|
HC SOM APOLIPOPROTEIN B
|
Facility
IP
|
$16.77
|
|
|
Service Code
|
CPT 82172
|
| Hospital Charge Code |
900910801
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.35 |
| Max. Negotiated Rate |
$15.09 |
| Rate for Payer: Cash Price |
$7.55
|
| Rate for Payer: Central Health Plan Commercial |
$13.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.71
|
| Rate for Payer: Galaxy Health WC |
$14.25
|
| Rate for Payer: Global Benefits Group Commercial |
$10.06
|
| Rate for Payer: Health Management Network EPO/PPO |
$15.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.35
|
| Rate for Payer: Multiplan Commercial |
$12.58
|
| Rate for Payer: Networks By Design Commercial |
$10.90
|
| Rate for Payer: Prime Health Services Commercial |
$14.25
|
|
|
HC SOM APOLIPOPROTEIN B
|
Facility
OP
|
$16.77
|
|
|
Service Code
|
CPT 82172
|
| Hospital Charge Code |
900910801
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.35 |
| 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 |
$10.06
|
| Rate for Payer: Blue Shield of California Commercial |
$10.36
|
| Rate for Payer: Blue Shield of California EPN |
$8.15
|
| Rate for Payer: Caremore Medicare Advantage |
$21.09
|
| Rate for Payer: Cash Price |
$7.55
|
| Rate for Payer: Cash Price |
$7.55
|
| Rate for Payer: Central Health Plan Commercial |
$13.42
|
| Rate for Payer: Cigna of CA HMO |
$10.73
|
| Rate for Payer: Cigna of CA PPO |
$12.41
|
| 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 |
$14.25
|
| Rate for Payer: Global Benefits Group Commercial |
$10.06
|
| Rate for Payer: Health Management Network EPO/PPO |
$15.09
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$12.58
|
| 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 |
$11.19
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.35
|
| 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 |
$12.58
|
| Rate for Payer: Networks By Design Commercial |
$10.90
|
| Rate for Payer: Prime Health Services Commercial |
$14.25
|
| Rate for Payer: Prime Health Services Medicare |
$22.36
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$10.06
|
| Rate for Payer: Riverside University Health MISP |
$23.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10.06
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$10.06
|
| 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 E GENOTYPING
|
Facility
IP
|
$203.61
|
|
|
Service Code
|
CPT 81401
|
| Hospital Charge Code |
900914646
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$40.72 |
| Max. Negotiated Rate |
$183.25 |
| Rate for Payer: Cash Price |
$91.62
|
| Rate for Payer: Central Health Plan Commercial |
$162.89
|
| Rate for Payer: EPIC Health Plan Commercial |
$81.44
|
| Rate for Payer: Galaxy Health WC |
$173.07
|
| Rate for Payer: Global Benefits Group Commercial |
$122.17
|
| Rate for Payer: Health Management Network EPO/PPO |
$183.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$135.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$40.72
|
| Rate for Payer: Multiplan Commercial |
$152.71
|
| Rate for Payer: Networks By Design Commercial |
$132.35
|
| Rate for Payer: Prime Health Services Commercial |
$173.07
|
|
|
HC SOM APOLIPOPROTEIN E GENOTYPING
|
Facility
OP
|
$203.61
|
|
|
Service Code
|
CPT 81401
|
| Hospital Charge Code |
900914646
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$40.72 |
| Max. Negotiated Rate |
$11,097.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$137.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$239.29
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$205.50
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$150.70
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$137.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$230.19
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$280.78
|
| Rate for Payer: BCBS Transplant Transplant |
$122.17
|
| Rate for Payer: Blue Shield of California Commercial |
$125.83
|
| Rate for Payer: Blue Shield of California EPN |
$98.95
|
| Rate for Payer: Caremore Medicare Advantage |
$137.00
|
| Rate for Payer: Cash Price |
$91.62
|
| Rate for Payer: Cash Price |
$91.62
|
| Rate for Payer: Central Health Plan Commercial |
$162.89
|
| Rate for Payer: Cigna of CA HMO |
$130.31
|
| Rate for Payer: Cigna of CA PPO |
$150.67
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$205.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$184.95
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$137.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$137.00
|
| Rate for Payer: Galaxy Health WC |
$173.07
|
| Rate for Payer: Global Benefits Group Commercial |
$122.17
|
| Rate for Payer: Health Management Network EPO/PPO |
$183.25
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$152.71
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$224.68
|
| Rate for Payer: IEHP medi-cal |
$226.05
|
| Rate for Payer: IEHP Medicare Advantage |
$137.00
|
| Rate for Payer: Innovage PACE Commercial |
$205.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$135.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$137.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$40.72
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$183.58
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$183.58
|
| Rate for Payer: Multiplan Commercial |
$152.71
|
| Rate for Payer: Networks By Design Commercial |
$132.35
|
| Rate for Payer: Prime Health Services Commercial |
$173.07
|
| Rate for Payer: Prime Health Services Medicare |
$145.22
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$122.17
|
| Rate for Payer: Riverside University Health MISP |
$150.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$122.17
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$122.17
|
| Rate for Payer: United Healthcare All Other Commercial |
$110.97
|
| Rate for Payer: United Healthcare All Other HMO |
$110.97
|
| Rate for Payer: United Healthcare HMO Rider |
$110.97
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,097.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$205.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$150.70
|
| Rate for Payer: Vantage Medical Group Senior |
$137.00
|
|
|
HC SOM ARSENIC BLOOD
|
Facility
IP
|
$25.00
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
900910563
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.00 |
| Max. Negotiated Rate |
$22.50 |
| Rate for Payer: Cash Price |
$11.25
|
| Rate for Payer: Central Health Plan Commercial |
$20.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.00
|
| Rate for Payer: Galaxy Health WC |
$21.25
|
| Rate for Payer: Global Benefits Group Commercial |
$15.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$22.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.00
|
| Rate for Payer: Multiplan Commercial |
$18.75
|
| Rate for Payer: Networks By Design Commercial |
$16.25
|
| Rate for Payer: Prime Health Services Commercial |
$21.25
|
|
|
HC SOM ARSENIC BLOOD
|
Facility
OP
|
$25.00
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
900910563
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.00 |
| Max. Negotiated Rate |
$168.35 |
| Rate for Payer: Adventist Health Medi-Cal |
$18.97
|
| Rate for Payer: Aetna of CA HMO/PPO |
$139.28
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$28.46
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$20.87
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$18.97
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$138.02
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$168.35
|
| Rate for Payer: BCBS Transplant Transplant |
$15.00
|
| Rate for Payer: Blue Shield of California Commercial |
$15.45
|
| Rate for Payer: Blue Shield of California EPN |
$12.15
|
| Rate for Payer: Caremore Medicare Advantage |
$18.97
|
| Rate for Payer: Cash Price |
$11.25
|
| Rate for Payer: Cash Price |
$11.25
|
| Rate for Payer: Central Health Plan Commercial |
$20.00
|
| Rate for Payer: Cigna of CA HMO |
$16.00
|
| Rate for Payer: Cigna of CA PPO |
$18.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$28.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$25.61
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$18.97
|
| Rate for Payer: EPIC Health Plan Transplant |
$18.97
|
| Rate for Payer: Galaxy Health WC |
$21.25
|
| Rate for Payer: Global Benefits Group Commercial |
$15.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$22.50
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$18.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$31.11
|
| Rate for Payer: IEHP medi-cal |
$31.30
|
| Rate for Payer: IEHP Medicare Advantage |
$18.97
|
| Rate for Payer: Innovage PACE Commercial |
$28.46
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$25.42
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$25.42
|
| Rate for Payer: Multiplan Commercial |
$18.75
|
| Rate for Payer: Networks By Design Commercial |
$16.25
|
| Rate for Payer: Prime Health Services Commercial |
$21.25
|
| Rate for Payer: Prime Health Services Medicare |
$20.11
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$15.00
|
| Rate for Payer: Riverside University Health MISP |
$20.87
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$15.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$15.36
|
| Rate for Payer: United Healthcare All Other HMO |
$15.36
|
| Rate for Payer: United Healthcare HMO Rider |
$15.36
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15.36
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$28.46
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$20.87
|
| Rate for Payer: Vantage Medical Group Senior |
$18.97
|
|
|
HC SOM ARSENIC SPECIATION, RAND, U
|
Facility
OP
|
$90.00
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
900915369
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.36 |
| Max. Negotiated Rate |
$168.35 |
| Rate for Payer: Adventist Health Medi-Cal |
$18.97
|
| Rate for Payer: Aetna of CA HMO/PPO |
$139.28
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$28.46
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$20.87
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$18.97
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$138.02
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$168.35
|
| Rate for Payer: BCBS Transplant Transplant |
$54.00
|
| Rate for Payer: Blue Shield of California Commercial |
$55.62
|
| Rate for Payer: Blue Shield of California EPN |
$43.74
|
| Rate for Payer: Caremore Medicare Advantage |
$18.97
|
| Rate for Payer: Cash Price |
$40.50
|
| Rate for Payer: Cash Price |
$40.50
|
| Rate for Payer: Central Health Plan Commercial |
$72.00
|
| Rate for Payer: Cigna of CA HMO |
$57.60
|
| Rate for Payer: Cigna of CA PPO |
$66.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$28.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$25.61
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$18.97
|
| Rate for Payer: EPIC Health Plan Transplant |
$18.97
|
| Rate for Payer: Galaxy Health WC |
$76.50
|
| Rate for Payer: Global Benefits Group Commercial |
$54.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$81.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$67.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$31.11
|
| Rate for Payer: IEHP medi-cal |
$31.30
|
| Rate for Payer: IEHP Medicare Advantage |
$18.97
|
| Rate for Payer: Innovage PACE Commercial |
$28.46
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$60.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$25.42
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$25.42
|
| Rate for Payer: Multiplan Commercial |
$67.50
|
| Rate for Payer: Networks By Design Commercial |
$58.50
|
| Rate for Payer: Prime Health Services Commercial |
$76.50
|
| Rate for Payer: Prime Health Services Medicare |
$20.11
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$54.00
|
| Rate for Payer: Riverside University Health MISP |
$20.87
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$54.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$54.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$15.36
|
| Rate for Payer: United Healthcare All Other HMO |
$15.36
|
| Rate for Payer: United Healthcare HMO Rider |
$15.36
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15.36
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$28.46
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$20.87
|
| Rate for Payer: Vantage Medical Group Senior |
$18.97
|
|
|
HC SOM ARSENIC SPECIATION, RAND, U
|
Facility
IP
|
$90.00
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
900915369
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$18.00 |
| Max. Negotiated Rate |
$81.00 |
| Rate for Payer: Cash Price |
$40.50
|
| Rate for Payer: Central Health Plan Commercial |
$72.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$36.00
|
| Rate for Payer: Galaxy Health WC |
$76.50
|
| Rate for Payer: Global Benefits Group Commercial |
$54.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$81.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$60.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18.00
|
| Rate for Payer: Multiplan Commercial |
$67.50
|
| Rate for Payer: Networks By Design Commercial |
$58.50
|
| Rate for Payer: Prime Health Services Commercial |
$76.50
|
|
|
HC SOM ARSENIC URINE QUANT
|
Facility
OP
|
$25.00
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
900911289
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.00 |
| Max. Negotiated Rate |
$168.35 |
| Rate for Payer: Adventist Health Medi-Cal |
$18.97
|
| Rate for Payer: Aetna of CA HMO/PPO |
$139.28
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$28.46
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$20.87
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$18.97
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$138.02
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$168.35
|
| Rate for Payer: BCBS Transplant Transplant |
$15.00
|
| Rate for Payer: Blue Shield of California Commercial |
$15.45
|
| Rate for Payer: Blue Shield of California EPN |
$12.15
|
| Rate for Payer: Caremore Medicare Advantage |
$18.97
|
| Rate for Payer: Cash Price |
$11.25
|
| Rate for Payer: Cash Price |
$11.25
|
| Rate for Payer: Central Health Plan Commercial |
$20.00
|
| Rate for Payer: Cigna of CA HMO |
$16.00
|
| Rate for Payer: Cigna of CA PPO |
$18.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$28.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$25.61
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$18.97
|
| Rate for Payer: EPIC Health Plan Transplant |
$18.97
|
| Rate for Payer: Galaxy Health WC |
$21.25
|
| Rate for Payer: Global Benefits Group Commercial |
$15.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$22.50
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$18.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$31.11
|
| Rate for Payer: IEHP medi-cal |
$31.30
|
| Rate for Payer: IEHP Medicare Advantage |
$18.97
|
| Rate for Payer: Innovage PACE Commercial |
$28.46
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$25.42
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$25.42
|
| Rate for Payer: Multiplan Commercial |
$18.75
|
| Rate for Payer: Networks By Design Commercial |
$16.25
|
| Rate for Payer: Prime Health Services Commercial |
$21.25
|
| Rate for Payer: Prime Health Services Medicare |
$20.11
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$15.00
|
| Rate for Payer: Riverside University Health MISP |
$20.87
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$15.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$15.36
|
| Rate for Payer: United Healthcare All Other HMO |
$15.36
|
| Rate for Payer: United Healthcare HMO Rider |
$15.36
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15.36
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$28.46
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$20.87
|
| Rate for Payer: Vantage Medical Group Senior |
$18.97
|
|
|
HC SOM ARSENIC URINE QUANT
|
Facility
IP
|
$25.00
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
900911289
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.00 |
| Max. Negotiated Rate |
$22.50 |
| Rate for Payer: Cash Price |
$11.25
|
| Rate for Payer: Central Health Plan Commercial |
$20.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.00
|
| Rate for Payer: Galaxy Health WC |
$21.25
|
| Rate for Payer: Global Benefits Group Commercial |
$15.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$22.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.00
|
| Rate for Payer: Multiplan Commercial |
$18.75
|
| Rate for Payer: Networks By Design Commercial |
$16.25
|
| Rate for Payer: Prime Health Services Commercial |
$21.25
|
|
|
HC SOM ARYLSULFATASE A, URINE
|
Facility
IP
|
$125.00
|
|
|
Service Code
|
CPT 84311
|
| Hospital Charge Code |
900910723
|
|
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 ARYLSULFATASE A, URINE
|
Facility
OP
|
$125.00
|
|
|
Service Code
|
CPT 84311
|
| Hospital Charge Code |
900910723
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.56 |
| Max. Negotiated Rate |
$112.50 |
| Rate for Payer: Adventist Health Medi-Cal |
$8.10
|
| Rate for Payer: Aetna of CA HMO/PPO |
$51.29
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$12.15
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$8.91
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$8.10
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$50.89
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$62.07
|
| 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 |
$8.10
|
| 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 |
$12.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.94
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$8.10
|
| Rate for Payer: EPIC Health Plan Transplant |
$8.10
|
| 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 |
$13.28
|
| Rate for Payer: IEHP medi-cal |
$13.36
|
| Rate for Payer: IEHP Medicare Advantage |
$8.10
|
| Rate for Payer: Innovage PACE Commercial |
$12.15
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$83.38
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.85
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10.85
|
| 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 |
$8.59
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$75.00
|
| Rate for Payer: Riverside University Health MISP |
$8.91
|
| 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 |
$6.56
|
| Rate for Payer: United Healthcare All Other HMO |
$6.56
|
| Rate for Payer: United Healthcare HMO Rider |
$6.56
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.56
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.91
|
| Rate for Payer: Vantage Medical Group Senior |
$8.10
|
|
|
HC SOM ASPERGILLUS(GALACT)ANTIGEN
|
Facility
OP
|
$20.00
|
|
|
Service Code
|
CPT 87305
|
| Hospital Charge Code |
900912574
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.00 |
| Max. Negotiated Rate |
$80.65 |
| Rate for Payer: Adventist Health Medi-Cal |
$11.98
|
| Rate for Payer: Aetna of CA HMO/PPO |
$68.17
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$17.97
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$13.18
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$11.98
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$66.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$80.65
|
| 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 |
$11.98
|
| 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 |
$17.97
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.17
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$11.98
|
| Rate for Payer: EPIC Health Plan Transplant |
$11.98
|
| 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 |
$19.65
|
| Rate for Payer: IEHP medi-cal |
$19.77
|
| Rate for Payer: IEHP Medicare Advantage |
$11.98
|
| Rate for Payer: Innovage PACE Commercial |
$17.97
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$13.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$11.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16.05
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16.05
|
| 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 |
$12.70
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$12.00
|
| Rate for Payer: Riverside University Health MISP |
$13.18
|
| 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 |
$9.70
|
| Rate for Payer: United Healthcare All Other HMO |
$9.70
|
| Rate for Payer: United Healthcare HMO Rider |
$9.70
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.70
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$17.97
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.18
|
| Rate for Payer: Vantage Medical Group Senior |
$11.98
|
|
|
HC SOM ASPERGILLUS(GALACT)ANTIGEN
|
Facility
IP
|
$20.00
|
|
|
Service Code
|
CPT 87305
|
| Hospital Charge Code |
900912574
|
|
Hospital Revenue Code
|
302
|
| 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 ATIVAN
|
Facility
IP
|
$73.59
|
|
|
Service Code
|
CPT 80346
|
| Hospital Charge Code |
900911456
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.72 |
| Max. Negotiated Rate |
$66.23 |
| Rate for Payer: Cash Price |
$33.12
|
| Rate for Payer: Central Health Plan Commercial |
$58.87
|
| Rate for Payer: EPIC Health Plan Commercial |
$29.44
|
| Rate for Payer: Galaxy Health WC |
$62.55
|
| Rate for Payer: Global Benefits Group Commercial |
$44.15
|
| Rate for Payer: Health Management Network EPO/PPO |
$66.23
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$49.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.72
|
| Rate for Payer: Multiplan Commercial |
$55.19
|
| Rate for Payer: Networks By Design Commercial |
$47.83
|
| Rate for Payer: Prime Health Services Commercial |
$62.55
|
|
|
HC SOM ATIVAN
|
Facility
OP
|
$73.59
|
|
|
Service Code
|
CPT 80346
|
| Hospital Charge Code |
900911456
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$0.06 |
| Max. Negotiated Rate |
$157.41 |
| Rate for Payer: Aetna of CA HMO/PPO |
$0.06
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$62.55
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$40.47
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$40.47
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$129.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$157.41
|
| Rate for Payer: BCBS Transplant Transplant |
$44.15
|
| Rate for Payer: Blue Shield of California Commercial |
$45.48
|
| Rate for Payer: Blue Shield of California EPN |
$35.76
|
| Rate for Payer: Cash Price |
$33.12
|
| Rate for Payer: Cash Price |
$33.12
|
| Rate for Payer: Central Health Plan Commercial |
$58.87
|
| Rate for Payer: Cigna of CA HMO |
$47.10
|
| Rate for Payer: Cigna of CA PPO |
$54.46
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$62.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$29.44
|
| Rate for Payer: EPIC Health Plan Transplant |
$29.44
|
| Rate for Payer: Galaxy Health WC |
$62.55
|
| Rate for Payer: Global Benefits Group Commercial |
$44.15
|
| Rate for Payer: Health Management Network EPO/PPO |
$66.23
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$55.19
|
| Rate for Payer: IEHP medi-cal |
$25.76
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$49.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.72
|
| Rate for Payer: Multiplan Commercial |
$55.19
|
| Rate for Payer: Networks By Design Commercial |
$47.83
|
| Rate for Payer: Prime Health Services Commercial |
$62.55
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$44.15
|
| Rate for Payer: Riverside University Health MISP |
$29.44
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$44.15
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$44.15
|
| Rate for Payer: United Healthcare All Other Commercial |
$36.80
|
| Rate for Payer: United Healthcare All Other HMO |
$36.80
|
| Rate for Payer: United Healthcare HMO Rider |
$36.80
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$36.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$62.55
|
| Rate for Payer: Vantage Medical Group Senior |
$62.55
|
|
|
HC SOM BACLOFEN 83789
|
Facility
OP
|
$319.00
|
|
|
Service Code
|
CPT 83789
|
| Hospital Charge Code |
900915259
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$19.53 |
| Max. Negotiated Rate |
$287.10 |
| Rate for Payer: Adventist Health Medi-Cal |
$24.11
|
| Rate for Payer: Aetna of CA HMO/PPO |
$132.53
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$36.16
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$26.52
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$24.11
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$130.82
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$159.57
|
| Rate for Payer: BCBS Transplant Transplant |
$191.40
|
| Rate for Payer: Blue Shield of California Commercial |
$197.14
|
| Rate for Payer: Blue Shield of California EPN |
$155.03
|
| Rate for Payer: Caremore Medicare Advantage |
$24.11
|
| Rate for Payer: Cash Price |
$143.55
|
| Rate for Payer: Cash Price |
$143.55
|
| Rate for Payer: Central Health Plan Commercial |
$255.20
|
| Rate for Payer: Cigna of CA HMO |
$204.16
|
| Rate for Payer: Cigna of CA PPO |
$236.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$36.16
|
| Rate for Payer: EPIC Health Plan Commercial |
$32.55
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$24.11
|
| Rate for Payer: EPIC Health Plan Transplant |
$24.11
|
| Rate for Payer: Galaxy Health WC |
$271.15
|
| Rate for Payer: Global Benefits Group Commercial |
$191.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$287.10
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$239.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$39.54
|
| Rate for Payer: IEHP medi-cal |
$39.78
|
| Rate for Payer: IEHP Medicare Advantage |
$24.11
|
| Rate for Payer: Innovage PACE Commercial |
$36.16
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$212.77
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$24.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$63.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$32.31
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$32.31
|
| Rate for Payer: Multiplan Commercial |
$239.25
|
| Rate for Payer: Networks By Design Commercial |
$207.35
|
| Rate for Payer: Prime Health Services Commercial |
$271.15
|
| Rate for Payer: Prime Health Services Medicare |
$25.56
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$191.40
|
| Rate for Payer: Riverside University Health MISP |
$26.52
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$191.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$191.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$19.53
|
| Rate for Payer: United Healthcare All Other HMO |
$19.53
|
| Rate for Payer: United Healthcare HMO Rider |
$19.53
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$19.53
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$36.16
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$26.52
|
| Rate for Payer: Vantage Medical Group Senior |
$24.11
|
|
|
HC SOM BACLOFEN 83789
|
Facility
IP
|
$319.00
|
|
|
Service Code
|
CPT 83789
|
| Hospital Charge Code |
900915259
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$63.80 |
| Max. Negotiated Rate |
$287.10 |
| Rate for Payer: Cash Price |
$143.55
|
| Rate for Payer: Central Health Plan Commercial |
$255.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$127.60
|
| Rate for Payer: Galaxy Health WC |
$271.15
|
| Rate for Payer: Global Benefits Group Commercial |
$191.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$287.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$212.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$63.80
|
| Rate for Payer: Multiplan Commercial |
$239.25
|
| Rate for Payer: Networks By Design Commercial |
$207.35
|
| Rate for Payer: Prime Health Services Commercial |
$271.15
|
|
|
HC SOM BARBITURATE CONFIRM, U
|
Facility
IP
|
$61.25
|
|
|
Service Code
|
CPT 80345
|
| Hospital Charge Code |
900912916
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.25 |
| Max. Negotiated Rate |
$55.12 |
| Rate for Payer: Cash Price |
$27.56
|
| Rate for Payer: Central Health Plan Commercial |
$49.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$24.50
|
| Rate for Payer: Galaxy Health WC |
$52.06
|
| Rate for Payer: Global Benefits Group Commercial |
$36.75
|
| Rate for Payer: Health Management Network EPO/PPO |
$55.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$40.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.25
|
| Rate for Payer: Multiplan Commercial |
$45.94
|
| Rate for Payer: Networks By Design Commercial |
$39.81
|
| Rate for Payer: Prime Health Services Commercial |
$52.06
|
|
|
HC SOM BARBITURATE CONFIRM, U
|
Facility
OP
|
$61.25
|
|
|
Service Code
|
CPT 80345
|
| Hospital Charge Code |
900912916
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$0.06 |
| Max. Negotiated Rate |
$97.50 |
| Rate for Payer: Aetna of CA HMO/PPO |
$0.06
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$52.06
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$33.69
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$33.69
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$79.93
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$97.50
|
| Rate for Payer: BCBS Transplant Transplant |
$36.75
|
| Rate for Payer: Blue Shield of California Commercial |
$37.85
|
| Rate for Payer: Blue Shield of California EPN |
$29.77
|
| Rate for Payer: Cash Price |
$27.56
|
| Rate for Payer: Cash Price |
$27.56
|
| Rate for Payer: Central Health Plan Commercial |
$49.00
|
| Rate for Payer: Cigna of CA HMO |
$39.20
|
| Rate for Payer: Cigna of CA PPO |
$45.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$52.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$24.50
|
| Rate for Payer: EPIC Health Plan Transplant |
$24.50
|
| Rate for Payer: Galaxy Health WC |
$52.06
|
| Rate for Payer: Global Benefits Group Commercial |
$36.75
|
| Rate for Payer: Health Management Network EPO/PPO |
$55.12
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$45.94
|
| Rate for Payer: IEHP medi-cal |
$21.44
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$40.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.25
|
| Rate for Payer: Multiplan Commercial |
$45.94
|
| Rate for Payer: Networks By Design Commercial |
$39.81
|
| Rate for Payer: Prime Health Services Commercial |
$52.06
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$36.75
|
| Rate for Payer: Riverside University Health MISP |
$24.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$36.75
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$36.75
|
| Rate for Payer: United Healthcare All Other Commercial |
$30.62
|
| Rate for Payer: United Healthcare All Other HMO |
$30.62
|
| Rate for Payer: United Healthcare HMO Rider |
$30.62
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$30.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$52.06
|
| Rate for Payer: Vantage Medical Group Senior |
$52.06
|
|
|
HC SOM BARTONELLA HENSELAE AB IGG
|
Facility
OP
|
$9.83
|
|
|
Service Code
|
CPT 86611
|
| Hospital Charge Code |
900911386
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$1.97 |
| Max. Negotiated Rate |
$90.21 |
| Rate for Payer: Adventist Health Medi-Cal |
$10.18
|
| Rate for Payer: Aetna of CA HMO/PPO |
$74.67
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$15.27
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$11.20
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$10.18
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$73.96
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$90.21
|
| Rate for Payer: BCBS Transplant Transplant |
$5.90
|
| Rate for Payer: Blue Shield of California Commercial |
$6.07
|
| Rate for Payer: Blue Shield of California EPN |
$4.78
|
| Rate for Payer: Caremore Medicare Advantage |
$10.18
|
| Rate for Payer: Cash Price |
$4.42
|
| Rate for Payer: Cash Price |
$4.42
|
| Rate for Payer: Central Health Plan Commercial |
$7.86
|
| Rate for Payer: Cigna of CA HMO |
$6.29
|
| Rate for Payer: Cigna of CA PPO |
$7.27
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.74
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$10.18
|
| Rate for Payer: EPIC Health Plan Transplant |
$10.18
|
| Rate for Payer: Galaxy Health WC |
$8.36
|
| Rate for Payer: Global Benefits Group Commercial |
$5.90
|
| Rate for Payer: Health Management Network EPO/PPO |
$8.85
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$7.37
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$16.70
|
| Rate for Payer: IEHP medi-cal |
$16.80
|
| Rate for Payer: IEHP Medicare Advantage |
$10.18
|
| Rate for Payer: Innovage PACE Commercial |
$15.27
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6.56
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.97
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$13.64
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$13.64
|
| Rate for Payer: Multiplan Commercial |
$7.37
|
| Rate for Payer: Networks By Design Commercial |
$6.39
|
| Rate for Payer: Prime Health Services Commercial |
$8.36
|
| Rate for Payer: Prime Health Services Medicare |
$10.79
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$5.90
|
| Rate for Payer: Riverside University Health MISP |
$11.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5.90
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5.90
|
| Rate for Payer: United Healthcare All Other Commercial |
$8.24
|
| Rate for Payer: United Healthcare All Other HMO |
$8.24
|
| Rate for Payer: United Healthcare HMO Rider |
$8.24
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8.24
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15.27
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11.20
|
| Rate for Payer: Vantage Medical Group Senior |
$10.18
|
|
|
HC SOM BARTONELLA HENSELAE AB IGG
|
Facility
IP
|
$9.83
|
|
|
Service Code
|
CPT 86611
|
| Hospital Charge Code |
900911386
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$1.97 |
| Max. Negotiated Rate |
$8.85 |
| Rate for Payer: Cash Price |
$4.42
|
| Rate for Payer: Central Health Plan Commercial |
$7.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.93
|
| Rate for Payer: Galaxy Health WC |
$8.36
|
| Rate for Payer: Global Benefits Group Commercial |
$5.90
|
| Rate for Payer: Health Management Network EPO/PPO |
$8.85
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.97
|
| Rate for Payer: Multiplan Commercial |
$7.37
|
| Rate for Payer: Networks By Design Commercial |
$6.39
|
| Rate for Payer: Prime Health Services Commercial |
$8.36
|
|
|
HC SOM BARTONELLA HENSELAE AB IGM
|
Facility
IP
|
$9.83
|
|
|
Service Code
|
CPT 86611
|
| Hospital Charge Code |
900912690
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$1.97 |
| Max. Negotiated Rate |
$8.85 |
| Rate for Payer: Cash Price |
$4.42
|
| Rate for Payer: Central Health Plan Commercial |
$7.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.93
|
| Rate for Payer: Galaxy Health WC |
$8.36
|
| Rate for Payer: Global Benefits Group Commercial |
$5.90
|
| Rate for Payer: Health Management Network EPO/PPO |
$8.85
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.97
|
| Rate for Payer: Multiplan Commercial |
$7.37
|
| Rate for Payer: Networks By Design Commercial |
$6.39
|
| Rate for Payer: Prime Health Services Commercial |
$8.36
|
|
|
HC SOM BARTONELLA HENSELAE AB IGM
|
Facility
OP
|
$9.83
|
|
|
Service Code
|
CPT 86611
|
| Hospital Charge Code |
900912690
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$1.97 |
| Max. Negotiated Rate |
$90.21 |
| Rate for Payer: Adventist Health Medi-Cal |
$10.18
|
| Rate for Payer: Aetna of CA HMO/PPO |
$74.67
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$15.27
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$11.20
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$10.18
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$73.96
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$90.21
|
| Rate for Payer: BCBS Transplant Transplant |
$5.90
|
| Rate for Payer: Blue Shield of California Commercial |
$6.07
|
| Rate for Payer: Blue Shield of California EPN |
$4.78
|
| Rate for Payer: Caremore Medicare Advantage |
$10.18
|
| Rate for Payer: Cash Price |
$4.42
|
| Rate for Payer: Cash Price |
$4.42
|
| Rate for Payer: Central Health Plan Commercial |
$7.86
|
| Rate for Payer: Cigna of CA HMO |
$6.29
|
| Rate for Payer: Cigna of CA PPO |
$7.27
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.74
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$10.18
|
| Rate for Payer: EPIC Health Plan Transplant |
$10.18
|
| Rate for Payer: Galaxy Health WC |
$8.36
|
| Rate for Payer: Global Benefits Group Commercial |
$5.90
|
| Rate for Payer: Health Management Network EPO/PPO |
$8.85
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$7.37
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$16.70
|
| Rate for Payer: IEHP medi-cal |
$16.80
|
| Rate for Payer: IEHP Medicare Advantage |
$10.18
|
| Rate for Payer: Innovage PACE Commercial |
$15.27
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6.56
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.97
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$13.64
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$13.64
|
| Rate for Payer: Multiplan Commercial |
$7.37
|
| Rate for Payer: Networks By Design Commercial |
$6.39
|
| Rate for Payer: Prime Health Services Commercial |
$8.36
|
| Rate for Payer: Prime Health Services Medicare |
$10.79
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$5.90
|
| Rate for Payer: Riverside University Health MISP |
$11.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5.90
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5.90
|
| Rate for Payer: United Healthcare All Other Commercial |
$8.24
|
| Rate for Payer: United Healthcare All Other HMO |
$8.24
|
| Rate for Payer: United Healthcare HMO Rider |
$8.24
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8.24
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15.27
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11.20
|
| Rate for Payer: Vantage Medical Group Senior |
$10.18
|
|
|
HC SOM BARTONELLA QUINTANA AB IGG
|
Facility
IP
|
$9.83
|
|
|
Service Code
|
CPT 86611
|
| Hospital Charge Code |
900912691
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$1.97 |
| Max. Negotiated Rate |
$8.85 |
| Rate for Payer: Cash Price |
$4.42
|
| Rate for Payer: Central Health Plan Commercial |
$7.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.93
|
| Rate for Payer: Galaxy Health WC |
$8.36
|
| Rate for Payer: Global Benefits Group Commercial |
$5.90
|
| Rate for Payer: Health Management Network EPO/PPO |
$8.85
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.97
|
| Rate for Payer: Multiplan Commercial |
$7.37
|
| Rate for Payer: Networks By Design Commercial |
$6.39
|
| Rate for Payer: Prime Health Services Commercial |
$8.36
|
|
