$35.60
|
| Rate for Payer: Cash Price |
$80.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$124.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$71.20
|
| Rate for Payer: EPIC Health Plan Senior |
$71.20
|
| Rate for Payer: Galaxy Health WC |
$151.30
|
| Rate for Payer: Global Benefits Group Commercial |
$106.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$113.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$105.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$42.72
|
| Rate for Payer: Multiplan Commercial |
$142.40
|
| Rate for Payer: Networks By Design Commercial |
$115.70
|
| Rate for Payer: Prime Health Services Commercial |
$151.30
|
|
|
HC MICROGUIDEWIRE
|
Facility
|
OP
|
$594.00
|
|
|
Service Code
|
CPT C1769
|
| Hospital Charge Code |
909081801
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$118.80 |
| Max. Negotiated Rate |
$504.90 |
| Rate for Payer: Adventist Health Commercial |
$118.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$449.04
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$504.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$326.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$445.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$381.17
|
| Rate for Payer: Cash Price |
$267.30
|
| Rate for Payer: Cash Price |
$267.30
|
| Rate for Payer: Cigna of CA HMO |
$380.16
|
| Rate for Payer: Cigna of CA PPO |
$439.56
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$504.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$504.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$504.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$415.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$237.60
|
| Rate for Payer: EPIC Health Plan Senior |
$237.60
|
| Rate for Payer: Galaxy Health WC |
$504.90
|
| Rate for Payer: Global Benefits Group Commercial |
$356.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$377.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$215.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$350.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$142.56
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$415.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$415.80
|
| Rate for Payer: Multiplan Commercial |
$475.20
|
| Rate for Payer: Networks By Design Commercial |
$386.10
|
| Rate for Payer: Prime Health Services Commercial |
$504.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$356.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$356.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$297.00
|
| Rate for Payer: United Healthcare All Other HMO |
$297.00
|
| Rate for Payer: United Healthcare HMO Rider |
$297.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$297.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$504.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$504.90
|
| Rate for Payer: Vantage Medical Group Senior |
$504.90
|
|
|
HC MICROGUIDEWIRE
|
Facility
|
IP
|
$594.00
|
|
|
Service Code
|
CPT C1769
|
| Hospital Charge Code |
909081801
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$118.80 |
| Max. Negotiated Rate |
$504.90 |
| Rate for Payer: Adventist Health Commercial |
$118.80
|
| Rate for Payer: Cash Price |
$267.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$415.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$237.60
|
| Rate for Payer: EPIC Health Plan Senior |
$237.60
|
| Rate for Payer: Galaxy Health WC |
$504.90
|
| Rate for Payer: Global Benefits Group Commercial |
$356.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$377.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$350.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$142.56
|
| Rate for Payer: Multiplan Commercial |
$475.20
|
| Rate for Payer: Networks By Design Commercial |
$386.10
|
| Rate for Payer: Prime Health Services Commercial |
$504.90
|
|
|
HC MICROHEMATOCRIT SPUN
|
Facility
|
OP
|
$10.00
|
|
|
Service Code
|
CPT 85013
|
| Hospital Charge Code |
900910790
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$2.00 |
| Max. Negotiated Rate |
$24.39 |
| Rate for Payer: Adventist Health Commercial |
$2.00
|
| Rate for Payer: Adventist Health Commercial |
$22.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$19.67
|
| Rate for Payer: Aetna of CA HMO/PPO |
$19.67
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10.50
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$24.39
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$24.39
|
| Rate for Payer: Blue Shield of California Commercial |
$50.71
|
| Rate for Payer: Blue Shield of California Commercial |
$4.61
|
| Rate for Payer: Blue Shield of California Commercial |
$76.67
|
| Rate for Payer: Blue Shield of California Commercial |
$6.97
|
| Rate for Payer: Cash Price |
$49.50
|
| Rate for Payer: Cash Price |
$49.50
|
| Rate for Payer: Cash Price |
$4.50
|
| Rate for Payer: Cash Price |
$4.50
|
| Rate for Payer: Cigna of CA HMO |
$70.40
|
| Rate for Payer: Cigna of CA HMO |
$6.40
|
| Rate for Payer: Cigna of CA PPO |
$7.40
|
| Rate for Payer: Cigna of CA PPO |
$81.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$77.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.55
|
| Rate for Payer: EPIC Health Plan Senior |
$7.70
|
| Rate for Payer: EPIC Health Plan Senior |
$7.70
|
| Rate for Payer: Galaxy Health WC |
$8.50
|
| Rate for Payer: Galaxy Health WC |
$93.50
|
| Rate for Payer: Global Benefits Group Commercial |
$6.00
|
| Rate for Payer: Global Benefits Group Commercial |
$66.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$11.48
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$11.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$3.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$3.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6.35
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$69.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$3.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$3.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$26.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8.82
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8.82
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9.38
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9.38
|
| Rate for Payer: Multiplan Commercial |
$88.00
|
| Rate for Payer: Multiplan Commercial |
$8.00
|
| Rate for Payer: Networks By Design Commercial |
$71.50
|
| Rate for Payer: Networks By Design Commercial |
$6.50
|
| Rate for Payer: Prime Health Services Commercial |
$8.50
|
| Rate for Payer: Prime Health Services Commercial |
$93.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$66.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$66.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.67
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.67
|
| Rate for Payer: United Healthcare All Other HMO |
$5.67
|
| Rate for Payer: United Healthcare All Other HMO |
$5.67
|
| Rate for Payer: United Healthcare HMO Rider |
$5.67
|
| Rate for Payer: United Healthcare HMO Rider |
$5.67
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.67
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.67
|
| Rate for Payer: Upland Medical Group Pediatric |
$7.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$7.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.70
|
| Rate for Payer: Vantage Medical Group Senior |
$7.00
|
| Rate for Payer: Vantage Medical Group Senior |
$7.00
|
|
|
HC MICROHEMATOCRIT SPUN
|
Facility
|
IP
|
$110.00
|
|
|
Service Code
|
CPT 85013
|
| Hospital Charge Code |
900910790
|
|
Hospital Revenue Code
|
305
|
| 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 MICROHEMATOCRIT SPUN BODY FLUID
|
Facility
|
OP
|
$133.00
|
|
|
Service Code
|
CPT 85013
|
| Hospital Charge Code |
900910159
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$3.41 |
| Max. Negotiated Rate |
$113.05 |
| Rate for Payer: Vantage Medical Group Senior |
$7.00
|
| Rate for Payer: Adventist Health Commercial |
$26.60
|
| Rate for Payer: Adventist Health Commercial |
$2.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$19.67
|
| Rate for Payer: Aetna of CA HMO/PPO |
$19.67
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10.50
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$24.39
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$24.39
|
| Rate for Payer: Blue Shield of California Commercial |
$6.45
|
| Rate for Payer: Blue Shield of California Commercial |
$61.31
|
| Rate for Payer: Blue Shield of California Commercial |
$9.76
|
| Rate for Payer: Blue Shield of California Commercial |
$92.70
|
| Rate for Payer: Cash Price |
$6.30
|
| Rate for Payer: Cash Price |
$6.30
|
| Rate for Payer: Cash Price |
$59.85
|
| Rate for Payer: Cash Price |
$59.85
|
| Rate for Payer: Cigna of CA HMO |
$8.96
|
| Rate for Payer: Cigna of CA HMO |
$85.12
|
| Rate for Payer: Cigna of CA PPO |
$98.42
|
| Rate for Payer: Cigna of CA PPO |
$10.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$93.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.55
|
| Rate for Payer: EPIC Health Plan Senior |
$7.70
|
| Rate for Payer: EPIC Health Plan Senior |
$7.70
|
| Rate for Payer: Galaxy Health WC |
$113.05
|
| Rate for Payer: Galaxy Health WC |
$11.90
|
| Rate for Payer: Global Benefits Group Commercial |
$79.80
|
| Rate for Payer: Global Benefits Group Commercial |
$8.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$11.48
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$11.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$3.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$3.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$84.45
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8.89
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$3.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$3.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$31.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8.82
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8.82
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9.38
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9.38
|
| Rate for Payer: Multiplan Commercial |
$11.20
|
| Rate for Payer: Multiplan Commercial |
$106.40
|
| Rate for Payer: Networks By Design Commercial |
$9.10
|
| Rate for Payer: Networks By Design Commercial |
$86.45
|
| Rate for Payer: Prime Health Services Commercial |
$113.05
|
| Rate for Payer: Prime Health Services Commercial |
$11.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$79.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$79.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$8.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.67
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.67
|
| Rate for Payer: United Healthcare All Other HMO |
$5.67
|
| Rate for Payer: United Healthcare All Other HMO |
$5.67
|
| Rate for Payer: United Healthcare HMO Rider |
$5.67
|
| Rate for Payer: United Healthcare HMO Rider |
$5.67
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.67
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.67
|
| Rate for Payer: Upland Medical Group Pediatric |
$7.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$7.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.70
|
| Rate for Payer: Vantage Medical Group Senior |
$7.00
|
|
|
HC MICROHEMATOCRIT SPUN BODY FLUID
|
Facility
|
IP
|
$133.00
|
|
|
Service Code
|
CPT 85013
|
| Hospital Charge Code |
900910159
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$26.60 |
| Max. Negotiated Rate |
$113.05 |
| Rate for Payer: Adventist Health Commercial |
$26.60
|
| Rate for Payer: Cash Price |
$59.85
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$93.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$53.20
|
| Rate for Payer: EPIC Health Plan Senior |
$53.20
|
| Rate for Payer: Galaxy Health WC |
$113.05
|
| Rate for Payer: Global Benefits Group Commercial |
$79.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$84.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$78.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$31.92
|
| Rate for Payer: Multiplan Commercial |
$106.40
|
| Rate for Payer: Networks By Design Commercial |
$86.45
|
| Rate for Payer: Prime Health Services Commercial |
$113.05
|
|
|
HC MICROPRO CNTRL FEATURE ADDN UE
|
Facility
|
IP
|
$5,230.00
|
|
|
Service Code
|
CPT L6882
|
| Hospital Charge Code |
905356882
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$1,046.00 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$1,046.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$2,353.50
|
| Rate for Payer: Cash Price |
$2,353.50
|
| Rate for Payer: Cigna of CA HMO |
$3,661.00
|
| Rate for Payer: Cigna of CA PPO |
$3,661.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,661.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,092.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,092.00
|
| Rate for Payer: Galaxy Health WC |
$4,445.50
|
| Rate for Payer: Global Benefits Group Commercial |
$3,138.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,321.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,085.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,255.20
|
| Rate for Payer: Multiplan Commercial |
$4,184.00
|
| Rate for Payer: Networks By Design Commercial |
$3,399.50
|
| Rate for Payer: Prime Health Services Commercial |
$4,445.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,962.82
|
| Rate for Payer: United Healthcare All Other HMO |
$1,910.52
|
| Rate for Payer: United Healthcare HMO Rider |
$1,869.20
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,712.83
|
|
|
HC MICROPRO CNTRL FEATURE ADDN UE
|
Facility
|
OP
|
$5,230.00
|
|
|
Service Code
|
CPT L6882
|
| Hospital Charge Code |
915356882
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$1,255.20 |
| Max. Negotiated Rate |
$4,445.50 |
| Rate for Payer: Adventist Health Commercial |
$2,144.30
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4,445.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,876.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,922.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,165.72
|
| Rate for Payer: Blue Shield of California Commercial |
$2,651.61
|
| Rate for Payer: Blue Shield of California Commercial |
$4,021.87
|
| Rate for Payer: Cash Price |
$2,353.50
|
| Rate for Payer: Cigna of CA HMO |
$3,661.00
|
| Rate for Payer: Cigna of CA PPO |
$3,661.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,445.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,445.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,445.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,661.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,092.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,092.00
|
| Rate for Payer: Galaxy Health WC |
$4,445.50
|
| Rate for Payer: Global Benefits Group Commercial |
$3,138.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,321.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,085.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,255.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,661.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,661.00
|
| Rate for Payer: Multiplan Commercial |
$4,184.00
|
| Rate for Payer: Networks By Design Commercial |
$2,615.00
|
| Rate for Payer: Prime Health Services Commercial |
$4,445.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,138.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,138.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,962.82
|
| Rate for Payer: United Healthcare All Other HMO |
$1,910.52
|
| Rate for Payer: United Healthcare HMO Rider |
$1,869.20
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,712.83
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4,445.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,445.50
|
| Rate for Payer: Vantage Medical Group Senior |
$4,445.50
|
|
|
HC MICROPRO CNTRL FEATURE ADDN UE
|
Facility
|
OP
|
$5,230.00
|
|
|
Service Code
|
CPT L6882
|
| Hospital Charge Code |
905356882
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$1,255.20 |
| Max. Negotiated Rate |
$4,445.50 |
| Rate for Payer: Adventist Health Commercial |
$2,144.30
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4,445.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,876.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,922.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,165.72
|
| Rate for Payer: Blue Shield of California Commercial |
$2,651.61
|
| Rate for Payer: Blue Shield of California Commercial |
$4,021.87
|
| Rate for Payer: Cash Price |
$2,353.50
|
| Rate for Payer: Cigna of CA HMO |
$3,661.00
|
| Rate for Payer: Cigna of CA PPO |
$3,661.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,445.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,445.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,445.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,661.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,092.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,092.00
|
| Rate for Payer: Galaxy Health WC |
$4,445.50
|
| Rate for Payer: Global Benefits Group Commercial |
$3,138.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,321.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,085.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,255.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,661.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,661.00
|
| Rate for Payer: Multiplan Commercial |
$4,184.00
|
| Rate for Payer: Networks By Design Commercial |
$2,615.00
|
| Rate for Payer: Prime Health Services Commercial |
$4,445.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,138.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,138.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,962.82
|
| Rate for Payer: United Healthcare All Other HMO |
$1,910.52
|
| Rate for Payer: United Healthcare HMO Rider |
$1,869.20
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,712.83
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4,445.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,445.50
|
| Rate for Payer: Vantage Medical Group Senior |
$4,445.50
|
|
|
HC MICROPRO CNTRL FEATURE ADDN UE
|
Facility
|
IP
|
$5,230.00
|
|
|
Service Code
|
CPT L6882
|
| Hospital Charge Code |
915356882
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$1,046.00 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$1,046.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$2,353.50
|
| Rate for Payer: Cash Price |
$2,353.50
|
| Rate for Payer: Cigna of CA HMO |
$3,661.00
|
| Rate for Payer: Cigna of CA PPO |
$3,661.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,661.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,092.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,092.00
|
| Rate for Payer: Galaxy Health WC |
$4,445.50
|
| Rate for Payer: Global Benefits Group Commercial |
$3,138.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,321.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,085.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,255.20
|
| Rate for Payer: Multiplan Commercial |
$4,184.00
|
| Rate for Payer: Networks By Design Commercial |
$3,399.50
|
| Rate for Payer: Prime Health Services Commercial |
$4,445.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,962.82
|
| Rate for Payer: United Healthcare All Other HMO |
$1,910.52
|
| Rate for Payer: United Healthcare HMO Rider |
$1,869.20
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,712.83
|
|
|
HC MICROWIRE MIRAGE
|
Facility
|
OP
|
$2,254.00
|
|
|
Service Code
|
CPT C1769
|
| Hospital Charge Code |
909000025
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$449.04 |
| Max. Negotiated Rate |
$1,915.90 |
| Rate for Payer: Adventist Health Commercial |
$450.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$449.04
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,915.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,239.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,690.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,446.39
|
| Rate for Payer: Cash Price |
$1,014.30
|
| Rate for Payer: Cash Price |
$1,014.30
|
| Rate for Payer: Cigna of CA HMO |
$1,442.56
|
| Rate for Payer: Cigna of CA PPO |
$1,667.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,915.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,915.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,915.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,577.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$901.60
|
| Rate for Payer: EPIC Health Plan Senior |
$901.60
|
| Rate for Payer: Galaxy Health WC |
$1,915.90
|
| Rate for Payer: Global Benefits Group Commercial |
$1,352.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,431.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$818.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,329.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$540.96
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,577.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,577.80
|
| Rate for Payer: Multiplan Commercial |
$1,803.20
|
| Rate for Payer: Networks By Design Commercial |
$1,465.10
|
| Rate for Payer: Prime Health Services Commercial |
$1,915.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,352.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,352.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,127.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,127.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,127.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,127.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,915.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,915.90
|
| Rate for Payer: Vantage Medical Group Senior |
$1,915.90
|
|
|
HC MICROWIRE MIRAGE
|
Facility
|
IP
|
$2,254.00
|
|
|
Service Code
|
CPT C1769
|
| Hospital Charge Code |
909000025
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$450.80 |
| Max. Negotiated Rate |
$1,915.90 |
| Rate for Payer: Adventist Health Commercial |
$450.80
|
| Rate for Payer: Cash Price |
$1,014.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,577.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$901.60
|
| Rate for Payer: EPIC Health Plan Senior |
$901.60
|
| Rate for Payer: Galaxy Health WC |
$1,915.90
|
| Rate for Payer: Global Benefits Group Commercial |
$1,352.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,431.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,329.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$540.96
|
| Rate for Payer: Multiplan Commercial |
$1,803.20
|
| Rate for Payer: Networks By Design Commercial |
$1,465.10
|
| Rate for Payer: Prime Health Services Commercial |
$1,915.90
|
|
