|
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
|
|
|
HC SOM BARTONELLA QUINTANA AB IGM
|
Facility
OP
|
$9.83
|
|
|
Service Code
|
CPT 86611
|
| Hospital Charge Code |
900912692
|
|
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 IGM
|
Facility
IP
|
$9.83
|
|
|
Service Code
|
CPT 86611
|
| Hospital Charge Code |
900912692
|
|
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 B-CELL LYMPH FISH INTERP
|
Facility
IP
|
$254.50
|
|
|
Service Code
|
CPT 88291
|
| Hospital Charge Code |
900914116
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$50.90 |
| Max. Negotiated Rate |
$229.05 |
| Rate for Payer: Cash Price |
$114.53
|
| Rate for Payer: Central Health Plan Commercial |
$203.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$101.80
|
| Rate for Payer: Galaxy Health WC |
$216.32
|
| Rate for Payer: Global Benefits Group Commercial |
$152.70
|
| Rate for Payer: Health Management Network EPO/PPO |
$229.05
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$169.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$50.90
|
| Rate for Payer: Multiplan Commercial |
$190.88
|
| Rate for Payer: Networks By Design Commercial |
$165.42
|
| Rate for Payer: Prime Health Services Commercial |
$216.32
|
|
|
HC SOM B-CELL LYMPH FISH INTERP
|
Facility
OP
|
$254.50
|
|
|
Service Code
|
CPT 88291
|
| Hospital Charge Code |
900914116
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$27.19 |
| Max. Negotiated Rate |
$2,718.90 |
| Rate for Payer: Aetna of CA HMO/PPO |
$155.72
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$216.32
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$139.98
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$139.98
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$135.91
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$165.78
|
| Rate for Payer: BCBS Transplant Transplant |
$152.70
|
| Rate for Payer: Blue Shield of California Commercial |
$157.28
|
| Rate for Payer: Blue Shield of California EPN |
$123.69
|
| Rate for Payer: Cash Price |
$114.53
|
| Rate for Payer: Cash Price |
$114.53
|
| Rate for Payer: Central Health Plan Commercial |
$203.60
|
| Rate for Payer: Cigna of CA HMO |
$162.88
|
| Rate for Payer: Cigna of CA PPO |
$188.33
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$216.32
|
| Rate for Payer: EPIC Health Plan Commercial |
$101.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$101.80
|
| Rate for Payer: Galaxy Health WC |
$216.32
|
| Rate for Payer: Global Benefits Group Commercial |
$152.70
|
| Rate for Payer: Health Management Network EPO/PPO |
$229.05
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$190.88
|
| Rate for Payer: IEHP medi-cal |
$89.08
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$169.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$50.90
|
| Rate for Payer: Multiplan Commercial |
$190.88
|
| Rate for Payer: Networks By Design Commercial |
$165.42
|
| Rate for Payer: Prime Health Services Commercial |
$216.32
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$152.70
|
| Rate for Payer: Riverside University Health MISP |
$101.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$152.70
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$152.70
|
| Rate for Payer: United Healthcare All Other Commercial |
$27.19
|
| Rate for Payer: United Healthcare All Other HMO |
$27.19
|
| Rate for Payer: United Healthcare HMO Rider |
$27.19
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,718.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$216.32
|
| Rate for Payer: Vantage Medical Group Senior |
$216.32
|
|
|
HC SOM BCR/ABL1, P190, MRNA DETECTION, RT-PCR, QUANTITATIVE, MONITORING ASSAY
|
Facility
IP
|
$350.00
|
|
|
Service Code
|
CPT 81207
|
| Hospital Charge Code |
900915426
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$70.00 |
| Max. Negotiated Rate |
$315.00 |
| Rate for Payer: Cash Price |
$157.50
|
| Rate for Payer: Central Health Plan Commercial |
$280.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$140.00
|
| Rate for Payer: Galaxy Health WC |
$297.50
|
| Rate for Payer: Global Benefits Group Commercial |
$210.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$315.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$233.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$70.00
|
| Rate for Payer: Multiplan Commercial |
$262.50
|
| Rate for Payer: Networks By Design Commercial |
$227.50
|
| Rate for Payer: Prime Health Services Commercial |
$297.50
|
|
|
HC SOM BCR/ABL1, P190, MRNA DETECTION, RT-PCR, QUANTITATIVE, MONITORING ASSAY
|
Facility
OP
|
$350.00
|
|
|
Service Code
|
CPT 81207
|
| Hospital Charge Code |
900915426
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$70.00 |
| Max. Negotiated Rate |
$358.38 |
| Rate for Payer: Adventist Health Medi-Cal |
$144.84
|
| Rate for Payer: Aetna of CA HMO/PPO |
$318.75
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$217.26
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$159.32
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$144.84
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$293.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$358.38
|
| Rate for Payer: BCBS Transplant Transplant |
$210.00
|
| Rate for Payer: Blue Shield of California Commercial |
$216.30
|
| Rate for Payer: Blue Shield of California EPN |
$170.10
|
| Rate for Payer: Caremore Medicare Advantage |
$144.84
|
| Rate for Payer: Cash Price |
$157.50
|
| Rate for Payer: Cash Price |
$157.50
|
| Rate for Payer: Central Health Plan Commercial |
$280.00
|
| Rate for Payer: Cigna of CA HMO |
$224.00
|
| Rate for Payer: Cigna of CA PPO |
$259.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$217.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$195.53
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$144.84
|
| Rate for Payer: EPIC Health Plan Transplant |
$144.84
|
| Rate for Payer: Galaxy Health WC |
$297.50
|
| Rate for Payer: Global Benefits Group Commercial |
$210.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$315.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$262.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$237.54
|
| Rate for Payer: IEHP medi-cal |
$238.99
|
| Rate for Payer: IEHP Medicare Advantage |
$144.84
|
| Rate for Payer: Innovage PACE Commercial |
$217.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$233.45
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$144.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$70.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$194.09
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$194.09
|
| Rate for Payer: Multiplan Commercial |
$262.50
|
| Rate for Payer: Networks By Design Commercial |
$227.50
|
| Rate for Payer: Prime Health Services Commercial |
$297.50
|
| Rate for Payer: Prime Health Services Medicare |
$153.53
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$210.00
|
| Rate for Payer: Riverside University Health MISP |
$159.32
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$210.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$210.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$117.32
|
| Rate for Payer: United Healthcare All Other HMO |
$117.32
|
| Rate for Payer: United Healthcare HMO Rider |
$117.32
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$117.32
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$217.26
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$159.32
|
| Rate for Payer: Vantage Medical Group Senior |
$144.84
|
|
|
HC SOM BCR ABL MUTAT ASPE
|
Facility
OP
|
$435.08
|
|
|
Service Code
|
CPT 81403
|
| Hospital Charge Code |
900914536
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$87.02 |
| Max. Negotiated Rate |
$1,327.96 |
| Rate for Payer: Adventist Health Medi-Cal |
$185.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$368.14
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$277.80
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$203.72
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$185.20
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,088.71
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,327.96
|
| Rate for Payer: BCBS Transplant Transplant |
$261.05
|
| Rate for Payer: Blue Shield of California Commercial |
$268.88
|
| Rate for Payer: Blue Shield of California EPN |
$211.45
|
| Rate for Payer: Caremore Medicare Advantage |
$185.20
|
| Rate for Payer: Cash Price |
$195.79
|
| Rate for Payer: Cash Price |
$195.79
|
| Rate for Payer: Central Health Plan Commercial |
$348.06
|
| Rate for Payer: Cigna of CA HMO |
$278.45
|
| Rate for Payer: Cigna of CA PPO |
$321.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$277.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$250.02
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$185.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$185.20
|
| Rate for Payer: Galaxy Health WC |
$369.82
|
| Rate for Payer: Global Benefits Group Commercial |
$261.05
|
| Rate for Payer: Health Management Network EPO/PPO |
$391.57
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$326.31
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$303.73
|
| Rate for Payer: IEHP medi-cal |
$305.58
|
| Rate for Payer: IEHP Medicare Advantage |
$185.20
|
| Rate for Payer: Innovage PACE Commercial |
$277.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$290.20
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$185.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$87.02
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$248.17
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$248.17
|
| Rate for Payer: Multiplan Commercial |
$326.31
|
| Rate for Payer: Networks By Design Commercial |
$282.80
|
| Rate for Payer: Prime Health Services Commercial |
$369.82
|
| Rate for Payer: Prime Health Services Medicare |
$196.31
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$261.05
|
| Rate for Payer: Riverside University Health MISP |
$203.72
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$261.05
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$261.05
|
| Rate for Payer: United Healthcare All Other Commercial |
$150.01
|
| Rate for Payer: United Healthcare All Other HMO |
$150.01
|
| Rate for Payer: United Healthcare HMO Rider |
$150.01
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$150.01
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$277.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$203.72
|
| Rate for Payer: Vantage Medical Group Senior |
$185.20
|
|
|
HC SOM BCR ABL MUTAT ASPE
|
Facility
IP
|
$435.08
|
|
|
Service Code
|
CPT 81403
|
| Hospital Charge Code |
900914536
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$87.02 |
| Max. Negotiated Rate |
$391.57 |
| Rate for Payer: Cash Price |
$195.79
|
| Rate for Payer: Central Health Plan Commercial |
$348.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$174.03
|
| Rate for Payer: Galaxy Health WC |
$369.82
|
| Rate for Payer: Global Benefits Group Commercial |
$261.05
|
| Rate for Payer: Health Management Network EPO/PPO |
$391.57
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$290.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$87.02
|
| Rate for Payer: Multiplan Commercial |
$326.31
|
| Rate for Payer: Networks By Design Commercial |
$282.80
|
| Rate for Payer: Prime Health Services Commercial |
$369.82
|
|
|
HC SOM BCR/ABL P210 QN MON
|
Facility
OP
|
$200.00
|
|
|
Service Code
|
CPT 81206
|
| Hospital Charge Code |
900914648
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$40.00 |
| Max. Negotiated Rate |
$358.38 |
| Rate for Payer: Adventist Health Medi-Cal |
$163.96
|
| Rate for Payer: Aetna of CA HMO/PPO |
$358.26
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$245.94
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$180.36
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$163.96
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$293.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$358.38
|
| Rate for Payer: BCBS Transplant Transplant |
$120.00
|
| Rate for Payer: Blue Shield of California Commercial |
$123.60
|
| Rate for Payer: Blue Shield of California EPN |
$97.20
|
| Rate for Payer: Caremore Medicare Advantage |
$163.96
|
| Rate for Payer: Cash Price |
$90.00
|
| Rate for Payer: Cash Price |
$90.00
|
| Rate for Payer: Central Health Plan Commercial |
$160.00
|
| Rate for Payer: Cigna of CA HMO |
$128.00
|
| Rate for Payer: Cigna of CA PPO |
$148.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$245.94
|
| Rate for Payer: EPIC Health Plan Commercial |
$221.35
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$163.96
|
| Rate for Payer: EPIC Health Plan Transplant |
$163.96
|
| Rate for Payer: Galaxy Health WC |
$170.00
|
| Rate for Payer: Global Benefits Group Commercial |
$120.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$180.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$150.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$268.89
|
| Rate for Payer: IEHP medi-cal |
$270.53
|
| Rate for Payer: IEHP Medicare Advantage |
$163.96
|
| Rate for Payer: Innovage PACE Commercial |
$245.94
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$133.40
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$163.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$40.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$219.71
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$219.71
|
| Rate for Payer: Multiplan Commercial |
$150.00
|
| Rate for Payer: Networks By Design Commercial |
$130.00
|
| Rate for Payer: Prime Health Services Commercial |
$170.00
|
| Rate for Payer: Prime Health Services Medicare |
$173.80
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$120.00
|
| Rate for Payer: Riverside University Health MISP |
$180.36
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$120.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$120.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$132.80
|
| Rate for Payer: United Healthcare All Other HMO |
$132.80
|
| Rate for Payer: United Healthcare HMO Rider |
$132.80
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$132.80
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$245.94
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$180.36
|
| Rate for Payer: Vantage Medical Group Senior |
$163.96
|
|
|
HC SOM BCR/ABL P210 QN MON
|
Facility
IP
|
$200.00
|
|
|
Service Code
|
CPT 81206
|
| Hospital Charge Code |
900914648
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$40.00 |
| Max. Negotiated Rate |
$180.00 |
| Rate for Payer: Cash Price |
$90.00
|
| Rate for Payer: Central Health Plan Commercial |
$160.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$80.00
|
| Rate for Payer: Galaxy Health WC |
$170.00
|
| Rate for Payer: Global Benefits Group Commercial |
$120.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$180.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$133.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$40.00
|
| Rate for Payer: Multiplan Commercial |
$150.00
|
| Rate for Payer: Networks By Design Commercial |
$130.00
|
| Rate for Payer: Prime Health Services Commercial |
$170.00
|
|
|
HC SOM BENZODIAZEPINE CONFIRM, U
|
Facility
IP
|
$36.96
|
|
|
Service Code
|
CPT 80346
|
| Hospital Charge Code |
900912915
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.39 |
| Max. Negotiated Rate |
$33.26 |
| Rate for Payer: Cash Price |
$16.63
|
| Rate for Payer: Central Health Plan Commercial |
$29.57
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.78
|
| Rate for Payer: Galaxy Health WC |
$31.42
|
| Rate for Payer: Global Benefits Group Commercial |
$22.18
|
| Rate for Payer: Health Management Network EPO/PPO |
$33.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$24.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.39
|
| Rate for Payer: Multiplan Commercial |
$27.72
|
| Rate for Payer: Networks By Design Commercial |
$24.02
|
| Rate for Payer: Prime Health Services Commercial |
$31.42
|
|
|
HC SOM BENZODIAZEPINE CONFIRM, U
|
Facility
OP
|
$36.96
|
|
|
Service Code
|
CPT 80346
|
| Hospital Charge Code |
900912915
|
|
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 |
$31.42
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$20.33
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$20.33
|
| 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 |
$22.18
|
| Rate for Payer: Blue Shield of California Commercial |
$22.84
|
| Rate for Payer: Blue Shield of California EPN |
$17.96
|
| Rate for Payer: Cash Price |
$16.63
|
| Rate for Payer: Cash Price |
$16.63
|
| Rate for Payer: Central Health Plan Commercial |
$29.57
|
| Rate for Payer: Cigna of CA HMO |
$23.65
|
| Rate for Payer: Cigna of CA PPO |
$27.35
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$31.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.78
|
| Rate for Payer: EPIC Health Plan Transplant |
$14.78
|
| Rate for Payer: Galaxy Health WC |
$31.42
|
| Rate for Payer: Global Benefits Group Commercial |
$22.18
|
| Rate for Payer: Health Management Network EPO/PPO |
$33.26
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$27.72
|
| Rate for Payer: IEHP medi-cal |
$12.94
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$24.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.39
|
| Rate for Payer: Multiplan Commercial |
$27.72
|
| Rate for Payer: Networks By Design Commercial |
$24.02
|
| Rate for Payer: Prime Health Services Commercial |
$31.42
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$22.18
|
| Rate for Payer: Riverside University Health MISP |
$14.78
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$22.18
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$22.18
|
| Rate for Payer: United Healthcare All Other Commercial |
$18.48
|
| Rate for Payer: United Healthcare All Other HMO |
$18.48
|
| Rate for Payer: United Healthcare HMO Rider |
$18.48
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$18.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$31.42
|
| Rate for Payer: Vantage Medical Group Senior |
$31.42
|
|
|
HC SOM BETA 2 MICROGLOBULIN CSF
|
Facility
IP
|
$220.67
|
|
|
Service Code
|
CPT 82232
|
| Hospital Charge Code |
900911369
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$44.13 |
| Max. Negotiated Rate |
$198.60 |
| Rate for Payer: Cash Price |
$99.30
|
| Rate for Payer: Central Health Plan Commercial |
$176.54
|
| Rate for Payer: EPIC Health Plan Commercial |
$88.27
|
| Rate for Payer: Galaxy Health WC |
$187.57
|
| Rate for Payer: Global Benefits Group Commercial |
$132.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$198.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$147.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$44.13
|
| Rate for Payer: Multiplan Commercial |
$165.50
|
| Rate for Payer: Networks By Design Commercial |
$143.44
|
| Rate for Payer: Prime Health Services Commercial |
$187.57
|
|
|
HC SOM BETA 2 MICROGLOBULIN CSF
|
Facility
OP
|
$220.67
|
|
|
Service Code
|
CPT 82232
|
| Hospital Charge Code |
900911369
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.10 |
| Max. Negotiated Rate |
$198.60 |
| Rate for Payer: Adventist Health Medi-Cal |
$16.18
|
| Rate for Payer: Aetna of CA HMO/PPO |
$118.73
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$24.27
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$17.80
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$16.18
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$117.74
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$143.61
|
| Rate for Payer: BCBS Transplant Transplant |
$132.40
|
| Rate for Payer: Blue Shield of California Commercial |
$136.37
|
| Rate for Payer: Blue Shield of California EPN |
$107.25
|
| Rate for Payer: Caremore Medicare Advantage |
$16.18
|
| Rate for Payer: Cash Price |
$99.30
|
| Rate for Payer: Cash Price |
$99.30
|
| Rate for Payer: Central Health Plan Commercial |
$176.54
|
| Rate for Payer: Cigna of CA HMO |
$141.23
|
| Rate for Payer: Cigna of CA PPO |
$163.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$24.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$21.84
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$16.18
|
| Rate for Payer: EPIC Health Plan Transplant |
$16.18
|
| Rate for Payer: Galaxy Health WC |
$187.57
|
| Rate for Payer: Global Benefits Group Commercial |
$132.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$198.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$165.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$26.54
|
| Rate for Payer: IEHP medi-cal |
$26.70
|
| Rate for Payer: IEHP Medicare Advantage |
$16.18
|
| Rate for Payer: Innovage PACE Commercial |
$24.27
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$147.19
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$44.13
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$21.68
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$21.68
|
| Rate for Payer: Multiplan Commercial |
$165.50
|
| Rate for Payer: Networks By Design Commercial |
$143.44
|
| Rate for Payer: Prime Health Services Commercial |
$187.57
|
| Rate for Payer: Prime Health Services Medicare |
$17.15
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$132.40
|
| Rate for Payer: Riverside University Health MISP |
$17.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$132.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$132.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$13.10
|
| Rate for Payer: United Healthcare All Other HMO |
$13.10
|
| Rate for Payer: United Healthcare HMO Rider |
$13.10
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$13.10
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$24.27
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$17.80
|
| Rate for Payer: Vantage Medical Group Senior |
$16.18
|
|
|
HC SOM BETA-2 MICROGLOBULINS
|
Facility
OP
|
$17.90
|
|
|
Service Code
|
CPT 82232
|
| Hospital Charge Code |
900914717
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.58 |
| Max. Negotiated Rate |
$143.61 |
| Rate for Payer: Adventist Health Medi-Cal |
$16.18
|
| Rate for Payer: Aetna of CA HMO/PPO |
$118.73
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$24.27
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$17.80
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$16.18
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$117.74
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$143.61
|
| Rate for Payer: BCBS Transplant Transplant |
$10.74
|
| Rate for Payer: Blue Shield of California Commercial |
$11.06
|
| Rate for Payer: Blue Shield of California EPN |
$8.70
|
| Rate for Payer: Caremore Medicare Advantage |
$16.18
|
| Rate for Payer: Cash Price |
$8.06
|
| Rate for Payer: Cash Price |
$8.06
|
| Rate for Payer: Central Health Plan Commercial |
$14.32
|
| Rate for Payer: Cigna of CA HMO |
$11.46
|
| Rate for Payer: Cigna of CA PPO |
$13.25
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$24.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$21.84
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$16.18
|
| Rate for Payer: EPIC Health Plan Transplant |
$16.18
|
| Rate for Payer: Galaxy Health WC |
$15.22
|
| Rate for Payer: Global Benefits Group Commercial |
$10.74
|
| Rate for Payer: Health Management Network EPO/PPO |
$16.11
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$13.42
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$26.54
|
| Rate for Payer: IEHP medi-cal |
$26.70
|
| Rate for Payer: IEHP Medicare Advantage |
$16.18
|
| Rate for Payer: Innovage PACE Commercial |
$24.27
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.58
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$21.68
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$21.68
|
| Rate for Payer: Multiplan Commercial |
$13.42
|
| Rate for Payer: Networks By Design Commercial |
$11.64
|
| Rate for Payer: Prime Health Services Commercial |
$15.22
|
| Rate for Payer: Prime Health Services Medicare |
$17.15
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$10.74
|
| Rate for Payer: Riverside University Health MISP |
$17.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10.74
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$10.74
|
| Rate for Payer: United Healthcare All Other Commercial |
$13.10
|
| Rate for Payer: United Healthcare All Other HMO |
$13.10
|
| Rate for Payer: United Healthcare HMO Rider |
$13.10
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$13.10
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$24.27
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$17.80
|
| Rate for Payer: Vantage Medical Group Senior |
$16.18
|
|
|
HC SOM BETA-2 MICROGLOBULINS
|
Facility
IP
|
$17.90
|
|
|
Service Code
|
CPT 82232
|
| Hospital Charge Code |
900914717
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.58 |
| Max. Negotiated Rate |
$16.11 |
| Rate for Payer: Cash Price |
$8.06
|
| Rate for Payer: Central Health Plan Commercial |
$14.32
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.16
|
| Rate for Payer: Galaxy Health WC |
$15.22
|
| Rate for Payer: Global Benefits Group Commercial |
$10.74
|
| Rate for Payer: Health Management Network EPO/PPO |
$16.11
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.58
|
| Rate for Payer: Multiplan Commercial |
$13.42
|
| Rate for Payer: Networks By Design Commercial |
$11.64
|
| Rate for Payer: Prime Health Services Commercial |
$15.22
|
|
|
HC SOM BETA 2 MICROGLOBULIN URINE
|
Facility
OP
|
$27.00
|
|
|
Service Code
|
CPT 82232
|
| Hospital Charge Code |
900911370
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.40 |
| Max. Negotiated Rate |
$143.61 |
| Rate for Payer: Adventist Health Medi-Cal |
$16.18
|
| Rate for Payer: Aetna of CA HMO/PPO |
$118.73
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$24.27
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$17.80
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$16.18
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$117.74
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$143.61
|
| Rate for Payer: BCBS Transplant Transplant |
$16.20
|
| Rate for Payer: Blue Shield of California Commercial |
$16.69
|
| Rate for Payer: Blue Shield of California EPN |
$13.12
|
| Rate for Payer: Caremore Medicare Advantage |
$16.18
|
| Rate for Payer: Cash Price |
$12.15
|
| Rate for Payer: Cash Price |
$12.15
|
| Rate for Payer: Central Health Plan Commercial |
$21.60
|
| Rate for Payer: Cigna of CA HMO |
$17.28
|
| Rate for Payer: Cigna of CA PPO |
$19.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$24.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$21.84
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$16.18
|
| Rate for Payer: EPIC Health Plan Transplant |
$16.18
|
| Rate for Payer: Galaxy Health WC |
$22.95
|
| Rate for Payer: Global Benefits Group Commercial |
$16.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$24.30
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$20.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$26.54
|
| Rate for Payer: IEHP medi-cal |
$26.70
|
| Rate for Payer: IEHP Medicare Advantage |
$16.18
|
| Rate for Payer: Innovage PACE Commercial |
$24.27
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$18.01
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$21.68
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$21.68
|
| Rate for Payer: Multiplan Commercial |
$20.25
|
| Rate for Payer: Networks By Design Commercial |
$17.55
|
| Rate for Payer: Prime Health Services Commercial |
$22.95
|
| Rate for Payer: Prime Health Services Medicare |
$17.15
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$16.20
|
| Rate for Payer: Riverside University Health MISP |
$17.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$16.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$16.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$13.10
|
| Rate for Payer: United Healthcare All Other HMO |
$13.10
|
| Rate for Payer: United Healthcare HMO Rider |
$13.10
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$13.10
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$24.27
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$17.80
|
| Rate for Payer: Vantage Medical Group Senior |
$16.18
|
|
|
HC SOM BETA 2 MICROGLOBULIN URINE
|
Facility
IP
|
$27.00
|
|
|
Service Code
|
CPT 82232
|
| Hospital Charge Code |
900911370
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.40 |
| Max. Negotiated Rate |
$24.30 |
| Rate for Payer: Cash Price |
$12.15
|
| Rate for Payer: Central Health Plan Commercial |
$21.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.80
|
| Rate for Payer: Galaxy Health WC |
$22.95
|
| Rate for Payer: Global Benefits Group Commercial |
$16.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$24.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$18.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.40
|
| Rate for Payer: Multiplan Commercial |
$20.25
|
| Rate for Payer: Networks By Design Commercial |
$17.55
|
| Rate for Payer: Prime Health Services Commercial |
$22.95
|
|
|
HC SOM BETA 2 TRANSFERRIN (TAU)
|
Facility
IP
|
$78.02
|
|
|
Service Code
|
CPT 86335
|
| Hospital Charge Code |
900911443
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.60 |
| Max. Negotiated Rate |
$70.22 |
| Rate for Payer: Cash Price |
$35.11
|
| Rate for Payer: Central Health Plan Commercial |
$62.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$31.21
|
| Rate for Payer: Galaxy Health WC |
$66.32
|
| Rate for Payer: Global Benefits Group Commercial |
$46.81
|
| Rate for Payer: Health Management Network EPO/PPO |
$70.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$52.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.60
|
| Rate for Payer: Multiplan Commercial |
$58.52
|
| Rate for Payer: Networks By Design Commercial |
$50.71
|
| Rate for Payer: Prime Health Services Commercial |
$66.32
|
|
|
HC SOM BETA 2 TRANSFERRIN (TAU)
|
Facility
OP
|
$78.02
|
|
|
Service Code
|
CPT 86335
|
| Hospital Charge Code |
900911443
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.60 |
| Max. Negotiated Rate |
$215.42 |
| Rate for Payer: Adventist Health Medi-Cal |
$29.35
|
| Rate for Payer: Aetna of CA HMO/PPO |
$215.42
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$44.02
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$32.28
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$29.35
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$101.24
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$123.48
|
| Rate for Payer: BCBS Transplant Transplant |
$46.81
|
| Rate for Payer: Blue Shield of California Commercial |
$48.22
|
| Rate for Payer: Blue Shield of California EPN |
$37.92
|
| Rate for Payer: Caremore Medicare Advantage |
$29.35
|
| Rate for Payer: Cash Price |
$35.11
|
| Rate for Payer: Cash Price |
$35.11
|
| Rate for Payer: Central Health Plan Commercial |
$62.42
|
| Rate for Payer: Cigna of CA HMO |
$49.93
|
| Rate for Payer: Cigna of CA PPO |
$57.73
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$44.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$39.62
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$29.35
|
| Rate for Payer: EPIC Health Plan Transplant |
$29.35
|
| Rate for Payer: Galaxy Health WC |
$66.32
|
| Rate for Payer: Global Benefits Group Commercial |
$46.81
|
| Rate for Payer: Health Management Network EPO/PPO |
$70.22
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$58.52
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$48.13
|
| Rate for Payer: IEHP medi-cal |
$48.43
|
| Rate for Payer: IEHP Medicare Advantage |
$29.35
|
| Rate for Payer: Innovage PACE Commercial |
$44.02
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$52.04
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$39.33
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$39.33
|
| Rate for Payer: Multiplan Commercial |
$58.52
|
| Rate for Payer: Networks By Design Commercial |
$50.71
|
| Rate for Payer: Prime Health Services Commercial |
$66.32
|
| Rate for Payer: Prime Health Services Medicare |
$31.11
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$46.81
|
| Rate for Payer: Riverside University Health MISP |
$32.28
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$46.81
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$46.81
|
| Rate for Payer: United Healthcare All Other Commercial |
$23.78
|
| Rate for Payer: United Healthcare All Other HMO |
$23.78
|
| Rate for Payer: United Healthcare HMO Rider |
$23.78
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$23.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$44.02
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$32.28
|
| Rate for Payer: Vantage Medical Group Senior |
$29.35
|
|
|
HC SOM BETA GALACTOSIDASE
|
Facility
OP
|
$546.35
|
|
|
Service Code
|
CPT 82657
|
| Hospital Charge Code |
900912511
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$17.96 |
| Max. Negotiated Rate |
$491.72 |
| Rate for Payer: Adventist Health Medi-Cal |
$22.17
|
| Rate for Payer: Aetna of CA HMO/PPO |
$132.53
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$33.26
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$24.39
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$22.17
|
| 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 |
$327.81
|
| Rate for Payer: Blue Shield of California Commercial |
$337.64
|
| Rate for Payer: Blue Shield of California EPN |
$265.53
|
| Rate for Payer: Caremore Medicare Advantage |
$22.17
|
| Rate for Payer: Cash Price |
$245.86
|
| Rate for Payer: Cash Price |
$245.86
|
| Rate for Payer: Central Health Plan Commercial |
$437.08
|
| Rate for Payer: Cigna of CA HMO |
$349.66
|
| Rate for Payer: Cigna of CA PPO |
$404.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$33.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$29.93
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$22.17
|
| Rate for Payer: EPIC Health Plan Transplant |
$22.17
|
| Rate for Payer: Galaxy Health WC |
$464.40
|
| Rate for Payer: Global Benefits Group Commercial |
$327.81
|
| Rate for Payer: Health Management Network EPO/PPO |
$491.72
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$409.76
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$36.36
|
| Rate for Payer: IEHP medi-cal |
$36.58
|
| Rate for Payer: IEHP Medicare Advantage |
$22.17
|
| Rate for Payer: Innovage PACE Commercial |
$33.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$364.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$109.27
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$29.71
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$29.71
|
| Rate for Payer: Multiplan Commercial |
$409.76
|
| Rate for Payer: Networks By Design Commercial |
$355.13
|
| Rate for Payer: Prime Health Services Commercial |
$464.40
|
| Rate for Payer: Prime Health Services Medicare |
$23.50
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$327.81
|
| Rate for Payer: Riverside University Health MISP |
$24.39
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$327.81
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$327.81
|
| Rate for Payer: United Healthcare All Other Commercial |
$17.96
|
| Rate for Payer: United Healthcare All Other HMO |
$17.96
|
| Rate for Payer: United Healthcare HMO Rider |
$17.96
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$17.96
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$33.26
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$24.39
|
| Rate for Payer: Vantage Medical Group Senior |
$22.17
|
|
|
HC SOM BETA GALACTOSIDASE
|
Facility
IP
|
$546.35
|
|
|
Service Code
|
CPT 82657
|
| Hospital Charge Code |
900912511
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$109.27 |
| Max. Negotiated Rate |
$491.72 |
| Rate for Payer: Cash Price |
$245.86
|
| Rate for Payer: Central Health Plan Commercial |
$437.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$218.54
|
| Rate for Payer: Galaxy Health WC |
$464.40
|
| Rate for Payer: Global Benefits Group Commercial |
$327.81
|
| Rate for Payer: Health Management Network EPO/PPO |
$491.72
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$364.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$109.27
|
| Rate for Payer: Multiplan Commercial |
$409.76
|
| Rate for Payer: Networks By Design Commercial |
$355.13
|
| Rate for Payer: Prime Health Services Commercial |
$464.40
|
|
|
HC SOM BETA GLYCOPROTEIN AB IGA
|
Facility
OP
|
$20.00
|
|
|
Service Code
|
CPT 86146
|
| Hospital Charge Code |
900912615
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.00 |
| Max. Negotiated Rate |
$225.64 |
| Rate for Payer: Adventist Health Medi-Cal |
$25.45
|
| Rate for Payer: Aetna of CA HMO/PPO |
$186.71
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$38.18
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$28.00
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$25.45
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$184.99
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$225.64
|
| 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 |
$25.45
|
| 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 |
$38.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$34.36
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$25.45
|
| Rate for Payer: EPIC Health Plan Transplant |
$25.45
|
| 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 |
$41.74
|
| Rate for Payer: IEHP medi-cal |
$41.99
|
| Rate for Payer: IEHP Medicare Advantage |
$25.45
|
| Rate for Payer: Innovage PACE Commercial |
$38.18
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$13.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$34.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$34.10
|
| 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 |
$26.98
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$12.00
|
| Rate for Payer: Riverside University Health MISP |
$28.00
|
| 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 |
$20.62
|
| Rate for Payer: United Healthcare All Other HMO |
$20.62
|
| Rate for Payer: United Healthcare HMO Rider |
$20.62
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$20.62
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$38.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$28.00
|
| Rate for Payer: Vantage Medical Group Senior |
$25.45
|
|
|
HC SOM BETA GLYCOPROTEIN AB IGA
|
Facility
IP
|
$20.00
|
|
|
Service Code
|
CPT 86146
|
| Hospital Charge Code |
900912615
|
|
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
|
|
