|
HC SOM 199PC 86301
|
Facility
IP
|
$29.81
|
|
|
Service Code
|
CPT 86301
|
| Hospital Charge Code |
900914879
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.96 |
| Max. Negotiated Rate |
$26.83 |
| Rate for Payer: Cash Price |
$13.41
|
| Rate for Payer: Central Health Plan Commercial |
$23.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.92
|
| Rate for Payer: Galaxy Health WC |
$25.34
|
| Rate for Payer: Global Benefits Group Commercial |
$17.89
|
| Rate for Payer: Health Management Network EPO/PPO |
$26.83
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$19.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.96
|
| Rate for Payer: Multiplan Commercial |
$22.36
|
| Rate for Payer: Networks By Design Commercial |
$19.38
|
| Rate for Payer: Prime Health Services Commercial |
$25.34
|
|
|
HC SOM 22FP 88271 MULTIPLE
|
Facility
OP
|
$19.22
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
900914753
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$3.84 |
| Max. Negotiated Rate |
$1,505.45 |
| Rate for Payer: Adventist Health Medi-Cal |
$21.42
|
| Rate for Payer: Aetna of CA HMO/PPO |
$157.20
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$32.13
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$23.56
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$21.42
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,234.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,505.45
|
| Rate for Payer: BCBS Transplant Transplant |
$11.53
|
| Rate for Payer: Blue Shield of California Commercial |
$11.88
|
| Rate for Payer: Blue Shield of California EPN |
$9.34
|
| Rate for Payer: Caremore Medicare Advantage |
$21.42
|
| Rate for Payer: Cash Price |
$8.65
|
| Rate for Payer: Cash Price |
$8.65
|
| Rate for Payer: Central Health Plan Commercial |
$15.38
|
| Rate for Payer: Cigna of CA HMO |
$12.30
|
| Rate for Payer: Cigna of CA PPO |
$14.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$32.13
|
| Rate for Payer: EPIC Health Plan Commercial |
$28.92
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$21.42
|
| Rate for Payer: EPIC Health Plan Transplant |
$21.42
|
| Rate for Payer: Galaxy Health WC |
$16.34
|
| Rate for Payer: Global Benefits Group Commercial |
$11.53
|
| Rate for Payer: Health Management Network EPO/PPO |
$17.30
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$14.42
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$35.13
|
| Rate for Payer: IEHP medi-cal |
$35.34
|
| Rate for Payer: IEHP Medicare Advantage |
$21.42
|
| Rate for Payer: Innovage PACE Commercial |
$32.13
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.84
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$28.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$28.70
|
| Rate for Payer: Multiplan Commercial |
$14.42
|
| Rate for Payer: Networks By Design Commercial |
$12.49
|
| Rate for Payer: Prime Health Services Commercial |
$16.34
|
| Rate for Payer: Prime Health Services Medicare |
$22.71
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$11.53
|
| Rate for Payer: Riverside University Health MISP |
$23.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$11.53
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$11.53
|
| Rate for Payer: United Healthcare All Other Commercial |
$17.35
|
| Rate for Payer: United Healthcare All Other HMO |
$17.35
|
| Rate for Payer: United Healthcare HMO Rider |
$17.35
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$17.35
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$32.13
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$23.56
|
| Rate for Payer: Vantage Medical Group Senior |
$21.42
|
|
|
HC SOM 22FP 88271 MULTIPLE
|
Facility
IP
|
$19.22
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
900914753
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$3.84 |
| Max. Negotiated Rate |
$17.30 |
| Rate for Payer: Cash Price |
$8.65
|
| Rate for Payer: Central Health Plan Commercial |
$15.38
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.69
|
| Rate for Payer: Galaxy Health WC |
$16.34
|
| Rate for Payer: Global Benefits Group Commercial |
$11.53
|
| Rate for Payer: Health Management Network EPO/PPO |
$17.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.84
|
| Rate for Payer: Multiplan Commercial |
$14.42
|
| Rate for Payer: Networks By Design Commercial |
$12.49
|
| Rate for Payer: Prime Health Services Commercial |
$16.34
|
|
|
HC SOM 22FP 88271 SINGLE
|
Facility
IP
|
$19.46
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
900914752
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$3.89 |
| Max. Negotiated Rate |
$17.51 |
| Rate for Payer: Cash Price |
$8.76
|
| Rate for Payer: Central Health Plan Commercial |
$15.57
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.78
|
| Rate for Payer: Galaxy Health WC |
$16.54
|
| Rate for Payer: Global Benefits Group Commercial |
$11.68
|
| Rate for Payer: Health Management Network EPO/PPO |
$17.51
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.89
|
| Rate for Payer: Multiplan Commercial |
$14.60
|
| Rate for Payer: Networks By Design Commercial |
$12.65
|
| Rate for Payer: Prime Health Services Commercial |
$16.54
|
|
|
HC SOM 22FP 88271 SINGLE
|
Facility
OP
|
$19.46
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
900914752
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$3.89 |
| Max. Negotiated Rate |
$1,505.45 |
| Rate for Payer: Adventist Health Medi-Cal |
$21.42
|
| Rate for Payer: Aetna of CA HMO/PPO |
$157.20
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$32.13
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$23.56
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$21.42
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,234.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,505.45
|
| Rate for Payer: BCBS Transplant Transplant |
$11.68
|
| Rate for Payer: Blue Shield of California Commercial |
$12.03
|
| Rate for Payer: Blue Shield of California EPN |
$9.46
|
| Rate for Payer: Caremore Medicare Advantage |
$21.42
|
| Rate for Payer: Cash Price |
$8.76
|
| Rate for Payer: Cash Price |
$8.76
|
| Rate for Payer: Central Health Plan Commercial |
$15.57
|
| Rate for Payer: Cigna of CA HMO |
$12.45
|
| Rate for Payer: Cigna of CA PPO |
$14.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$32.13
|
| Rate for Payer: EPIC Health Plan Commercial |
$28.92
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$21.42
|
| Rate for Payer: EPIC Health Plan Transplant |
$21.42
|
| Rate for Payer: Galaxy Health WC |
$16.54
|
| Rate for Payer: Global Benefits Group Commercial |
$11.68
|
| Rate for Payer: Health Management Network EPO/PPO |
$17.51
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$14.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$35.13
|
| Rate for Payer: IEHP medi-cal |
$35.34
|
| Rate for Payer: IEHP Medicare Advantage |
$21.42
|
| Rate for Payer: Innovage PACE Commercial |
$32.13
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.89
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$28.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$28.70
|
| Rate for Payer: Multiplan Commercial |
$14.60
|
| Rate for Payer: Networks By Design Commercial |
$12.65
|
| Rate for Payer: Prime Health Services Commercial |
$16.54
|
| Rate for Payer: Prime Health Services Medicare |
$22.71
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$11.68
|
| Rate for Payer: Riverside University Health MISP |
$23.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$11.68
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$11.68
|
| Rate for Payer: United Healthcare All Other Commercial |
$17.35
|
| Rate for Payer: United Healthcare All Other HMO |
$17.35
|
| Rate for Payer: United Healthcare HMO Rider |
$17.35
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$17.35
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$32.13
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$23.56
|
| Rate for Payer: Vantage Medical Group Senior |
$21.42
|
|
|
HC SOM 22FP 88275 MULTIPLE
|
Facility
OP
|
$19.22
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
900914754
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$3.84 |
| Max. Negotiated Rate |
$2,322.69 |
| Rate for Payer: Adventist Health Medi-Cal |
$51.19
|
| Rate for Payer: Aetna of CA HMO/PPO |
$294.70
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$76.78
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$56.31
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$51.19
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,904.23
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,322.69
|
| Rate for Payer: BCBS Transplant Transplant |
$11.53
|
| Rate for Payer: Blue Shield of California Commercial |
$11.88
|
| Rate for Payer: Blue Shield of California EPN |
$9.34
|
| Rate for Payer: Caremore Medicare Advantage |
$51.19
|
| Rate for Payer: Cash Price |
$8.65
|
| Rate for Payer: Cash Price |
$8.65
|
| Rate for Payer: Central Health Plan Commercial |
$15.38
|
| Rate for Payer: Cigna of CA HMO |
$12.30
|
| Rate for Payer: Cigna of CA PPO |
$14.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$76.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$69.11
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$51.19
|
| Rate for Payer: EPIC Health Plan Transplant |
$51.19
|
| Rate for Payer: Galaxy Health WC |
$16.34
|
| Rate for Payer: Global Benefits Group Commercial |
$11.53
|
| Rate for Payer: Health Management Network EPO/PPO |
$17.30
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$14.42
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$83.95
|
| Rate for Payer: IEHP medi-cal |
$84.46
|
| Rate for Payer: IEHP Medicare Advantage |
$51.19
|
| Rate for Payer: Innovage PACE Commercial |
$76.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$51.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.84
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$68.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$68.59
|
| Rate for Payer: Multiplan Commercial |
$14.42
|
| Rate for Payer: Networks By Design Commercial |
$12.49
|
| Rate for Payer: Prime Health Services Commercial |
$16.34
|
| Rate for Payer: Prime Health Services Medicare |
$54.26
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$11.53
|
| Rate for Payer: Riverside University Health MISP |
$56.31
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$11.53
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$11.53
|
| Rate for Payer: United Healthcare All Other Commercial |
$41.46
|
| Rate for Payer: United Healthcare All Other HMO |
$41.46
|
| Rate for Payer: United Healthcare HMO Rider |
$41.46
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$41.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$76.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$56.31
|
| Rate for Payer: Vantage Medical Group Senior |
$51.19
|
|
|
HC SOM 22FP 88275 MULTIPLE
|
Facility
IP
|
$19.22
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
900914754
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$3.84 |
| Max. Negotiated Rate |
$17.30 |
| Rate for Payer: Cash Price |
$8.65
|
| Rate for Payer: Central Health Plan Commercial |
$15.38
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.69
|
| Rate for Payer: Galaxy Health WC |
$16.34
|
| Rate for Payer: Global Benefits Group Commercial |
$11.53
|
| Rate for Payer: Health Management Network EPO/PPO |
$17.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.84
|
| Rate for Payer: Multiplan Commercial |
$14.42
|
| Rate for Payer: Networks By Design Commercial |
$12.49
|
| Rate for Payer: Prime Health Services Commercial |
$16.34
|
|
|
HC SOM 26 ADD FISH PROB 100-300
|
Facility
OP
|
$281.76
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
900914714
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$41.46 |
| Max. Negotiated Rate |
$2,322.69 |
| Rate for Payer: Adventist Health Medi-Cal |
$51.19
|
| Rate for Payer: Aetna of CA HMO/PPO |
$294.70
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$76.78
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$56.31
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$51.19
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,904.23
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,322.69
|
| Rate for Payer: BCBS Transplant Transplant |
$169.06
|
| Rate for Payer: Blue Shield of California Commercial |
$174.13
|
| Rate for Payer: Blue Shield of California EPN |
$136.94
|
| Rate for Payer: Caremore Medicare Advantage |
$51.19
|
| Rate for Payer: Cash Price |
$126.79
|
| Rate for Payer: Cash Price |
$126.79
|
| Rate for Payer: Central Health Plan Commercial |
$225.41
|
| Rate for Payer: Cigna of CA HMO |
$180.33
|
| Rate for Payer: Cigna of CA PPO |
$208.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$76.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$69.11
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$51.19
|
| Rate for Payer: EPIC Health Plan Transplant |
$51.19
|
| Rate for Payer: Galaxy Health WC |
$239.50
|
| Rate for Payer: Global Benefits Group Commercial |
$169.06
|
| Rate for Payer: Health Management Network EPO/PPO |
$253.58
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$211.32
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$83.95
|
| Rate for Payer: IEHP medi-cal |
$84.46
|
| Rate for Payer: IEHP Medicare Advantage |
$51.19
|
| Rate for Payer: Innovage PACE Commercial |
$76.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$187.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$51.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$56.35
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$68.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$68.59
|
| Rate for Payer: Multiplan Commercial |
$211.32
|
| Rate for Payer: Networks By Design Commercial |
$183.14
|
| Rate for Payer: Prime Health Services Commercial |
$239.50
|
| Rate for Payer: Prime Health Services Medicare |
$54.26
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$169.06
|
| Rate for Payer: Riverside University Health MISP |
$56.31
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$169.06
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$169.06
|
| Rate for Payer: United Healthcare All Other Commercial |
$41.46
|
| Rate for Payer: United Healthcare All Other HMO |
$41.46
|
| Rate for Payer: United Healthcare HMO Rider |
$41.46
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$41.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$76.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$56.31
|
| Rate for Payer: Vantage Medical Group Senior |
$51.19
|
|
|
HC SOM 26 ADD FISH PROB 100-300
|
Facility
IP
|
$281.76
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
900914714
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$56.35 |
| Max. Negotiated Rate |
$253.58 |
| Rate for Payer: Cash Price |
$126.79
|
| Rate for Payer: Central Health Plan Commercial |
$225.41
|
| Rate for Payer: EPIC Health Plan Commercial |
$112.70
|
| Rate for Payer: Galaxy Health WC |
$239.50
|
| Rate for Payer: Global Benefits Group Commercial |
$169.06
|
| Rate for Payer: Health Management Network EPO/PPO |
$253.58
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$187.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$56.35
|
| Rate for Payer: Multiplan Commercial |
$211.32
|
| Rate for Payer: Networks By Design Commercial |
$183.14
|
| Rate for Payer: Prime Health Services Commercial |
$239.50
|
|
|
HC SOM 26 ADD FISH PROBES
|
Facility
OP
|
$463.14
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
900914713
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$17.35 |
| Max. Negotiated Rate |
$1,505.45 |
| Rate for Payer: Adventist Health Medi-Cal |
$21.42
|
| Rate for Payer: Aetna of CA HMO/PPO |
$157.20
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$32.13
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$23.56
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$21.42
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,234.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,505.45
|
| Rate for Payer: BCBS Transplant Transplant |
$277.88
|
| Rate for Payer: Blue Shield of California Commercial |
$286.22
|
| Rate for Payer: Blue Shield of California EPN |
$225.09
|
| Rate for Payer: Caremore Medicare Advantage |
$21.42
|
| Rate for Payer: Cash Price |
$208.41
|
| Rate for Payer: Cash Price |
$208.41
|
| Rate for Payer: Central Health Plan Commercial |
$370.51
|
| Rate for Payer: Cigna of CA HMO |
$296.41
|
| Rate for Payer: Cigna of CA PPO |
$342.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$32.13
|
| Rate for Payer: EPIC Health Plan Commercial |
$28.92
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$21.42
|
| Rate for Payer: EPIC Health Plan Transplant |
$21.42
|
| Rate for Payer: Galaxy Health WC |
$393.67
|
| Rate for Payer: Global Benefits Group Commercial |
$277.88
|
| Rate for Payer: Health Management Network EPO/PPO |
$416.83
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$347.36
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$35.13
|
| Rate for Payer: IEHP medi-cal |
$35.34
|
| Rate for Payer: IEHP Medicare Advantage |
$21.42
|
| Rate for Payer: Innovage PACE Commercial |
$32.13
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$308.91
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$92.63
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$28.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$28.70
|
| Rate for Payer: Multiplan Commercial |
$347.36
|
| Rate for Payer: Networks By Design Commercial |
$301.04
|
| Rate for Payer: Prime Health Services Commercial |
$393.67
|
| Rate for Payer: Prime Health Services Medicare |
$22.71
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$277.88
|
| Rate for Payer: Riverside University Health MISP |
$23.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$277.88
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$277.88
|
| Rate for Payer: United Healthcare All Other Commercial |
$17.35
|
| Rate for Payer: United Healthcare All Other HMO |
$17.35
|
| Rate for Payer: United Healthcare HMO Rider |
$17.35
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$17.35
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$32.13
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$23.56
|
| Rate for Payer: Vantage Medical Group Senior |
$21.42
|
|
|
HC SOM 26 ADD FISH PROBES
|
Facility
IP
|
$463.14
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
900914713
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$92.63 |
| Max. Negotiated Rate |
$416.83 |
| Rate for Payer: Cash Price |
$208.41
|
| Rate for Payer: Central Health Plan Commercial |
$370.51
|
| Rate for Payer: EPIC Health Plan Commercial |
$185.26
|
| Rate for Payer: Galaxy Health WC |
$393.67
|
| Rate for Payer: Global Benefits Group Commercial |
$277.88
|
| Rate for Payer: Health Management Network EPO/PPO |
$416.83
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$308.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$92.63
|
| Rate for Payer: Multiplan Commercial |
$347.36
|
| Rate for Payer: Networks By Design Commercial |
$301.04
|
| Rate for Payer: Prime Health Services Commercial |
$393.67
|
|
|
HC SOM 28 ADD FISH PROB 100-300
|
Facility
IP
|
$302.64
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
900914712
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$60.53 |
| Max. Negotiated Rate |
$272.38 |
| Rate for Payer: Cash Price |
$136.19
|
| Rate for Payer: Central Health Plan Commercial |
$242.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$121.06
|
| Rate for Payer: Galaxy Health WC |
$257.24
|
| Rate for Payer: Global Benefits Group Commercial |
$181.58
|
| Rate for Payer: Health Management Network EPO/PPO |
$272.38
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$201.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$60.53
|
| Rate for Payer: Multiplan Commercial |
$226.98
|
| Rate for Payer: Networks By Design Commercial |
$196.72
|
| Rate for Payer: Prime Health Services Commercial |
$257.24
|
|
|
HC SOM 28 ADD FISH PROB 100-300
|
Facility
OP
|
$302.64
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
900914712
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$41.46 |
| Max. Negotiated Rate |
$2,322.69 |
| Rate for Payer: Adventist Health Medi-Cal |
$51.19
|
| Rate for Payer: Aetna of CA HMO/PPO |
$294.70
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$76.78
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$56.31
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$51.19
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,904.23
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,322.69
|
| Rate for Payer: BCBS Transplant Transplant |
$181.58
|
| Rate for Payer: Blue Shield of California Commercial |
$187.03
|
| Rate for Payer: Blue Shield of California EPN |
$147.08
|
| Rate for Payer: Caremore Medicare Advantage |
$51.19
|
| Rate for Payer: Cash Price |
$136.19
|
| Rate for Payer: Cash Price |
$136.19
|
| Rate for Payer: Central Health Plan Commercial |
$242.11
|
| Rate for Payer: Cigna of CA HMO |
$193.69
|
| Rate for Payer: Cigna of CA PPO |
$223.95
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$76.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$69.11
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$51.19
|
| Rate for Payer: EPIC Health Plan Transplant |
$51.19
|
| Rate for Payer: Galaxy Health WC |
$257.24
|
| Rate for Payer: Global Benefits Group Commercial |
$181.58
|
| Rate for Payer: Health Management Network EPO/PPO |
$272.38
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$226.98
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$83.95
|
| Rate for Payer: IEHP medi-cal |
$84.46
|
| Rate for Payer: IEHP Medicare Advantage |
$51.19
|
| Rate for Payer: Innovage PACE Commercial |
$76.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$201.86
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$51.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$60.53
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$68.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$68.59
|
| Rate for Payer: Multiplan Commercial |
$226.98
|
| Rate for Payer: Networks By Design Commercial |
$196.72
|
| Rate for Payer: Prime Health Services Commercial |
$257.24
|
| Rate for Payer: Prime Health Services Medicare |
$54.26
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$181.58
|
| Rate for Payer: Riverside University Health MISP |
$56.31
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$181.58
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$181.58
|
| Rate for Payer: United Healthcare All Other Commercial |
$41.46
|
| Rate for Payer: United Healthcare All Other HMO |
$41.46
|
| Rate for Payer: United Healthcare HMO Rider |
$41.46
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$41.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$76.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$56.31
|
| Rate for Payer: Vantage Medical Group Senior |
$51.19
|
|
|
HC SOM 28 ADD FISH PROBES
|
Facility
OP
|
$497.56
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
900914711
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$17.35 |
| Max. Negotiated Rate |
$1,505.45 |
| Rate for Payer: Adventist Health Medi-Cal |
$21.42
|
| Rate for Payer: Aetna of CA HMO/PPO |
$157.20
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$32.13
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$23.56
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$21.42
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,234.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,505.45
|
| Rate for Payer: BCBS Transplant Transplant |
$298.54
|
| Rate for Payer: Blue Shield of California Commercial |
$307.49
|
| Rate for Payer: Blue Shield of California EPN |
$241.81
|
| Rate for Payer: Caremore Medicare Advantage |
$21.42
|
| Rate for Payer: Cash Price |
$223.90
|
| Rate for Payer: Cash Price |
$223.90
|
| Rate for Payer: Central Health Plan Commercial |
$398.05
|
| Rate for Payer: Cigna of CA HMO |
$318.44
|
| Rate for Payer: Cigna of CA PPO |
$368.19
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$32.13
|
| Rate for Payer: EPIC Health Plan Commercial |
$28.92
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$21.42
|
| Rate for Payer: EPIC Health Plan Transplant |
$21.42
|
| Rate for Payer: Galaxy Health WC |
$422.93
|
| Rate for Payer: Global Benefits Group Commercial |
$298.54
|
| Rate for Payer: Health Management Network EPO/PPO |
$447.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$373.17
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$35.13
|
| Rate for Payer: IEHP medi-cal |
$35.34
|
| Rate for Payer: IEHP Medicare Advantage |
$21.42
|
| Rate for Payer: Innovage PACE Commercial |
$32.13
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$331.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$99.51
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$28.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$28.70
|
| Rate for Payer: Multiplan Commercial |
$373.17
|
| Rate for Payer: Networks By Design Commercial |
$323.41
|
| Rate for Payer: Prime Health Services Commercial |
$422.93
|
| Rate for Payer: Prime Health Services Medicare |
$22.71
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$298.54
|
| Rate for Payer: Riverside University Health MISP |
$23.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$298.54
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$298.54
|
| Rate for Payer: United Healthcare All Other Commercial |
$17.35
|
| Rate for Payer: United Healthcare All Other HMO |
$17.35
|
| Rate for Payer: United Healthcare HMO Rider |
$17.35
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$17.35
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$32.13
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$23.56
|
| Rate for Payer: Vantage Medical Group Senior |
$21.42
|
|
|
HC SOM 28 ADD FISH PROBES
|
Facility
IP
|
$497.56
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
900914711
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$99.51 |
| Max. Negotiated Rate |
$447.80 |
| Rate for Payer: Cash Price |
$223.90
|
| Rate for Payer: Central Health Plan Commercial |
$398.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$199.02
|
| Rate for Payer: Galaxy Health WC |
$422.93
|
| Rate for Payer: Global Benefits Group Commercial |
$298.54
|
| Rate for Payer: Health Management Network EPO/PPO |
$447.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$331.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$99.51
|
| Rate for Payer: Multiplan Commercial |
$373.17
|
| Rate for Payer: Networks By Design Commercial |
$323.41
|
| Rate for Payer: Prime Health Services Commercial |
$422.93
|
|
|
HC SOM 5-FLUOROCYTOSINE
|
Facility
OP
|
$34.02
|
|
|
Service Code
|
CPT 80299
|
| Hospital Charge Code |
900911263
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.80 |
| Max. Negotiated Rate |
$129.22 |
| Rate for Payer: Adventist Health Medi-Cal |
$18.64
|
| Rate for Payer: Aetna of CA HMO/PPO |
$97.19
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$27.96
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$20.50
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$18.64
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$105.94
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$129.22
|
| Rate for Payer: BCBS Transplant Transplant |
$20.41
|
| Rate for Payer: Blue Shield of California Commercial |
$21.02
|
| Rate for Payer: Blue Shield of California EPN |
$16.53
|
| Rate for Payer: Caremore Medicare Advantage |
$18.64
|
| Rate for Payer: Cash Price |
$15.31
|
| Rate for Payer: Cash Price |
$15.31
|
| Rate for Payer: Central Health Plan Commercial |
$27.22
|
| Rate for Payer: Cigna of CA HMO |
$21.77
|
| Rate for Payer: Cigna of CA PPO |
$25.17
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$27.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$25.16
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$18.64
|
| Rate for Payer: EPIC Health Plan Transplant |
$18.64
|
| Rate for Payer: Galaxy Health WC |
$28.92
|
| Rate for Payer: Global Benefits Group Commercial |
$20.41
|
| Rate for Payer: Health Management Network EPO/PPO |
$30.62
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$25.52
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$30.57
|
| Rate for Payer: IEHP medi-cal |
$30.76
|
| Rate for Payer: IEHP Medicare Advantage |
$18.64
|
| Rate for Payer: Innovage PACE Commercial |
$27.96
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$22.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$24.98
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$24.98
|
| Rate for Payer: Multiplan Commercial |
$25.52
|
| Rate for Payer: Networks By Design Commercial |
$22.11
|
| Rate for Payer: Prime Health Services Commercial |
$28.92
|
| Rate for Payer: Prime Health Services Medicare |
$19.76
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$20.41
|
| Rate for Payer: Riverside University Health MISP |
$20.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$20.41
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$20.41
|
| Rate for Payer: United Healthcare All Other Commercial |
$15.10
|
| Rate for Payer: United Healthcare All Other HMO |
$15.10
|
| Rate for Payer: United Healthcare HMO Rider |
$15.10
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15.10
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$27.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$20.50
|
| Rate for Payer: Vantage Medical Group Senior |
$18.64
|
|
|
HC SOM 5-FLUOROCYTOSINE
|
Facility
IP
|
$34.02
|
|
|
Service Code
|
CPT 80299
|
| Hospital Charge Code |
900911263
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.80 |
| Max. Negotiated Rate |
$30.62 |
| Rate for Payer: Cash Price |
$15.31
|
| Rate for Payer: Central Health Plan Commercial |
$27.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.61
|
| Rate for Payer: Galaxy Health WC |
$28.92
|
| Rate for Payer: Global Benefits Group Commercial |
$20.41
|
| Rate for Payer: Health Management Network EPO/PPO |
$30.62
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$22.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.80
|
| Rate for Payer: Multiplan Commercial |
$25.52
|
| Rate for Payer: Networks By Design Commercial |
$22.11
|
| Rate for Payer: Prime Health Services Commercial |
$28.92
|
|
|
HC SOM 7-DEHYDROCHOLESTERL
|
Facility
IP
|
$100.00
|
|
|
Service Code
|
CPT 82542
|
| Hospital Charge Code |
900910710
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$20.00 |
| Max. Negotiated Rate |
$90.00 |
| Rate for Payer: Cash Price |
$45.00
|
| Rate for Payer: Central Health Plan Commercial |
$80.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$40.00
|
| Rate for Payer: Galaxy Health WC |
$85.00
|
| Rate for Payer: Global Benefits Group Commercial |
$60.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$90.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$66.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.00
|
| Rate for Payer: Multiplan Commercial |
$75.00
|
| Rate for Payer: Networks By Design Commercial |
$65.00
|
| Rate for Payer: Prime Health Services Commercial |
$85.00
|
|
|
HC SOM 7-DEHYDROCHOLESTERL
|
Facility
OP
|
$100.00
|
|
|
Service Code
|
CPT 82542
|
| Hospital Charge Code |
900910710
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$19.51 |
| Max. Negotiated Rate |
$159.57 |
| Rate for Payer: Adventist Health Medi-Cal |
$24.09
|
| Rate for Payer: Aetna of CA HMO/PPO |
$132.53
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$36.14
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$26.50
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$24.09
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$130.82
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$159.57
|
| Rate for Payer: BCBS Transplant Transplant |
$60.00
|
| Rate for Payer: Blue Shield of California Commercial |
$61.80
|
| Rate for Payer: Blue Shield of California EPN |
$48.60
|
| Rate for Payer: Caremore Medicare Advantage |
$24.09
|
| Rate for Payer: Cash Price |
$45.00
|
| Rate for Payer: Cash Price |
$45.00
|
| Rate for Payer: Central Health Plan Commercial |
$80.00
|
| Rate for Payer: Cigna of CA HMO |
$64.00
|
| Rate for Payer: Cigna of CA PPO |
$74.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$36.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$32.52
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$24.09
|
| Rate for Payer: EPIC Health Plan Transplant |
$24.09
|
| Rate for Payer: Galaxy Health WC |
$85.00
|
| Rate for Payer: Global Benefits Group Commercial |
$60.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$90.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$75.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$39.51
|
| Rate for Payer: IEHP medi-cal |
$39.75
|
| Rate for Payer: IEHP Medicare Advantage |
$24.09
|
| Rate for Payer: Innovage PACE Commercial |
$36.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$66.70
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$24.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$32.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$32.28
|
| Rate for Payer: Multiplan Commercial |
$75.00
|
| Rate for Payer: Networks By Design Commercial |
$65.00
|
| Rate for Payer: Prime Health Services Commercial |
$85.00
|
| Rate for Payer: Prime Health Services Medicare |
$25.54
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$60.00
|
| Rate for Payer: Riverside University Health MISP |
$26.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$60.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$60.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$19.51
|
| Rate for Payer: United Healthcare All Other HMO |
$19.51
|
| Rate for Payer: United Healthcare HMO Rider |
$19.51
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$19.51
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$36.14
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$26.50
|
| Rate for Payer: Vantage Medical Group Senior |
$24.09
|
|
|
HC SOM ACETYLCHOLINE RECPT AB BINDING
|
Facility
OP
|
$39.75
|
|
|
Service Code
|
CPT 83519
|
| Hospital Charge Code |
900911205
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.95 |
| Max. Negotiated Rate |
$119.90 |
| Rate for Payer: Adventist Health Medi-Cal |
$18.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$99.15
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$27.60
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$20.24
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$18.40
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$98.30
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$119.90
|
| Rate for Payer: BCBS Transplant Transplant |
$23.85
|
| Rate for Payer: Blue Shield of California Commercial |
$24.57
|
| Rate for Payer: Blue Shield of California EPN |
$19.32
|
| Rate for Payer: Caremore Medicare Advantage |
$18.40
|
| Rate for Payer: Cash Price |
$17.89
|
| Rate for Payer: Cash Price |
$17.89
|
| Rate for Payer: Central Health Plan Commercial |
$31.80
|
| Rate for Payer: Cigna of CA HMO |
$25.44
|
| Rate for Payer: Cigna of CA PPO |
$29.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$27.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$24.84
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$18.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$18.40
|
| Rate for Payer: Galaxy Health WC |
$33.79
|
| Rate for Payer: Global Benefits Group Commercial |
$23.85
|
| Rate for Payer: Health Management Network EPO/PPO |
$35.78
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$29.81
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$30.18
|
| Rate for Payer: IEHP medi-cal |
$30.36
|
| Rate for Payer: IEHP Medicare Advantage |
$18.40
|
| Rate for Payer: Innovage PACE Commercial |
$27.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$26.51
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.95
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$24.66
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$24.66
|
| Rate for Payer: Multiplan Commercial |
$29.81
|
| Rate for Payer: Networks By Design Commercial |
$25.84
|
| Rate for Payer: Prime Health Services Commercial |
$33.79
|
| Rate for Payer: Prime Health Services Medicare |
$19.50
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$23.85
|
| Rate for Payer: Riverside University Health MISP |
$20.24
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$23.85
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$23.85
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.90
|
| Rate for Payer: United Healthcare All Other HMO |
$14.90
|
| Rate for Payer: United Healthcare HMO Rider |
$14.90
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.90
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$27.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$20.24
|
| Rate for Payer: Vantage Medical Group Senior |
$18.40
|
|
|
HC SOM ACETYLCHOLINE RECPT AB BINDING
|
Facility
IP
|
$39.75
|
|
|
Service Code
|
CPT 83519
|
| Hospital Charge Code |
900911205
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.95 |
| Max. Negotiated Rate |
$35.78 |
| Rate for Payer: Cash Price |
$17.89
|
| Rate for Payer: Central Health Plan Commercial |
$31.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.90
|
| Rate for Payer: Galaxy Health WC |
$33.79
|
| Rate for Payer: Global Benefits Group Commercial |
$23.85
|
| Rate for Payer: Health Management Network EPO/PPO |
$35.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$26.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.95
|
| Rate for Payer: Multiplan Commercial |
$29.81
|
| Rate for Payer: Networks By Design Commercial |
$25.84
|
| Rate for Payer: Prime Health Services Commercial |
$33.79
|
|
|
HC SOM ACETYLCHOLINESTERASE
|
Facility
OP
|
$38.00
|
|
|
Service Code
|
CPT 82482
|
| Hospital Charge Code |
900910948
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.60 |
| Max. Negotiated Rate |
$68.16 |
| Rate for Payer: Adventist Health Medi-Cal |
$9.81
|
| Rate for Payer: Aetna of CA HMO/PPO |
$56.39
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$14.72
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$10.79
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$9.81
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$55.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$68.16
|
| Rate for Payer: BCBS Transplant Transplant |
$22.80
|
| Rate for Payer: Blue Shield of California Commercial |
$23.48
|
| Rate for Payer: Blue Shield of California EPN |
$18.47
|
| Rate for Payer: Caremore Medicare Advantage |
$9.81
|
| Rate for Payer: Cash Price |
$17.10
|
| Rate for Payer: Cash Price |
$17.10
|
| Rate for Payer: Central Health Plan Commercial |
$30.40
|
| Rate for Payer: Cigna of CA HMO |
$24.32
|
| Rate for Payer: Cigna of CA PPO |
$28.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$14.72
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.24
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$9.81
|
| Rate for Payer: EPIC Health Plan Transplant |
$9.81
|
| Rate for Payer: Galaxy Health WC |
$32.30
|
| Rate for Payer: Global Benefits Group Commercial |
$22.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$34.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$28.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$16.09
|
| Rate for Payer: IEHP medi-cal |
$16.19
|
| Rate for Payer: IEHP Medicare Advantage |
$9.81
|
| Rate for Payer: Innovage PACE Commercial |
$14.72
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$25.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$13.15
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$13.15
|
| Rate for Payer: Multiplan Commercial |
$28.50
|
| Rate for Payer: Networks By Design Commercial |
$24.70
|
| Rate for Payer: Prime Health Services Commercial |
$32.30
|
| Rate for Payer: Prime Health Services Medicare |
$10.40
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$22.80
|
| Rate for Payer: Riverside University Health MISP |
$10.79
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$22.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$22.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.95
|
| Rate for Payer: United Healthcare All Other HMO |
$7.95
|
| Rate for Payer: United Healthcare HMO Rider |
$7.95
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.95
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$14.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.79
|
| Rate for Payer: Vantage Medical Group Senior |
$9.81
|
|
|
HC SOM ACETYLCHOLINESTERASE
|
Facility
IP
|
$38.00
|
|
|
Service Code
|
CPT 82482
|
| Hospital Charge Code |
900910948
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.60 |
| Max. Negotiated Rate |
$34.20 |
| Rate for Payer: Cash Price |
$17.10
|
| Rate for Payer: Central Health Plan Commercial |
$30.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.20
|
| Rate for Payer: Galaxy Health WC |
$32.30
|
| Rate for Payer: Global Benefits Group Commercial |
$22.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$34.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$25.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.60
|
| Rate for Payer: Multiplan Commercial |
$28.50
|
| Rate for Payer: Networks By Design Commercial |
$24.70
|
| Rate for Payer: Prime Health Services Commercial |
$32.30
|
|
|
HC SOM ACH RECEPTOR BINDING AB
|
Facility
OP
|
$39.75
|
|
|
Service Code
|
CPT 83519
|
| Hospital Charge Code |
900912583
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.95 |
| Max. Negotiated Rate |
$119.90 |
| Rate for Payer: Adventist Health Medi-Cal |
$18.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$99.15
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$27.60
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$20.24
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$18.40
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$98.30
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$119.90
|
| Rate for Payer: BCBS Transplant Transplant |
$23.85
|
| Rate for Payer: Blue Shield of California Commercial |
$24.57
|
| Rate for Payer: Blue Shield of California EPN |
$19.32
|
| Rate for Payer: Caremore Medicare Advantage |
$18.40
|
| Rate for Payer: Cash Price |
$17.89
|
| Rate for Payer: Cash Price |
$17.89
|
| Rate for Payer: Central Health Plan Commercial |
$31.80
|
| Rate for Payer: Cigna of CA HMO |
$25.44
|
| Rate for Payer: Cigna of CA PPO |
$29.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$27.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$24.84
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$18.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$18.40
|
| Rate for Payer: Galaxy Health WC |
$33.79
|
| Rate for Payer: Global Benefits Group Commercial |
$23.85
|
| Rate for Payer: Health Management Network EPO/PPO |
$35.78
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$29.81
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$30.18
|
| Rate for Payer: IEHP medi-cal |
$30.36
|
| Rate for Payer: IEHP Medicare Advantage |
$18.40
|
| Rate for Payer: Innovage PACE Commercial |
$27.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$26.51
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.95
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$24.66
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$24.66
|
| Rate for Payer: Multiplan Commercial |
$29.81
|
| Rate for Payer: Networks By Design Commercial |
$25.84
|
| Rate for Payer: Prime Health Services Commercial |
$33.79
|
| Rate for Payer: Prime Health Services Medicare |
$19.50
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$23.85
|
| Rate for Payer: Riverside University Health MISP |
$20.24
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$23.85
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$23.85
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.90
|
| Rate for Payer: United Healthcare All Other HMO |
$14.90
|
| Rate for Payer: United Healthcare HMO Rider |
$14.90
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.90
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$27.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$20.24
|
| Rate for Payer: Vantage Medical Group Senior |
$18.40
|
|
|
HC SOM ACH RECEPTOR BINDING AB
|
Facility
IP
|
$39.75
|
|
|
Service Code
|
CPT 83519
|
| Hospital Charge Code |
900912583
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.95 |
| Max. Negotiated Rate |
$35.78 |
| Rate for Payer: Cash Price |
$17.89
|
| Rate for Payer: Central Health Plan Commercial |
$31.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.90
|
| Rate for Payer: Galaxy Health WC |
$33.79
|
| Rate for Payer: Global Benefits Group Commercial |
$23.85
|
| Rate for Payer: Health Management Network EPO/PPO |
$35.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$26.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.95
|
| Rate for Payer: Multiplan Commercial |
$29.81
|
| Rate for Payer: Networks By Design Commercial |
$25.84
|
| Rate for Payer: Prime Health Services Commercial |
$33.79
|
|
