|
HC SOM ANDROSTENEDIONE
|
Facility
OP
|
$24.00
|
|
|
Service Code
|
CPT 82157
|
| Hospital Charge Code |
900911011
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.80 |
| Max. Negotiated Rate |
$259.69 |
| Rate for Payer: Adventist Health Medi-Cal |
$29.28
|
| Rate for Payer: Aetna of CA HMO/PPO |
$214.87
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$43.92
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$32.21
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$29.28
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$212.90
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$259.69
|
| Rate for Payer: BCBS Transplant Transplant |
$14.40
|
| Rate for Payer: Blue Shield of California Commercial |
$14.83
|
| Rate for Payer: Blue Shield of California EPN |
$11.66
|
| Rate for Payer: Caremore Medicare Advantage |
$29.28
|
| Rate for Payer: Cash Price |
$10.80
|
| Rate for Payer: Cash Price |
$10.80
|
| Rate for Payer: Central Health Plan Commercial |
$19.20
|
| Rate for Payer: Cigna of CA HMO |
$15.36
|
| Rate for Payer: Cigna of CA PPO |
$17.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$43.92
|
| Rate for Payer: EPIC Health Plan Commercial |
$39.53
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$29.28
|
| Rate for Payer: EPIC Health Plan Transplant |
$29.28
|
| Rate for Payer: Galaxy Health WC |
$20.40
|
| Rate for Payer: Global Benefits Group Commercial |
$14.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$21.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$18.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$48.02
|
| Rate for Payer: IEHP medi-cal |
$48.31
|
| Rate for Payer: IEHP Medicare Advantage |
$29.28
|
| Rate for Payer: Innovage PACE Commercial |
$43.92
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16.01
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$39.24
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$39.24
|
| Rate for Payer: Multiplan Commercial |
$18.00
|
| Rate for Payer: Networks By Design Commercial |
$15.60
|
| Rate for Payer: Prime Health Services Commercial |
$20.40
|
| Rate for Payer: Prime Health Services Medicare |
$31.04
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$14.40
|
| Rate for Payer: Riverside University Health MISP |
$32.21
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$14.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$14.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$23.72
|
| Rate for Payer: United Healthcare All Other HMO |
$23.72
|
| Rate for Payer: United Healthcare HMO Rider |
$23.72
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$23.72
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$43.92
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$32.21
|
| Rate for Payer: Vantage Medical Group Senior |
$29.28
|
|
|
HC SOM ANGIOTENSIN 1 CONVERTING ENZYM
|
Facility
OP
|
$12.00
|
|
|
Service Code
|
CPT 82164
|
| Hospital Charge Code |
900911119
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.40 |
| Max. Negotiated Rate |
$129.52 |
| Rate for Payer: Adventist Health Medi-Cal |
$14.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$107.13
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$21.90
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$16.06
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$14.60
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$106.18
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$129.52
|
| Rate for Payer: BCBS Transplant Transplant |
$7.20
|
| Rate for Payer: Blue Shield of California Commercial |
$7.42
|
| Rate for Payer: Blue Shield of California EPN |
$5.83
|
| Rate for Payer: Caremore Medicare Advantage |
$14.60
|
| Rate for Payer: Cash Price |
$5.40
|
| Rate for Payer: Cash Price |
$5.40
|
| Rate for Payer: Central Health Plan Commercial |
$9.60
|
| Rate for Payer: Cigna of CA HMO |
$7.68
|
| Rate for Payer: Cigna of CA PPO |
$8.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.71
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$14.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$14.60
|
| Rate for Payer: Galaxy Health WC |
$10.20
|
| Rate for Payer: Global Benefits Group Commercial |
$7.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$10.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$9.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$23.94
|
| Rate for Payer: IEHP medi-cal |
$24.09
|
| Rate for Payer: IEHP Medicare Advantage |
$14.60
|
| Rate for Payer: Innovage PACE Commercial |
$21.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$19.56
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$19.56
|
| Rate for Payer: Multiplan Commercial |
$9.00
|
| Rate for Payer: Networks By Design Commercial |
$7.80
|
| Rate for Payer: Prime Health Services Commercial |
$10.20
|
| Rate for Payer: Prime Health Services Medicare |
$15.48
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$7.20
|
| Rate for Payer: Riverside University Health MISP |
$16.06
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$11.83
|
| Rate for Payer: United Healthcare All Other HMO |
$11.83
|
| Rate for Payer: United Healthcare HMO Rider |
$11.83
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.83
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$16.06
|
| Rate for Payer: Vantage Medical Group Senior |
$14.60
|
|
|
HC SOM ANGIOTENSIN 1 CONVERTING ENZYM
|
Facility
IP
|
$12.00
|
|
|
Service Code
|
CPT 82164
|
| Hospital Charge Code |
900911119
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.40 |
| Max. Negotiated Rate |
$10.80 |
| Rate for Payer: Cash Price |
$5.40
|
| Rate for Payer: Central Health Plan Commercial |
$9.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.80
|
| Rate for Payer: Galaxy Health WC |
$10.20
|
| Rate for Payer: Global Benefits Group Commercial |
$7.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$10.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.40
|
| Rate for Payer: Multiplan Commercial |
$9.00
|
| Rate for Payer: Networks By Design Commercial |
$7.80
|
| Rate for Payer: Prime Health Services Commercial |
$10.20
|
|
|
HC SOM ANGIOTENSIN CONVERT ENZ CS
|
Facility
OP
|
$68.50
|
|
|
Service Code
|
CPT 82164
|
| Hospital Charge Code |
900913826
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.83 |
| Max. Negotiated Rate |
$129.52 |
| Rate for Payer: Adventist Health Medi-Cal |
$14.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$107.13
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$21.90
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$16.06
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$14.60
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$106.18
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$129.52
|
| Rate for Payer: BCBS Transplant Transplant |
$41.10
|
| Rate for Payer: Blue Shield of California Commercial |
$42.33
|
| Rate for Payer: Blue Shield of California EPN |
$33.29
|
| Rate for Payer: Caremore Medicare Advantage |
$14.60
|
| Rate for Payer: Cash Price |
$30.83
|
| Rate for Payer: Cash Price |
$30.83
|
| Rate for Payer: Central Health Plan Commercial |
$54.80
|
| Rate for Payer: Cigna of CA HMO |
$43.84
|
| Rate for Payer: Cigna of CA PPO |
$50.69
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.71
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$14.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$14.60
|
| Rate for Payer: Galaxy Health WC |
$58.22
|
| Rate for Payer: Global Benefits Group Commercial |
$41.10
|
| Rate for Payer: Health Management Network EPO/PPO |
$61.65
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$51.38
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$23.94
|
| Rate for Payer: IEHP medi-cal |
$24.09
|
| Rate for Payer: IEHP Medicare Advantage |
$14.60
|
| Rate for Payer: Innovage PACE Commercial |
$21.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$45.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.70
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$19.56
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$19.56
|
| Rate for Payer: Multiplan Commercial |
$51.38
|
| Rate for Payer: Networks By Design Commercial |
$44.52
|
| Rate for Payer: Prime Health Services Commercial |
$58.22
|
| Rate for Payer: Prime Health Services Medicare |
$15.48
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$41.10
|
| Rate for Payer: Riverside University Health MISP |
$16.06
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$41.10
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$41.10
|
| Rate for Payer: United Healthcare All Other Commercial |
$11.83
|
| Rate for Payer: United Healthcare All Other HMO |
$11.83
|
| Rate for Payer: United Healthcare HMO Rider |
$11.83
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.83
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$16.06
|
| Rate for Payer: Vantage Medical Group Senior |
$14.60
|
|
|
HC SOM ANGIOTENSIN CONVERT ENZ CS
|
Facility
IP
|
$68.50
|
|
|
Service Code
|
CPT 82164
|
| Hospital Charge Code |
900913826
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.70 |
| Max. Negotiated Rate |
$61.65 |
| Rate for Payer: Cash Price |
$30.83
|
| Rate for Payer: Central Health Plan Commercial |
$54.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$27.40
|
| Rate for Payer: Galaxy Health WC |
$58.22
|
| Rate for Payer: Global Benefits Group Commercial |
$41.10
|
| Rate for Payer: Health Management Network EPO/PPO |
$61.65
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$45.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.70
|
| Rate for Payer: Multiplan Commercial |
$51.38
|
| Rate for Payer: Networks By Design Commercial |
$44.52
|
| Rate for Payer: Prime Health Services Commercial |
$58.22
|
|
|
HC SOM ANTI-DIURETIC HORMONE
|
Facility
OP
|
$80.00
|
|
|
Service Code
|
CPT 84588
|
| Hospital Charge Code |
900911035
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$16.00 |
| Max. Negotiated Rate |
$302.34 |
| Rate for Payer: Adventist Health Medi-Cal |
$33.94
|
| Rate for Payer: Aetna of CA HMO/PPO |
$249.11
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$50.91
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$37.33
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$33.94
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$247.87
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$302.34
|
| Rate for Payer: BCBS Transplant Transplant |
$48.00
|
| Rate for Payer: Blue Shield of California Commercial |
$49.44
|
| Rate for Payer: Blue Shield of California EPN |
$38.88
|
| Rate for Payer: Caremore Medicare Advantage |
$33.94
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Central Health Plan Commercial |
$64.00
|
| Rate for Payer: Cigna of CA HMO |
$51.20
|
| Rate for Payer: Cigna of CA PPO |
$59.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$50.91
|
| Rate for Payer: EPIC Health Plan Commercial |
$45.82
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$33.94
|
| Rate for Payer: EPIC Health Plan Transplant |
$33.94
|
| Rate for Payer: Galaxy Health WC |
$68.00
|
| Rate for Payer: Global Benefits Group Commercial |
$48.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$72.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$60.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$55.66
|
| Rate for Payer: IEHP medi-cal |
$56.00
|
| Rate for Payer: IEHP Medicare Advantage |
$33.94
|
| Rate for Payer: Innovage PACE Commercial |
$50.91
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$53.36
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$33.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$45.48
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$45.48
|
| Rate for Payer: Multiplan Commercial |
$60.00
|
| Rate for Payer: Networks By Design Commercial |
$52.00
|
| Rate for Payer: Prime Health Services Commercial |
$68.00
|
| Rate for Payer: Prime Health Services Medicare |
$35.98
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$48.00
|
| Rate for Payer: Riverside University Health MISP |
$37.33
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$48.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$48.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$27.50
|
| Rate for Payer: United Healthcare All Other HMO |
$27.50
|
| Rate for Payer: United Healthcare HMO Rider |
$27.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$27.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$50.91
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$37.33
|
| Rate for Payer: Vantage Medical Group Senior |
$33.94
|
|
|
HC SOM ANTI-DIURETIC HORMONE
|
Facility
IP
|
$80.00
|
|
|
Service Code
|
CPT 84588
|
| Hospital Charge Code |
900911035
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$16.00 |
| Max. Negotiated Rate |
$72.00 |
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Central Health Plan Commercial |
$64.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$32.00
|
| Rate for Payer: Galaxy Health WC |
$68.00
|
| Rate for Payer: Global Benefits Group Commercial |
$48.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$72.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$53.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.00
|
| Rate for Payer: Multiplan Commercial |
$60.00
|
| Rate for Payer: Networks By Design Commercial |
$52.00
|
| Rate for Payer: Prime Health Services Commercial |
$68.00
|
|
|
HC SOM ANTI-GBM TITER AB
|
Facility
OP
|
$26.00
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
900911188
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.20 |
| Max. Negotiated Rate |
$207.60 |
| Rate for Payer: Adventist Health Medi-Cal |
$11.53
|
| Rate for Payer: Aetna of CA HMO/PPO |
$68.17
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$17.30
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$12.68
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$11.53
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$170.20
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$207.60
|
| Rate for Payer: BCBS Transplant Transplant |
$15.60
|
| Rate for Payer: Blue Shield of California Commercial |
$16.07
|
| Rate for Payer: Blue Shield of California EPN |
$12.64
|
| Rate for Payer: Caremore Medicare Advantage |
$11.53
|
| Rate for Payer: Cash Price |
$11.70
|
| Rate for Payer: Cash Price |
$11.70
|
| Rate for Payer: Central Health Plan Commercial |
$20.80
|
| Rate for Payer: Cigna of CA HMO |
$16.64
|
| Rate for Payer: Cigna of CA PPO |
$19.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$17.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.57
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$11.53
|
| Rate for Payer: EPIC Health Plan Transplant |
$11.53
|
| Rate for Payer: Galaxy Health WC |
$22.10
|
| Rate for Payer: Global Benefits Group Commercial |
$15.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$23.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$19.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$18.91
|
| Rate for Payer: IEHP medi-cal |
$19.02
|
| Rate for Payer: IEHP Medicare Advantage |
$11.53
|
| Rate for Payer: Innovage PACE Commercial |
$17.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$11.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$15.45
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$15.45
|
| Rate for Payer: Multiplan Commercial |
$19.50
|
| Rate for Payer: Networks By Design Commercial |
$16.90
|
| Rate for Payer: Prime Health Services Commercial |
$22.10
|
| Rate for Payer: Prime Health Services Medicare |
$12.22
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$15.60
|
| Rate for Payer: Riverside University Health MISP |
$12.68
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$15.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.34
|
| Rate for Payer: United Healthcare All Other HMO |
$9.34
|
| Rate for Payer: United Healthcare HMO Rider |
$9.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.34
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$17.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$12.68
|
| Rate for Payer: Vantage Medical Group Senior |
$11.53
|
|
|
HC SOM ANTI-GBM TITER AB
|
Facility
IP
|
$26.00
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
900911188
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.20 |
| Max. Negotiated Rate |
$23.40 |
| Rate for Payer: Cash Price |
$11.70
|
| Rate for Payer: Central Health Plan Commercial |
$20.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.40
|
| Rate for Payer: Galaxy Health WC |
$22.10
|
| Rate for Payer: Global Benefits Group Commercial |
$15.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$23.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.20
|
| Rate for Payer: Multiplan Commercial |
$19.50
|
| Rate for Payer: Networks By Design Commercial |
$16.90
|
| Rate for Payer: Prime Health Services Commercial |
$22.10
|
|
|
HC SOM ANTI-LIVERKIDNEY MICROSOMAL AB
|
Facility
IP
|
$21.76
|
|
|
Service Code
|
CPT 86376
|
| Hospital Charge Code |
900911453
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.35 |
| Max. Negotiated Rate |
$19.58 |
| Rate for Payer: Cash Price |
$9.79
|
| Rate for Payer: Central Health Plan Commercial |
$17.41
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.70
|
| Rate for Payer: Galaxy Health WC |
$18.50
|
| Rate for Payer: Global Benefits Group Commercial |
$13.06
|
| Rate for Payer: Health Management Network EPO/PPO |
$19.58
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$14.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.35
|
| Rate for Payer: Multiplan Commercial |
$16.32
|
| Rate for Payer: Networks By Design Commercial |
$14.14
|
| Rate for Payer: Prime Health Services Commercial |
$18.50
|
|
|
HC SOM ANTI-LIVERKIDNEY MICROSOMAL AB
|
Facility
OP
|
$21.76
|
|
|
Service Code
|
CPT 86376
|
| Hospital Charge Code |
900911453
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.35 |
| Max. Negotiated Rate |
$129.93 |
| Rate for Payer: Adventist Health Medi-Cal |
$14.55
|
| Rate for Payer: Aetna of CA HMO/PPO |
$106.82
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$21.82
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$16.00
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$14.55
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$106.52
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$129.93
|
| Rate for Payer: BCBS Transplant Transplant |
$13.06
|
| Rate for Payer: Blue Shield of California Commercial |
$13.45
|
| Rate for Payer: Blue Shield of California EPN |
$10.58
|
| Rate for Payer: Caremore Medicare Advantage |
$14.55
|
| Rate for Payer: Cash Price |
$9.79
|
| Rate for Payer: Cash Price |
$9.79
|
| Rate for Payer: Central Health Plan Commercial |
$17.41
|
| Rate for Payer: Cigna of CA HMO |
$13.93
|
| Rate for Payer: Cigna of CA PPO |
$16.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.64
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$14.55
|
| Rate for Payer: EPIC Health Plan Transplant |
$14.55
|
| Rate for Payer: Galaxy Health WC |
$18.50
|
| Rate for Payer: Global Benefits Group Commercial |
$13.06
|
| Rate for Payer: Health Management Network EPO/PPO |
$19.58
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$16.32
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$23.86
|
| Rate for Payer: IEHP medi-cal |
$24.01
|
| Rate for Payer: IEHP Medicare Advantage |
$14.55
|
| Rate for Payer: Innovage PACE Commercial |
$21.82
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$14.51
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.35
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$19.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$19.50
|
| Rate for Payer: Multiplan Commercial |
$16.32
|
| Rate for Payer: Networks By Design Commercial |
$14.14
|
| Rate for Payer: Prime Health Services Commercial |
$18.50
|
| Rate for Payer: Prime Health Services Medicare |
$15.42
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$13.06
|
| Rate for Payer: Riverside University Health MISP |
$16.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$13.06
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$13.06
|
| Rate for Payer: United Healthcare All Other Commercial |
$11.79
|
| Rate for Payer: United Healthcare All Other HMO |
$11.79
|
| Rate for Payer: United Healthcare HMO Rider |
$11.79
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.79
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$16.00
|
| Rate for Payer: Vantage Medical Group Senior |
$14.55
|
|
|
HC SOM ANTIMULLERIAN HORMONE, S
|
Facility
OP
|
$55.00
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
900912908
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.00 |
| Max. Negotiated Rate |
$114.88 |
| Rate for Payer: Adventist Health Medi-Cal |
$17.27
|
| Rate for Payer: Aetna of CA HMO/PPO |
$95.04
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$25.90
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$19.00
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$17.27
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$94.18
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$114.88
|
| Rate for Payer: BCBS Transplant Transplant |
$33.00
|
| Rate for Payer: Blue Shield of California Commercial |
$33.99
|
| Rate for Payer: Blue Shield of California EPN |
$26.73
|
| Rate for Payer: Caremore Medicare Advantage |
$17.27
|
| Rate for Payer: Cash Price |
$24.75
|
| Rate for Payer: Cash Price |
$24.75
|
| Rate for Payer: Central Health Plan Commercial |
$44.00
|
| Rate for Payer: Cigna of CA HMO |
$35.20
|
| Rate for Payer: Cigna of CA PPO |
$40.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$25.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$23.31
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$17.27
|
| Rate for Payer: EPIC Health Plan Transplant |
$17.27
|
| Rate for Payer: Galaxy Health WC |
$46.75
|
| Rate for Payer: Global Benefits Group Commercial |
$33.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$49.50
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$41.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$28.32
|
| Rate for Payer: IEHP medi-cal |
$28.50
|
| Rate for Payer: IEHP Medicare Advantage |
$17.27
|
| Rate for Payer: Innovage PACE Commercial |
$25.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$36.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$17.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$23.14
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$23.14
|
| Rate for Payer: Multiplan Commercial |
$41.25
|
| Rate for Payer: Networks By Design Commercial |
$35.75
|
| Rate for Payer: Prime Health Services Commercial |
$46.75
|
| Rate for Payer: Prime Health Services Medicare |
$18.31
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$33.00
|
| Rate for Payer: Riverside University Health MISP |
$19.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$33.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$33.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$13.99
|
| Rate for Payer: United Healthcare All Other HMO |
$13.99
|
| Rate for Payer: United Healthcare HMO Rider |
$13.99
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$13.99
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$25.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.00
|
| Rate for Payer: Vantage Medical Group Senior |
$17.27
|
|
|
HC SOM ANTIMULLERIAN HORMONE, S
|
Facility
IP
|
$55.00
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
900912908
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.00 |
| Max. Negotiated Rate |
$49.50 |
| Rate for Payer: Cash Price |
$24.75
|
| Rate for Payer: Central Health Plan Commercial |
$44.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$22.00
|
| Rate for Payer: Galaxy Health WC |
$46.75
|
| Rate for Payer: Global Benefits Group Commercial |
$33.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$49.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$36.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.00
|
| Rate for Payer: Multiplan Commercial |
$41.25
|
| Rate for Payer: Networks By Design Commercial |
$35.75
|
| Rate for Payer: Prime Health Services Commercial |
$46.75
|
|
|
HC SOM ANTI-NEUTROPHIL AB
|
Facility
IP
|
$68.00
|
|
|
Service Code
|
CPT 86021
|
| Hospital Charge Code |
900911211
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.60 |
| Max. Negotiated Rate |
$61.20 |
| Rate for Payer: Cash Price |
$30.60
|
| Rate for Payer: Central Health Plan Commercial |
$54.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$27.20
|
| Rate for Payer: Galaxy Health WC |
$57.80
|
| Rate for Payer: Global Benefits Group Commercial |
$40.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$61.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$45.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.60
|
| Rate for Payer: Multiplan Commercial |
$51.00
|
| Rate for Payer: Networks By Design Commercial |
$44.20
|
| Rate for Payer: Prime Health Services Commercial |
$57.80
|
|
|
HC SOM ANTI-NEUTROPHIL AB
|
Facility
OP
|
$68.00
|
|
|
Service Code
|
CPT 86021
|
| Hospital Charge Code |
900911211
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.20 |
| Max. Negotiated Rate |
$133.58 |
| Rate for Payer: Adventist Health Medi-Cal |
$15.05
|
| Rate for Payer: Aetna of CA HMO/PPO |
$100.32
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$22.58
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$16.56
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$15.05
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$109.51
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$133.58
|
| Rate for Payer: BCBS Transplant Transplant |
$40.80
|
| Rate for Payer: Blue Shield of California Commercial |
$42.02
|
| Rate for Payer: Blue Shield of California EPN |
$33.05
|
| Rate for Payer: Caremore Medicare Advantage |
$15.05
|
| Rate for Payer: Cash Price |
$30.60
|
| Rate for Payer: Cash Price |
$30.60
|
| Rate for Payer: Central Health Plan Commercial |
$54.40
|
| Rate for Payer: Cigna of CA HMO |
$43.52
|
| Rate for Payer: Cigna of CA PPO |
$50.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$22.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$20.32
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$15.05
|
| Rate for Payer: EPIC Health Plan Transplant |
$15.05
|
| Rate for Payer: Galaxy Health WC |
$57.80
|
| Rate for Payer: Global Benefits Group Commercial |
$40.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$61.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$51.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$24.68
|
| Rate for Payer: IEHP medi-cal |
$24.83
|
| Rate for Payer: IEHP Medicare Advantage |
$15.05
|
| Rate for Payer: Innovage PACE Commercial |
$22.58
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$45.36
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$20.17
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$20.17
|
| Rate for Payer: Multiplan Commercial |
$51.00
|
| Rate for Payer: Networks By Design Commercial |
$44.20
|
| Rate for Payer: Prime Health Services Commercial |
$57.80
|
| Rate for Payer: Prime Health Services Medicare |
$15.95
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$40.80
|
| Rate for Payer: Riverside University Health MISP |
$16.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$40.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$40.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$12.20
|
| Rate for Payer: United Healthcare All Other HMO |
$12.20
|
| Rate for Payer: United Healthcare HMO Rider |
$12.20
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$12.20
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$22.58
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$16.56
|
| Rate for Payer: Vantage Medical Group Senior |
$15.05
|
|
|
HC SOM ANTI-NEUTROPHIL CYTOPLASM ANTI
|
Facility
IP
|
$23.15
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
900910287
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.63 |
| Max. Negotiated Rate |
$20.84 |
| Rate for Payer: Cash Price |
$10.42
|
| Rate for Payer: Central Health Plan Commercial |
$18.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.26
|
| Rate for Payer: Galaxy Health WC |
$19.68
|
| Rate for Payer: Global Benefits Group Commercial |
$13.89
|
| Rate for Payer: Health Management Network EPO/PPO |
$20.84
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.63
|
| Rate for Payer: Multiplan Commercial |
$17.36
|
| Rate for Payer: Networks By Design Commercial |
$15.05
|
| Rate for Payer: Prime Health Services Commercial |
$19.68
|
|
|
HC SOM ANTI-NEUTROPHIL CYTOPLASM ANTI
|
Facility
OP
|
$23.15
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
900910287
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.63 |
| Max. Negotiated Rate |
$106.99 |
| Rate for Payer: Adventist Health Medi-Cal |
$12.05
|
| Rate for Payer: Aetna of CA HMO/PPO |
$88.48
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$18.08
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$13.26
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$12.05
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$87.72
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$106.99
|
| Rate for Payer: BCBS Transplant Transplant |
$13.89
|
| Rate for Payer: Blue Shield of California Commercial |
$14.31
|
| Rate for Payer: Blue Shield of California EPN |
$11.25
|
| Rate for Payer: Caremore Medicare Advantage |
$12.05
|
| Rate for Payer: Cash Price |
$10.42
|
| Rate for Payer: Cash Price |
$10.42
|
| Rate for Payer: Central Health Plan Commercial |
$18.52
|
| Rate for Payer: Cigna of CA HMO |
$14.82
|
| Rate for Payer: Cigna of CA PPO |
$17.13
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$18.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.27
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$12.05
|
| Rate for Payer: EPIC Health Plan Transplant |
$12.05
|
| Rate for Payer: Galaxy Health WC |
$19.68
|
| Rate for Payer: Global Benefits Group Commercial |
$13.89
|
| Rate for Payer: Health Management Network EPO/PPO |
$20.84
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$17.36
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$19.76
|
| Rate for Payer: IEHP medi-cal |
$19.88
|
| Rate for Payer: IEHP Medicare Advantage |
$12.05
|
| Rate for Payer: Innovage PACE Commercial |
$18.08
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.63
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16.15
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16.15
|
| Rate for Payer: Multiplan Commercial |
$17.36
|
| Rate for Payer: Networks By Design Commercial |
$15.05
|
| Rate for Payer: Prime Health Services Commercial |
$19.68
|
| Rate for Payer: Prime Health Services Medicare |
$12.77
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$13.89
|
| Rate for Payer: Riverside University Health MISP |
$13.26
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$13.89
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$13.89
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.76
|
| Rate for Payer: United Healthcare All Other HMO |
$9.76
|
| Rate for Payer: United Healthcare HMO Rider |
$9.76
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.76
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$18.08
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.26
|
| Rate for Payer: Vantage Medical Group Senior |
$12.05
|
|
|
HC SOM ANTINUCLEAR AB,HEP-2 SUB,S
|
Facility
OP
|
$10.00
|
|
|
Service Code
|
CPT 86039
|
| Hospital Charge Code |
900912903
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.00 |
| Max. Negotiated Rate |
$98.93 |
| Rate for Payer: Adventist Health Medi-Cal |
$11.16
|
| Rate for Payer: Aetna of CA HMO/PPO |
$81.91
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$16.74
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$12.28
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$11.16
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$81.11
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$98.93
|
| 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 |
$11.16
|
| 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 |
$16.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.07
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$11.16
|
| Rate for Payer: EPIC Health Plan Transplant |
$11.16
|
| 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 |
$18.30
|
| Rate for Payer: IEHP medi-cal |
$18.41
|
| Rate for Payer: IEHP Medicare Advantage |
$11.16
|
| Rate for Payer: Innovage PACE Commercial |
$16.74
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$11.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$14.95
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14.95
|
| 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 |
$11.83
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$6.00
|
| Rate for Payer: Riverside University Health MISP |
$12.28
|
| 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 |
$9.04
|
| Rate for Payer: United Healthcare All Other HMO |
$9.04
|
| Rate for Payer: United Healthcare HMO Rider |
$9.04
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.04
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$16.74
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$12.28
|
| Rate for Payer: Vantage Medical Group Senior |
$11.16
|
|
|
HC SOM ANTINUCLEAR AB,HEP-2 SUB,S
|
Facility
IP
|
$10.00
|
|
|
Service Code
|
CPT 86039
|
| Hospital Charge Code |
900912903
|
|
Hospital Revenue Code
|
302
|
| 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 ANTI-SMOOTH MUSCLE
|
Facility
OP
|
$12.90
|
|
|
Service Code
|
CPT 86015
|
| Hospital Charge Code |
900911176
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.58 |
| Max. Negotiated Rate |
$60.13 |
| Rate for Payer: Adventist Health Medi-Cal |
$12.05
|
| Rate for Payer: Aetna of CA HMO/PPO |
$60.13
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$18.08
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$13.26
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$12.05
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$23.56
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$28.73
|
| Rate for Payer: BCBS Transplant Transplant |
$7.74
|
| Rate for Payer: Blue Shield of California Commercial |
$7.97
|
| Rate for Payer: Blue Shield of California EPN |
$6.27
|
| Rate for Payer: Caremore Medicare Advantage |
$12.05
|
| Rate for Payer: Cash Price |
$5.81
|
| Rate for Payer: Cash Price |
$5.81
|
| Rate for Payer: Central Health Plan Commercial |
$10.32
|
| Rate for Payer: Cigna of CA HMO |
$8.26
|
| Rate for Payer: Cigna of CA PPO |
$9.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$18.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.27
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$12.05
|
| Rate for Payer: EPIC Health Plan Transplant |
$12.05
|
| Rate for Payer: Galaxy Health WC |
$10.96
|
| Rate for Payer: Global Benefits Group Commercial |
$7.74
|
| Rate for Payer: Health Management Network EPO/PPO |
$11.61
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$9.68
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$19.76
|
| Rate for Payer: IEHP medi-cal |
$19.88
|
| Rate for Payer: IEHP Medicare Advantage |
$12.05
|
| Rate for Payer: Innovage PACE Commercial |
$18.08
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8.60
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.58
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16.15
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16.15
|
| Rate for Payer: Multiplan Commercial |
$9.68
|
| Rate for Payer: Networks By Design Commercial |
$8.38
|
| Rate for Payer: Prime Health Services Commercial |
$10.96
|
| Rate for Payer: Prime Health Services Medicare |
$12.77
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$7.74
|
| Rate for Payer: Riverside University Health MISP |
$13.26
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7.74
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7.74
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.34
|
| Rate for Payer: United Healthcare All Other HMO |
$9.34
|
| Rate for Payer: United Healthcare HMO Rider |
$9.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.34
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$18.08
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.26
|
| Rate for Payer: Vantage Medical Group Senior |
$12.05
|
|
|
HC SOM ANTI-SMOOTH MUSCLE
|
Facility
IP
|
$12.90
|
|
|
Service Code
|
CPT 86015
|
| Hospital Charge Code |
900911176
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.58 |
| Max. Negotiated Rate |
$11.61 |
| Rate for Payer: Cash Price |
$5.81
|
| Rate for Payer: Central Health Plan Commercial |
$10.32
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.16
|
| Rate for Payer: Galaxy Health WC |
$10.96
|
| Rate for Payer: Global Benefits Group Commercial |
$7.74
|
| Rate for Payer: Health Management Network EPO/PPO |
$11.61
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.58
|
| Rate for Payer: Multiplan Commercial |
$9.68
|
| Rate for Payer: Networks By Design Commercial |
$8.38
|
| Rate for Payer: Prime Health Services Commercial |
$10.96
|
|
|
HC SOM ANTI-STRIATED MUSCLE AB
|
Facility
IP
|
$24.00
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
900911368
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.80 |
| Max. Negotiated Rate |
$21.60 |
| Rate for Payer: Cash Price |
$10.80
|
| Rate for Payer: Central Health Plan Commercial |
$19.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.60
|
| Rate for Payer: Galaxy Health WC |
$20.40
|
| Rate for Payer: Global Benefits Group Commercial |
$14.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$21.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.80
|
| Rate for Payer: Multiplan Commercial |
$18.00
|
| Rate for Payer: Networks By Design Commercial |
$15.60
|
| Rate for Payer: Prime Health Services Commercial |
$20.40
|
|
|
HC SOM ANTI-STRIATED MUSCLE AB
|
Facility
OP
|
$24.00
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
900911368
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.80 |
| Max. Negotiated Rate |
$114.88 |
| Rate for Payer: Adventist Health Medi-Cal |
$17.27
|
| Rate for Payer: Aetna of CA HMO/PPO |
$95.04
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$25.90
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$19.00
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$17.27
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$94.18
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$114.88
|
| Rate for Payer: BCBS Transplant Transplant |
$14.40
|
| Rate for Payer: Blue Shield of California Commercial |
$14.83
|
| Rate for Payer: Blue Shield of California EPN |
$11.66
|
| Rate for Payer: Caremore Medicare Advantage |
$17.27
|
| Rate for Payer: Cash Price |
$10.80
|
| Rate for Payer: Cash Price |
$10.80
|
| Rate for Payer: Central Health Plan Commercial |
$19.20
|
| Rate for Payer: Cigna of CA HMO |
$15.36
|
| Rate for Payer: Cigna of CA PPO |
$17.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$25.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$23.31
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$17.27
|
| Rate for Payer: EPIC Health Plan Transplant |
$17.27
|
| Rate for Payer: Galaxy Health WC |
$20.40
|
| Rate for Payer: Global Benefits Group Commercial |
$14.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$21.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$18.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$28.32
|
| Rate for Payer: IEHP medi-cal |
$28.50
|
| Rate for Payer: IEHP Medicare Advantage |
$17.27
|
| Rate for Payer: Innovage PACE Commercial |
$25.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16.01
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$17.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$23.14
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$23.14
|
| Rate for Payer: Multiplan Commercial |
$18.00
|
| Rate for Payer: Networks By Design Commercial |
$15.60
|
| Rate for Payer: Prime Health Services Commercial |
$20.40
|
| Rate for Payer: Prime Health Services Medicare |
$18.31
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$14.40
|
| Rate for Payer: Riverside University Health MISP |
$19.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$14.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$14.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$13.99
|
| Rate for Payer: United Healthcare All Other HMO |
$13.99
|
| Rate for Payer: United Healthcare HMO Rider |
$13.99
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$13.99
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$25.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.00
|
| Rate for Payer: Vantage Medical Group Senior |
$17.27
|
|
|
HC SOM APOLIPOPROTEIN A-1
|
Facility
OP
|
$20.00
|
|
|
Service Code
|
CPT 82172
|
| Hospital Charge Code |
900910800
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.00 |
| Max. Negotiated Rate |
$104.13 |
| Rate for Payer: Adventist Health Medi-Cal |
$21.09
|
| Rate for Payer: Aetna of CA HMO/PPO |
$103.45
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$31.64
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$23.20
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$21.09
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$85.37
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$104.13
|
| 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 |
$21.09
|
| 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 |
$31.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$28.47
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$21.09
|
| Rate for Payer: EPIC Health Plan Transplant |
$21.09
|
| 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 |
$34.59
|
| Rate for Payer: IEHP medi-cal |
$34.80
|
| Rate for Payer: IEHP Medicare Advantage |
$21.09
|
| Rate for Payer: Innovage PACE Commercial |
$31.64
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$13.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$28.26
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$28.26
|
| 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 |
$22.36
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$12.00
|
| Rate for Payer: Riverside University Health MISP |
$23.20
|
| 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 |
$17.08
|
| Rate for Payer: United Healthcare All Other HMO |
$17.08
|
| Rate for Payer: United Healthcare HMO Rider |
$17.08
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$17.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$31.64
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$23.20
|
| Rate for Payer: Vantage Medical Group Senior |
$21.09
|
|
|
HC SOM APOLIPOPROTEIN A-1
|
Facility
IP
|
$20.00
|
|
|
Service Code
|
CPT 82172
|
| Hospital Charge Code |
900910800
|
|
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
|
|
