|
HC SOM AF CULT GENE TEST CRYO
|
Facility
IP
|
$14.46
|
|
|
Service Code
|
CPT 88240
|
| Hospital Charge Code |
900915289
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$2.89 |
| Max. Negotiated Rate |
$13.01 |
| Rate for Payer: Cash Price |
$6.51
|
| Rate for Payer: Central Health Plan Commercial |
$11.57
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.78
|
| Rate for Payer: Galaxy Health WC |
$12.29
|
| Rate for Payer: Global Benefits Group Commercial |
$8.68
|
| Rate for Payer: Health Management Network EPO/PPO |
$13.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.89
|
| Rate for Payer: Multiplan Commercial |
$10.84
|
| Rate for Payer: Networks By Design Commercial |
$9.40
|
| Rate for Payer: Prime Health Services Commercial |
$12.29
|
|
|
HC SOM AFP & TOTAL AFT, SERUM
|
Facility
IP
|
$125.00
|
|
|
Service Code
|
CPT 82107
|
| Hospital Charge Code |
900913812
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$25.00 |
| Max. Negotiated Rate |
$112.50 |
| Rate for Payer: Cash Price |
$56.25
|
| Rate for Payer: Central Health Plan Commercial |
$100.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$50.00
|
| Rate for Payer: Galaxy Health WC |
$106.25
|
| Rate for Payer: Global Benefits Group Commercial |
$75.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$112.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$83.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.00
|
| Rate for Payer: Multiplan Commercial |
$93.75
|
| Rate for Payer: Networks By Design Commercial |
$81.25
|
| Rate for Payer: Prime Health Services Commercial |
$106.25
|
|
|
HC SOM AFP & TOTAL AFT, SERUM
|
Facility
OP
|
$125.00
|
|
|
Service Code
|
CPT 82107
|
| Hospital Charge Code |
900913812
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$25.00 |
| Max. Negotiated Rate |
$559.11 |
| Rate for Payer: Adventist Health Medi-Cal |
$64.41
|
| Rate for Payer: Aetna of CA HMO/PPO |
$472.69
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$96.62
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$70.85
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$64.41
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$458.38
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$559.11
|
| Rate for Payer: BCBS Transplant Transplant |
$75.00
|
| Rate for Payer: Blue Shield of California Commercial |
$77.25
|
| Rate for Payer: Blue Shield of California EPN |
$60.75
|
| Rate for Payer: Caremore Medicare Advantage |
$64.41
|
| Rate for Payer: Cash Price |
$56.25
|
| Rate for Payer: Cash Price |
$56.25
|
| Rate for Payer: Central Health Plan Commercial |
$100.00
|
| Rate for Payer: Cigna of CA HMO |
$80.00
|
| Rate for Payer: Cigna of CA PPO |
$92.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$96.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$86.95
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$64.41
|
| Rate for Payer: EPIC Health Plan Transplant |
$64.41
|
| Rate for Payer: Galaxy Health WC |
$106.25
|
| Rate for Payer: Global Benefits Group Commercial |
$75.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$112.50
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$93.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$105.63
|
| Rate for Payer: IEHP medi-cal |
$106.28
|
| Rate for Payer: IEHP Medicare Advantage |
$64.41
|
| Rate for Payer: Innovage PACE Commercial |
$96.62
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$83.38
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$64.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$86.31
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$86.31
|
| Rate for Payer: Multiplan Commercial |
$93.75
|
| Rate for Payer: Networks By Design Commercial |
$81.25
|
| Rate for Payer: Prime Health Services Commercial |
$106.25
|
| Rate for Payer: Prime Health Services Medicare |
$68.27
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$75.00
|
| Rate for Payer: Riverside University Health MISP |
$70.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$75.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$75.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$52.17
|
| Rate for Payer: United Healthcare All Other HMO |
$52.17
|
| Rate for Payer: United Healthcare HMO Rider |
$52.17
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$52.17
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$96.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$70.85
|
| Rate for Payer: Vantage Medical Group Senior |
$64.41
|
|
|
HC SOM ALBUMIN LEVEL BODY FLUID
|
Facility
OP
|
$10.00
|
|
|
Service Code
|
CPT 82042
|
| Hospital Charge Code |
900914481
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.00 |
| Max. Negotiated Rate |
$45.88 |
| Rate for Payer: Adventist Health Medi-Cal |
$7.78
|
| Rate for Payer: Aetna of CA HMO/PPO |
$24.05
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$11.67
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$8.56
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$7.78
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$37.61
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$45.88
|
| Rate for Payer: BCBS Transplant Transplant |
$6.00
|
| Rate for Payer: Blue Shield of California Commercial |
$6.18
|
| Rate for Payer: Blue Shield of California EPN |
$4.86
|
| Rate for Payer: Caremore Medicare Advantage |
$7.78
|
| Rate for Payer: Cash Price |
$4.50
|
| Rate for Payer: Cash Price |
$4.50
|
| Rate for Payer: Central Health Plan Commercial |
$8.00
|
| Rate for Payer: Cigna of CA HMO |
$6.40
|
| Rate for Payer: Cigna of CA PPO |
$7.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.50
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$7.78
|
| Rate for Payer: EPIC Health Plan Transplant |
$7.78
|
| Rate for Payer: Galaxy Health WC |
$8.50
|
| Rate for Payer: Global Benefits Group Commercial |
$6.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$9.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$7.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$12.76
|
| Rate for Payer: IEHP medi-cal |
$12.84
|
| Rate for Payer: IEHP Medicare Advantage |
$7.78
|
| Rate for Payer: Innovage PACE Commercial |
$11.67
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.43
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10.43
|
| Rate for Payer: Multiplan Commercial |
$7.50
|
| Rate for Payer: Networks By Design Commercial |
$6.50
|
| Rate for Payer: Prime Health Services Commercial |
$8.50
|
| Rate for Payer: Prime Health Services Medicare |
$8.25
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$6.00
|
| Rate for Payer: Riverside University Health MISP |
$8.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.30
|
| Rate for Payer: United Healthcare All Other HMO |
$6.30
|
| Rate for Payer: United Healthcare HMO Rider |
$6.30
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.30
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11.67
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.56
|
| Rate for Payer: Vantage Medical Group Senior |
$7.78
|
|
|
HC SOM ALBUMIN LEVEL BODY FLUID
|
Facility
IP
|
$10.00
|
|
|
Service Code
|
CPT 82042
|
| Hospital Charge Code |
900914481
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.00 |
| Max. Negotiated Rate |
$9.00 |
| Rate for Payer: Cash Price |
$4.50
|
| Rate for Payer: Central Health Plan Commercial |
$8.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.00
|
| Rate for Payer: Galaxy Health WC |
$8.50
|
| Rate for Payer: Global Benefits Group Commercial |
$6.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$9.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.00
|
| Rate for Payer: Multiplan Commercial |
$7.50
|
| Rate for Payer: Networks By Design Commercial |
$6.50
|
| Rate for Payer: Prime Health Services Commercial |
$8.50
|
|
|
HC SOM ALDOLASE
|
Facility
IP
|
$9.00
|
|
|
Service Code
|
CPT 82085
|
| Hospital Charge Code |
900910218
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$1.80 |
| Max. Negotiated Rate |
$8.10 |
| Rate for Payer: Cash Price |
$4.05
|
| Rate for Payer: Central Health Plan Commercial |
$7.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.60
|
| Rate for Payer: Galaxy Health WC |
$7.65
|
| Rate for Payer: Global Benefits Group Commercial |
$5.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$8.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.80
|
| Rate for Payer: Multiplan Commercial |
$6.75
|
| Rate for Payer: Networks By Design Commercial |
$5.85
|
| Rate for Payer: Prime Health Services Commercial |
$7.65
|
|
|
HC SOM ALDOLASE
|
Facility
OP
|
$9.00
|
|
|
Service Code
|
CPT 82085
|
| Hospital Charge Code |
900910218
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$1.80 |
| Max. Negotiated Rate |
$86.15 |
| Rate for Payer: Adventist Health Medi-Cal |
$9.71
|
| Rate for Payer: Aetna of CA HMO/PPO |
$71.24
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$14.56
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$10.68
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$9.71
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$70.62
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$86.15
|
| Rate for Payer: BCBS Transplant Transplant |
$5.40
|
| Rate for Payer: Blue Shield of California Commercial |
$5.56
|
| Rate for Payer: Blue Shield of California EPN |
$4.37
|
| Rate for Payer: Caremore Medicare Advantage |
$9.71
|
| Rate for Payer: Cash Price |
$4.05
|
| Rate for Payer: Cash Price |
$4.05
|
| Rate for Payer: Central Health Plan Commercial |
$7.20
|
| Rate for Payer: Cigna of CA HMO |
$5.76
|
| Rate for Payer: Cigna of CA PPO |
$6.66
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$14.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.11
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$9.71
|
| Rate for Payer: EPIC Health Plan Transplant |
$9.71
|
| Rate for Payer: Galaxy Health WC |
$7.65
|
| Rate for Payer: Global Benefits Group Commercial |
$5.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$8.10
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$6.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$15.92
|
| Rate for Payer: IEHP medi-cal |
$16.02
|
| Rate for Payer: IEHP Medicare Advantage |
$9.71
|
| Rate for Payer: Innovage PACE Commercial |
$14.56
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$13.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$13.01
|
| Rate for Payer: Multiplan Commercial |
$6.75
|
| Rate for Payer: Networks By Design Commercial |
$5.85
|
| Rate for Payer: Prime Health Services Commercial |
$7.65
|
| Rate for Payer: Prime Health Services Medicare |
$10.29
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$5.40
|
| Rate for Payer: Riverside University Health MISP |
$10.68
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.87
|
| Rate for Payer: United Healthcare All Other HMO |
$7.87
|
| Rate for Payer: United Healthcare HMO Rider |
$7.87
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.87
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$14.56
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.68
|
| Rate for Payer: Vantage Medical Group Senior |
$9.71
|
|
|
HC SOM ALDOSTERONE
|
Facility
OP
|
$19.50
|
|
|
Service Code
|
CPT 82088
|
| Hospital Charge Code |
900910965
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.90 |
| Max. Negotiated Rate |
$361.67 |
| Rate for Payer: Adventist Health Medi-Cal |
$40.75
|
| Rate for Payer: Aetna of CA HMO/PPO |
$299.12
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$61.12
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$44.82
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$40.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$296.51
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$361.67
|
| Rate for Payer: BCBS Transplant Transplant |
$11.70
|
| Rate for Payer: Blue Shield of California Commercial |
$12.05
|
| Rate for Payer: Blue Shield of California EPN |
$9.48
|
| Rate for Payer: Caremore Medicare Advantage |
$40.75
|
| Rate for Payer: Cash Price |
$8.78
|
| Rate for Payer: Cash Price |
$8.78
|
| Rate for Payer: Central Health Plan Commercial |
$15.60
|
| Rate for Payer: Cigna of CA HMO |
$12.48
|
| Rate for Payer: Cigna of CA PPO |
$14.43
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$61.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$55.01
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$40.75
|
| Rate for Payer: EPIC Health Plan Transplant |
$40.75
|
| Rate for Payer: Galaxy Health WC |
$16.58
|
| Rate for Payer: Global Benefits Group Commercial |
$11.70
|
| Rate for Payer: Health Management Network EPO/PPO |
$17.55
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$14.62
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$66.83
|
| Rate for Payer: IEHP medi-cal |
$67.24
|
| Rate for Payer: IEHP Medicare Advantage |
$40.75
|
| Rate for Payer: Innovage PACE Commercial |
$61.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$13.01
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$40.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.90
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$54.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$54.60
|
| Rate for Payer: Multiplan Commercial |
$14.62
|
| Rate for Payer: Networks By Design Commercial |
$12.68
|
| Rate for Payer: Prime Health Services Commercial |
$16.58
|
| Rate for Payer: Prime Health Services Medicare |
$43.20
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$11.70
|
| Rate for Payer: Riverside University Health MISP |
$44.82
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$11.70
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$11.70
|
| Rate for Payer: United Healthcare All Other Commercial |
$33.01
|
| Rate for Payer: United Healthcare All Other HMO |
$33.01
|
| Rate for Payer: United Healthcare HMO Rider |
$33.01
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$33.01
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$61.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$44.82
|
| Rate for Payer: Vantage Medical Group Senior |
$40.75
|
|
|
HC SOM ALDOSTERONE
|
Facility
IP
|
$19.50
|
|
|
Service Code
|
CPT 82088
|
| Hospital Charge Code |
900910965
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.90 |
| Max. Negotiated Rate |
$17.55 |
| Rate for Payer: Cash Price |
$8.78
|
| Rate for Payer: Central Health Plan Commercial |
$15.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.80
|
| Rate for Payer: Galaxy Health WC |
$16.58
|
| Rate for Payer: Global Benefits Group Commercial |
$11.70
|
| Rate for Payer: Health Management Network EPO/PPO |
$17.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$13.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.90
|
| Rate for Payer: Multiplan Commercial |
$14.62
|
| Rate for Payer: Networks By Design Commercial |
$12.68
|
| Rate for Payer: Prime Health Services Commercial |
$16.58
|
|
|
HC SOM ALDOSTERONE URINE
|
Facility
IP
|
$45.00
|
|
|
Service Code
|
CPT 82088
|
| Hospital Charge Code |
900910945
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.00 |
| Max. Negotiated Rate |
$40.50 |
| Rate for Payer: Cash Price |
$20.25
|
| Rate for Payer: Central Health Plan Commercial |
$36.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$18.00
|
| Rate for Payer: Galaxy Health WC |
$38.25
|
| Rate for Payer: Global Benefits Group Commercial |
$27.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$40.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$30.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.00
|
| Rate for Payer: Multiplan Commercial |
$33.75
|
| Rate for Payer: Networks By Design Commercial |
$29.25
|
| Rate for Payer: Prime Health Services Commercial |
$38.25
|
|
|
HC SOM ALDOSTERONE URINE
|
Facility
OP
|
$45.00
|
|
|
Service Code
|
CPT 82088
|
| Hospital Charge Code |
900910945
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.00 |
| Max. Negotiated Rate |
$361.67 |
| Rate for Payer: Adventist Health Medi-Cal |
$40.75
|
| Rate for Payer: Aetna of CA HMO/PPO |
$299.12
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$61.12
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$44.82
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$40.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$296.51
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$361.67
|
| Rate for Payer: BCBS Transplant Transplant |
$27.00
|
| Rate for Payer: Blue Shield of California Commercial |
$27.81
|
| Rate for Payer: Blue Shield of California EPN |
$21.87
|
| Rate for Payer: Caremore Medicare Advantage |
$40.75
|
| Rate for Payer: Cash Price |
$20.25
|
| Rate for Payer: Cash Price |
$20.25
|
| Rate for Payer: Central Health Plan Commercial |
$36.00
|
| Rate for Payer: Cigna of CA HMO |
$28.80
|
| Rate for Payer: Cigna of CA PPO |
$33.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$61.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$55.01
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$40.75
|
| Rate for Payer: EPIC Health Plan Transplant |
$40.75
|
| Rate for Payer: Galaxy Health WC |
$38.25
|
| Rate for Payer: Global Benefits Group Commercial |
$27.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$40.50
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$33.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$66.83
|
| Rate for Payer: IEHP medi-cal |
$67.24
|
| Rate for Payer: IEHP Medicare Advantage |
$40.75
|
| Rate for Payer: Innovage PACE Commercial |
$61.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$30.02
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$40.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$54.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$54.60
|
| Rate for Payer: Multiplan Commercial |
$33.75
|
| Rate for Payer: Networks By Design Commercial |
$29.25
|
| Rate for Payer: Prime Health Services Commercial |
$38.25
|
| Rate for Payer: Prime Health Services Medicare |
$43.20
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$27.00
|
| Rate for Payer: Riverside University Health MISP |
$44.82
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$27.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$27.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$33.01
|
| Rate for Payer: United Healthcare All Other HMO |
$33.01
|
| Rate for Payer: United Healthcare HMO Rider |
$33.01
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$33.01
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$61.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$44.82
|
| Rate for Payer: Vantage Medical Group Senior |
$40.75
|
|
|
HC SOM ALKALINE PHOSPHATSE ISO
|
Facility
OP
|
$16.34
|
|
|
Service Code
|
CPT 84080
|
| Hospital Charge Code |
900911249
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.27 |
| Max. Negotiated Rate |
$131.25 |
| Rate for Payer: Adventist Health Medi-Cal |
$14.78
|
| Rate for Payer: Aetna of CA HMO/PPO |
$108.60
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$22.17
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$16.26
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$14.78
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$107.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$131.25
|
| Rate for Payer: BCBS Transplant Transplant |
$9.80
|
| Rate for Payer: Blue Shield of California Commercial |
$10.10
|
| Rate for Payer: Blue Shield of California EPN |
$7.94
|
| Rate for Payer: Caremore Medicare Advantage |
$14.78
|
| Rate for Payer: Cash Price |
$7.35
|
| Rate for Payer: Cash Price |
$7.35
|
| Rate for Payer: Central Health Plan Commercial |
$13.07
|
| Rate for Payer: Cigna of CA HMO |
$10.46
|
| Rate for Payer: Cigna of CA PPO |
$12.09
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$22.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.95
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$14.78
|
| Rate for Payer: EPIC Health Plan Transplant |
$14.78
|
| Rate for Payer: Galaxy Health WC |
$13.89
|
| Rate for Payer: Global Benefits Group Commercial |
$9.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$14.71
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$12.26
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$24.24
|
| Rate for Payer: IEHP medi-cal |
$24.39
|
| Rate for Payer: IEHP Medicare Advantage |
$14.78
|
| Rate for Payer: Innovage PACE Commercial |
$22.17
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.27
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$19.81
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$19.81
|
| Rate for Payer: Multiplan Commercial |
$12.26
|
| Rate for Payer: Networks By Design Commercial |
$10.62
|
| Rate for Payer: Prime Health Services Commercial |
$13.89
|
| Rate for Payer: Prime Health Services Medicare |
$15.67
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$9.80
|
| Rate for Payer: Riverside University Health MISP |
$16.26
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$11.97
|
| Rate for Payer: United Healthcare All Other HMO |
$11.97
|
| Rate for Payer: United Healthcare HMO Rider |
$11.97
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.97
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$22.17
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$16.26
|
| Rate for Payer: Vantage Medical Group Senior |
$14.78
|
|
|
HC SOM ALKALINE PHOSPHATSE ISO
|
Facility
IP
|
$16.34
|
|
|
Service Code
|
CPT 84080
|
| Hospital Charge Code |
900911249
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.27 |
| Max. Negotiated Rate |
$14.71 |
| Rate for Payer: Cash Price |
$7.35
|
| Rate for Payer: Central Health Plan Commercial |
$13.07
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.54
|
| Rate for Payer: Galaxy Health WC |
$13.89
|
| Rate for Payer: Global Benefits Group Commercial |
$9.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$14.71
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.27
|
| Rate for Payer: Multiplan Commercial |
$12.26
|
| Rate for Payer: Networks By Design Commercial |
$10.62
|
| Rate for Payer: Prime Health Services Commercial |
$13.89
|
|
|
HC SOM ALK PHOS TOTAL (SO)
|
Facility
IP
|
$5.73
|
|
|
Service Code
|
CPT 84075
|
| Hospital Charge Code |
900912824
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$1.15 |
| Max. Negotiated Rate |
$5.16 |
| Rate for Payer: Cash Price |
$2.58
|
| Rate for Payer: Central Health Plan Commercial |
$4.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.29
|
| Rate for Payer: Galaxy Health WC |
$4.87
|
| Rate for Payer: Global Benefits Group Commercial |
$3.44
|
| Rate for Payer: Health Management Network EPO/PPO |
$5.16
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.15
|
| Rate for Payer: Multiplan Commercial |
$4.30
|
| Rate for Payer: Networks By Design Commercial |
$3.72
|
| Rate for Payer: Prime Health Services Commercial |
$4.87
|
|
|
HC SOM ALK PHOS TOTAL (SO)
|
Facility
OP
|
$5.73
|
|
|
Service Code
|
CPT 84075
|
| Hospital Charge Code |
900912824
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$1.15 |
| Max. Negotiated Rate |
$45.88 |
| Rate for Payer: Adventist Health Medi-Cal |
$5.18
|
| Rate for Payer: Aetna of CA HMO/PPO |
$37.98
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$7.77
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$5.70
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$5.18
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$37.61
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$45.88
|
| Rate for Payer: BCBS Transplant Transplant |
$3.44
|
| Rate for Payer: Blue Shield of California Commercial |
$3.54
|
| Rate for Payer: Blue Shield of California EPN |
$2.78
|
| Rate for Payer: Caremore Medicare Advantage |
$5.18
|
| Rate for Payer: Cash Price |
$2.58
|
| Rate for Payer: Cash Price |
$2.58
|
| Rate for Payer: Central Health Plan Commercial |
$4.58
|
| Rate for Payer: Cigna of CA HMO |
$3.67
|
| Rate for Payer: Cigna of CA PPO |
$4.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.99
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$5.18
|
| Rate for Payer: EPIC Health Plan Transplant |
$5.18
|
| Rate for Payer: Galaxy Health WC |
$4.87
|
| Rate for Payer: Global Benefits Group Commercial |
$3.44
|
| Rate for Payer: Health Management Network EPO/PPO |
$5.16
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$4.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$8.50
|
| Rate for Payer: IEHP medi-cal |
$8.55
|
| Rate for Payer: IEHP Medicare Advantage |
$5.18
|
| Rate for Payer: Innovage PACE Commercial |
$7.77
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.15
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.94
|
| Rate for Payer: Multiplan Commercial |
$4.30
|
| Rate for Payer: Networks By Design Commercial |
$3.72
|
| Rate for Payer: Prime Health Services Commercial |
$4.87
|
| Rate for Payer: Prime Health Services Medicare |
$5.49
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$3.44
|
| Rate for Payer: Riverside University Health MISP |
$5.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3.44
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3.44
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.19
|
| Rate for Payer: United Healthcare All Other HMO |
$4.19
|
| Rate for Payer: United Healthcare HMO Rider |
$4.19
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.19
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.77
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.70
|
| Rate for Payer: Vantage Medical Group Senior |
$5.18
|
|
|
HC SOM ALPHA-1-ANTITRYPSIN PHENO A1AT
|
Facility
OP
|
$12.77
|
|
|
Service Code
|
CPT 82103
|
| Hospital Charge Code |
900912818
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.55 |
| Max. Negotiated Rate |
$119.12 |
| Rate for Payer: Adventist Health Medi-Cal |
$13.44
|
| Rate for Payer: Aetna of CA HMO/PPO |
$98.60
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$20.16
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$14.78
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$13.44
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$97.66
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$119.12
|
| Rate for Payer: BCBS Transplant Transplant |
$7.66
|
| Rate for Payer: Blue Shield of California Commercial |
$7.89
|
| Rate for Payer: Blue Shield of California EPN |
$6.21
|
| Rate for Payer: Caremore Medicare Advantage |
$13.44
|
| Rate for Payer: Cash Price |
$5.75
|
| Rate for Payer: Cash Price |
$5.75
|
| Rate for Payer: Central Health Plan Commercial |
$10.22
|
| Rate for Payer: Cigna of CA HMO |
$8.17
|
| Rate for Payer: Cigna of CA PPO |
$9.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20.16
|
| Rate for Payer: EPIC Health Plan Commercial |
$18.14
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$13.44
|
| Rate for Payer: EPIC Health Plan Transplant |
$13.44
|
| Rate for Payer: Galaxy Health WC |
$10.85
|
| Rate for Payer: Global Benefits Group Commercial |
$7.66
|
| Rate for Payer: Health Management Network EPO/PPO |
$11.49
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$9.58
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$22.04
|
| Rate for Payer: IEHP medi-cal |
$22.18
|
| Rate for Payer: IEHP Medicare Advantage |
$13.44
|
| Rate for Payer: Innovage PACE Commercial |
$20.16
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8.52
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.55
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18.01
|
| Rate for Payer: Multiplan Commercial |
$9.58
|
| Rate for Payer: Networks By Design Commercial |
$8.30
|
| Rate for Payer: Prime Health Services Commercial |
$10.85
|
| Rate for Payer: Prime Health Services Medicare |
$14.25
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$7.66
|
| Rate for Payer: Riverside University Health MISP |
$14.78
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7.66
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7.66
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.89
|
| Rate for Payer: United Healthcare All Other HMO |
$10.89
|
| Rate for Payer: United Healthcare HMO Rider |
$10.89
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.89
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20.16
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.78
|
| Rate for Payer: Vantage Medical Group Senior |
$13.44
|
|
|
HC SOM ALPHA-1-ANTITRYPSIN PHENO A1AT
|
Facility
IP
|
$12.77
|
|
|
Service Code
|
CPT 82103
|
| Hospital Charge Code |
900912818
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.55 |
| Max. Negotiated Rate |
$11.49 |
| Rate for Payer: Cash Price |
$5.75
|
| Rate for Payer: Central Health Plan Commercial |
$10.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.11
|
| Rate for Payer: Galaxy Health WC |
$10.85
|
| Rate for Payer: Global Benefits Group Commercial |
$7.66
|
| Rate for Payer: Health Management Network EPO/PPO |
$11.49
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.55
|
| Rate for Payer: Multiplan Commercial |
$9.58
|
| Rate for Payer: Networks By Design Commercial |
$8.30
|
| Rate for Payer: Prime Health Services Commercial |
$10.85
|
|
|
HC SOM ALPHA 1-ANTITRYPSIN PHENOTYPE
|
Facility
IP
|
$12.77
|
|
|
Service Code
|
CPT 82104
|
| Hospital Charge Code |
900911068
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.55 |
| Max. Negotiated Rate |
$11.49 |
| Rate for Payer: Cash Price |
$5.75
|
| Rate for Payer: Central Health Plan Commercial |
$10.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.11
|
| Rate for Payer: Galaxy Health WC |
$10.85
|
| Rate for Payer: Global Benefits Group Commercial |
$7.66
|
| Rate for Payer: Health Management Network EPO/PPO |
$11.49
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.55
|
| Rate for Payer: Multiplan Commercial |
$9.58
|
| Rate for Payer: Networks By Design Commercial |
$8.30
|
| Rate for Payer: Prime Health Services Commercial |
$10.85
|
|
|
HC SOM ALPHA 1-ANTITRYPSIN PHENOTYPE
|
Facility
OP
|
$12.77
|
|
|
Service Code
|
CPT 82104
|
| Hospital Charge Code |
900911068
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.55 |
| Max. Negotiated Rate |
$128.26 |
| Rate for Payer: Adventist Health Medi-Cal |
$14.46
|
| Rate for Payer: Aetna of CA HMO/PPO |
$106.15
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$21.69
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$15.91
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$14.46
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$105.15
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$128.26
|
| Rate for Payer: BCBS Transplant Transplant |
$7.66
|
| Rate for Payer: Blue Shield of California Commercial |
$7.89
|
| Rate for Payer: Blue Shield of California EPN |
$6.21
|
| Rate for Payer: Caremore Medicare Advantage |
$14.46
|
| Rate for Payer: Cash Price |
$5.75
|
| Rate for Payer: Cash Price |
$5.75
|
| Rate for Payer: Central Health Plan Commercial |
$10.22
|
| Rate for Payer: Cigna of CA HMO |
$8.17
|
| Rate for Payer: Cigna of CA PPO |
$9.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.52
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$14.46
|
| Rate for Payer: EPIC Health Plan Transplant |
$14.46
|
| Rate for Payer: Galaxy Health WC |
$10.85
|
| Rate for Payer: Global Benefits Group Commercial |
$7.66
|
| Rate for Payer: Health Management Network EPO/PPO |
$11.49
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$9.58
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$23.71
|
| Rate for Payer: IEHP medi-cal |
$23.86
|
| Rate for Payer: IEHP Medicare Advantage |
$14.46
|
| Rate for Payer: Innovage PACE Commercial |
$21.69
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8.52
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.55
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$19.38
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$19.38
|
| Rate for Payer: Multiplan Commercial |
$9.58
|
| Rate for Payer: Networks By Design Commercial |
$8.30
|
| Rate for Payer: Prime Health Services Commercial |
$10.85
|
| Rate for Payer: Prime Health Services Medicare |
$15.33
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$7.66
|
| Rate for Payer: Riverside University Health MISP |
$15.91
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7.66
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7.66
|
| Rate for Payer: United Healthcare All Other Commercial |
$11.71
|
| Rate for Payer: United Healthcare All Other HMO |
$11.71
|
| Rate for Payer: United Healthcare HMO Rider |
$11.71
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.71
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21.69
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15.91
|
| Rate for Payer: Vantage Medical Group Senior |
$14.46
|
|
|
HC SOM ALPHA-1-ANTITRYPSIN, STOOL
|
Facility
OP
|
$20.00
|
|
|
Service Code
|
CPT 82103
|
| Hospital Charge Code |
900910858
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.00 |
| Max. Negotiated Rate |
$119.12 |
| Rate for Payer: Adventist Health Medi-Cal |
$13.44
|
| Rate for Payer: Aetna of CA HMO/PPO |
$98.60
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$20.16
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$14.78
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$13.44
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$97.66
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$119.12
|
| Rate for Payer: BCBS Transplant Transplant |
$12.00
|
| Rate for Payer: Blue Shield of California Commercial |
$12.36
|
| Rate for Payer: Blue Shield of California EPN |
$9.72
|
| Rate for Payer: Caremore Medicare Advantage |
$13.44
|
| Rate for Payer: Cash Price |
$9.00
|
| Rate for Payer: Cash Price |
$9.00
|
| Rate for Payer: Central Health Plan Commercial |
$16.00
|
| Rate for Payer: Cigna of CA HMO |
$12.80
|
| Rate for Payer: Cigna of CA PPO |
$14.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20.16
|
| Rate for Payer: EPIC Health Plan Commercial |
$18.14
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$13.44
|
| Rate for Payer: EPIC Health Plan Transplant |
$13.44
|
| Rate for Payer: Galaxy Health WC |
$17.00
|
| Rate for Payer: Global Benefits Group Commercial |
$12.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$18.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$15.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$22.04
|
| Rate for Payer: IEHP medi-cal |
$22.18
|
| Rate for Payer: IEHP Medicare Advantage |
$13.44
|
| Rate for Payer: Innovage PACE Commercial |
$20.16
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$13.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18.01
|
| Rate for Payer: Multiplan Commercial |
$15.00
|
| Rate for Payer: Networks By Design Commercial |
$13.00
|
| Rate for Payer: Prime Health Services Commercial |
$17.00
|
| Rate for Payer: Prime Health Services Medicare |
$14.25
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$12.00
|
| Rate for Payer: Riverside University Health MISP |
$14.78
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$12.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$12.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.89
|
| Rate for Payer: United Healthcare All Other HMO |
$10.89
|
| Rate for Payer: United Healthcare HMO Rider |
$10.89
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.89
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20.16
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.78
|
| Rate for Payer: Vantage Medical Group Senior |
$13.44
|
|
|
HC SOM ALPHA-1-ANTITRYPSIN, STOOL
|
Facility
IP
|
$20.00
|
|
|
Service Code
|
CPT 82103
|
| Hospital Charge Code |
900910858
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.00 |
| Max. Negotiated Rate |
$18.00 |
| Rate for Payer: Cash Price |
$9.00
|
| Rate for Payer: Central Health Plan Commercial |
$16.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.00
|
| Rate for Payer: Galaxy Health WC |
$17.00
|
| Rate for Payer: Global Benefits Group Commercial |
$12.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$18.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$13.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.00
|
| Rate for Payer: Multiplan Commercial |
$15.00
|
| Rate for Payer: Networks By Design Commercial |
$13.00
|
| Rate for Payer: Prime Health Services Commercial |
$17.00
|
|
|
HC SOM ALPHA-2-MACROGLOBULIN
|
Facility
OP
|
$30.00
|
|
|
Service Code
|
CPT 83883
|
| Hospital Charge Code |
900911487
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.00 |
| Max. Negotiated Rate |
$120.79 |
| Rate for Payer: Adventist Health Medi-Cal |
$13.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$99.77
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$20.40
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$14.96
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$13.60
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$99.03
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$120.79
|
| Rate for Payer: BCBS Transplant Transplant |
$18.00
|
| Rate for Payer: Blue Shield of California Commercial |
$18.54
|
| Rate for Payer: Blue Shield of California EPN |
$14.58
|
| Rate for Payer: Caremore Medicare Advantage |
$13.60
|
| Rate for Payer: Cash Price |
$13.50
|
| Rate for Payer: Cash Price |
$13.50
|
| Rate for Payer: Central Health Plan Commercial |
$24.00
|
| Rate for Payer: Cigna of CA HMO |
$19.20
|
| Rate for Payer: Cigna of CA PPO |
$22.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$18.36
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$13.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$13.60
|
| Rate for Payer: Galaxy Health WC |
$25.50
|
| Rate for Payer: Global Benefits Group Commercial |
$18.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$27.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$22.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$22.30
|
| Rate for Payer: IEHP medi-cal |
$22.44
|
| Rate for Payer: IEHP Medicare Advantage |
$13.60
|
| Rate for Payer: Innovage PACE Commercial |
$20.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20.01
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18.22
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18.22
|
| Rate for Payer: Multiplan Commercial |
$22.50
|
| Rate for Payer: Networks By Design Commercial |
$19.50
|
| Rate for Payer: Prime Health Services Commercial |
$25.50
|
| Rate for Payer: Prime Health Services Medicare |
$14.42
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$18.00
|
| Rate for Payer: Riverside University Health MISP |
$14.96
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$18.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$18.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$11.02
|
| Rate for Payer: United Healthcare All Other HMO |
$11.02
|
| Rate for Payer: United Healthcare HMO Rider |
$11.02
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.02
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.96
|
| Rate for Payer: Vantage Medical Group Senior |
$13.60
|
|
|
HC SOM ALPHA-2-MACROGLOBULIN
|
Facility
IP
|
$30.00
|
|
|
Service Code
|
CPT 83883
|
| Hospital Charge Code |
900911487
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.00 |
| Max. Negotiated Rate |
$27.00 |
| Rate for Payer: Cash Price |
$13.50
|
| Rate for Payer: Central Health Plan Commercial |
$24.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.00
|
| Rate for Payer: Galaxy Health WC |
$25.50
|
| Rate for Payer: Global Benefits Group Commercial |
$18.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$27.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.00
|
| Rate for Payer: Multiplan Commercial |
$22.50
|
| Rate for Payer: Networks By Design Commercial |
$19.50
|
| Rate for Payer: Prime Health Services Commercial |
$25.50
|
|
|
HC SOM ALPHA-FETOPROTEIN, AMNIOTIC FL
|
Facility
IP
|
$35.00
|
|
|
Service Code
|
CPT 82106
|
| Hospital Charge Code |
900910946
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.00 |
| Max. Negotiated Rate |
$31.50 |
| Rate for Payer: Cash Price |
$15.75
|
| Rate for Payer: Central Health Plan Commercial |
$28.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.00
|
| Rate for Payer: Galaxy Health WC |
$29.75
|
| Rate for Payer: Global Benefits Group Commercial |
$21.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$31.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$23.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.00
|
| Rate for Payer: Multiplan Commercial |
$26.25
|
| Rate for Payer: Networks By Design Commercial |
$22.75
|
| Rate for Payer: Prime Health Services Commercial |
$29.75
|
|
|
HC SOM ALPHA-FETOPROTEIN, AMNIOTIC FL
|
Facility
OP
|
$35.00
|
|
|
Service Code
|
CPT 82106
|
| Hospital Charge Code |
900910946
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.00 |
| Max. Negotiated Rate |
$148.87 |
| Rate for Payer: Adventist Health Medi-Cal |
$17.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$123.14
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$25.50
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$18.70
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$17.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$122.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$148.87
|
| Rate for Payer: BCBS Transplant Transplant |
$21.00
|
| Rate for Payer: Blue Shield of California Commercial |
$21.63
|
| Rate for Payer: Blue Shield of California EPN |
$17.01
|
| Rate for Payer: Caremore Medicare Advantage |
$17.00
|
| Rate for Payer: Cash Price |
$15.75
|
| Rate for Payer: Cash Price |
$15.75
|
| Rate for Payer: Central Health Plan Commercial |
$28.00
|
| Rate for Payer: Cigna of CA HMO |
$22.40
|
| Rate for Payer: Cigna of CA PPO |
$25.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$25.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$22.95
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$17.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$17.00
|
| Rate for Payer: Galaxy Health WC |
$29.75
|
| Rate for Payer: Global Benefits Group Commercial |
$21.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$31.50
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$26.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$27.88
|
| Rate for Payer: IEHP medi-cal |
$28.05
|
| Rate for Payer: IEHP Medicare Advantage |
$17.00
|
| Rate for Payer: Innovage PACE Commercial |
$25.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$23.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$17.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$22.78
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$22.78
|
| Rate for Payer: Multiplan Commercial |
$26.25
|
| Rate for Payer: Networks By Design Commercial |
$22.75
|
| Rate for Payer: Prime Health Services Commercial |
$29.75
|
| Rate for Payer: Prime Health Services Medicare |
$18.02
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$21.00
|
| Rate for Payer: Riverside University Health MISP |
$18.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$21.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$21.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$13.77
|
| Rate for Payer: United Healthcare All Other HMO |
$13.77
|
| Rate for Payer: United Healthcare HMO Rider |
$13.77
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$13.77
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$25.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$18.70
|
| Rate for Payer: Vantage Medical Group Senior |
$17.00
|
|
