|
HC SOM BETA GLYCOPROTEIN AB IGG
|
Facility
IP
|
$20.00
|
|
|
Service Code
|
CPT 86146
|
| Hospital Charge Code |
900910565
|
|
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 BETA GLYCOPROTEIN AB IGG
|
Facility
OP
|
$20.00
|
|
|
Service Code
|
CPT 86146
|
| Hospital Charge Code |
900910565
|
|
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 IGM
|
Facility
IP
|
$20.00
|
|
|
Service Code
|
CPT 86146
|
| Hospital Charge Code |
900912616
|
|
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 BETA GLYCOPROTEIN AB IGM
|
Facility
OP
|
$20.00
|
|
|
Service Code
|
CPT 86146
|
| Hospital Charge Code |
900912616
|
|
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 HCG CSF
|
Facility
OP
|
$35.00
|
|
|
Service Code
|
CPT 84702
|
| Hospital Charge Code |
900910726
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.00 |
| Max. Negotiated Rate |
$127.84 |
| Rate for Payer: Adventist Health Medi-Cal |
$15.05
|
| Rate for Payer: Aetna of CA HMO/PPO |
$110.50
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$22.58
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$16.56
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$15.05
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$104.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$127.84
|
| Rate for Payer: BCBS Transplant Transplant |
$21.00
|
| Rate for Payer: Blue Shield of California Commercial |
$21.63
|
| Rate for Payer: Blue Shield of California EPN |
$17.01
|
| Rate for Payer: Caremore Medicare Advantage |
$15.05
|
| Rate for Payer: Cash Price |
$15.75
|
| Rate for Payer: Cash Price |
$15.75
|
| Rate for Payer: Central Health Plan Commercial |
$28.00
|
| Rate for Payer: Cigna of CA HMO |
$22.40
|
| Rate for Payer: Cigna of CA PPO |
$25.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$22.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$20.32
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$15.05
|
| Rate for Payer: EPIC Health Plan Transplant |
$15.05
|
| Rate for Payer: Galaxy Health WC |
$29.75
|
| Rate for Payer: Global Benefits Group Commercial |
$21.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$31.50
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$26.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$24.68
|
| Rate for Payer: IEHP medi-cal |
$24.83
|
| Rate for Payer: IEHP Medicare Advantage |
$15.05
|
| Rate for Payer: Innovage PACE Commercial |
$22.58
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$23.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$20.17
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$20.17
|
| Rate for Payer: Multiplan Commercial |
$26.25
|
| Rate for Payer: Networks By Design Commercial |
$22.75
|
| Rate for Payer: Prime Health Services Commercial |
$29.75
|
| Rate for Payer: Prime Health Services Medicare |
$15.95
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$21.00
|
| Rate for Payer: Riverside University Health MISP |
$16.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$21.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$21.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$12.20
|
| Rate for Payer: United Healthcare All Other HMO |
$12.20
|
| Rate for Payer: United Healthcare HMO Rider |
$12.20
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$12.20
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$22.58
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$16.56
|
| Rate for Payer: Vantage Medical Group Senior |
$15.05
|
|
|
HC SOM BETA HCG CSF
|
Facility
IP
|
$35.00
|
|
|
Service Code
|
CPT 84702
|
| Hospital Charge Code |
900910726
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.00 |
| Max. Negotiated Rate |
$31.50 |
| Rate for Payer: Cash Price |
$15.75
|
| Rate for Payer: Central Health Plan Commercial |
$28.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.00
|
| Rate for Payer: Galaxy Health WC |
$29.75
|
| Rate for Payer: Global Benefits Group Commercial |
$21.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$31.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$23.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.00
|
| Rate for Payer: Multiplan Commercial |
$26.25
|
| Rate for Payer: Networks By Design Commercial |
$22.75
|
| Rate for Payer: Prime Health Services Commercial |
$29.75
|
|
|
HC SOM BICARBONATE URINE
|
Facility
OP
|
$83.00
|
|
|
Service Code
|
CPT 82374
|
| Hospital Charge Code |
900910363
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.95 |
| Max. Negotiated Rate |
$74.70 |
| Rate for Payer: Adventist Health Medi-Cal |
$4.88
|
| Rate for Payer: Aetna of CA HMO/PPO |
$35.89
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$7.32
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$5.37
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$4.88
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$34.53
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$42.12
|
| Rate for Payer: BCBS Transplant Transplant |
$49.80
|
| Rate for Payer: Blue Shield of California Commercial |
$51.29
|
| Rate for Payer: Blue Shield of California EPN |
$40.34
|
| Rate for Payer: Caremore Medicare Advantage |
$4.88
|
| Rate for Payer: Cash Price |
$37.35
|
| Rate for Payer: Cash Price |
$37.35
|
| Rate for Payer: Central Health Plan Commercial |
$66.40
|
| Rate for Payer: Cigna of CA HMO |
$53.12
|
| Rate for Payer: Cigna of CA PPO |
$61.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.32
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.59
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4.88
|
| Rate for Payer: EPIC Health Plan Transplant |
$4.88
|
| Rate for Payer: Galaxy Health WC |
$70.55
|
| Rate for Payer: Global Benefits Group Commercial |
$49.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$74.70
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$62.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$8.00
|
| Rate for Payer: IEHP medi-cal |
$8.05
|
| Rate for Payer: IEHP Medicare Advantage |
$4.88
|
| Rate for Payer: Innovage PACE Commercial |
$7.32
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$55.36
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.54
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.54
|
| Rate for Payer: Multiplan Commercial |
$62.25
|
| Rate for Payer: Networks By Design Commercial |
$53.95
|
| Rate for Payer: Prime Health Services Commercial |
$70.55
|
| Rate for Payer: Prime Health Services Medicare |
$5.17
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$49.80
|
| Rate for Payer: Riverside University Health MISP |
$5.37
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$49.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$49.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.95
|
| Rate for Payer: United Healthcare All Other HMO |
$3.95
|
| Rate for Payer: United Healthcare HMO Rider |
$3.95
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.95
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.37
|
| Rate for Payer: Vantage Medical Group Senior |
$4.88
|
|
|
HC SOM BICARBONATE URINE
|
Facility
IP
|
$83.00
|
|
|
Service Code
|
CPT 82374
|
| Hospital Charge Code |
900910363
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$16.60 |
| Max. Negotiated Rate |
$74.70 |
| Rate for Payer: Cash Price |
$37.35
|
| Rate for Payer: Central Health Plan Commercial |
$66.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$33.20
|
| Rate for Payer: Galaxy Health WC |
$70.55
|
| Rate for Payer: Global Benefits Group Commercial |
$49.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$74.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$55.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.60
|
| Rate for Payer: Multiplan Commercial |
$62.25
|
| Rate for Payer: Networks By Design Commercial |
$53.95
|
| Rate for Payer: Prime Health Services Commercial |
$70.55
|
|
|
HC SOM BILE ACIDS TOTAL
|
Facility
OP
|
$30.00
|
|
|
Service Code
|
CPT 82239
|
| Hospital Charge Code |
900911123
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.00 |
| Max. Negotiated Rate |
$153.47 |
| Rate for Payer: Adventist Health Medi-Cal |
$17.12
|
| Rate for Payer: Aetna of CA HMO/PPO |
$125.72
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$25.68
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$18.83
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$17.12
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$125.82
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$153.47
|
| Rate for Payer: BCBS Transplant Transplant |
$18.00
|
| Rate for Payer: Blue Shield of California Commercial |
$18.54
|
| Rate for Payer: Blue Shield of California EPN |
$14.58
|
| Rate for Payer: Caremore Medicare Advantage |
$17.12
|
| Rate for Payer: Cash Price |
$13.50
|
| Rate for Payer: Cash Price |
$13.50
|
| Rate for Payer: Central Health Plan Commercial |
$24.00
|
| Rate for Payer: Cigna of CA HMO |
$19.20
|
| Rate for Payer: Cigna of CA PPO |
$22.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$25.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$23.11
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$17.12
|
| Rate for Payer: EPIC Health Plan Transplant |
$17.12
|
| Rate for Payer: Galaxy Health WC |
$25.50
|
| Rate for Payer: Global Benefits Group Commercial |
$18.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$27.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$22.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$28.08
|
| Rate for Payer: IEHP medi-cal |
$28.25
|
| Rate for Payer: IEHP Medicare Advantage |
$17.12
|
| Rate for Payer: Innovage PACE Commercial |
$25.68
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20.01
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$17.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$22.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$22.94
|
| Rate for Payer: Multiplan Commercial |
$22.50
|
| Rate for Payer: Networks By Design Commercial |
$19.50
|
| Rate for Payer: Prime Health Services Commercial |
$25.50
|
| Rate for Payer: Prime Health Services Medicare |
$18.15
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$18.00
|
| Rate for Payer: Riverside University Health MISP |
$18.83
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$18.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$18.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$13.87
|
| Rate for Payer: United Healthcare All Other HMO |
$13.87
|
| Rate for Payer: United Healthcare HMO Rider |
$13.87
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$13.87
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$25.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$18.83
|
| Rate for Payer: Vantage Medical Group Senior |
$17.12
|
|
|
HC SOM BILE ACIDS TOTAL
|
Facility
IP
|
$30.00
|
|
|
Service Code
|
CPT 82239
|
| Hospital Charge Code |
900911123
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.00 |
| Max. Negotiated Rate |
$27.00 |
| Rate for Payer: Cash Price |
$13.50
|
| Rate for Payer: Central Health Plan Commercial |
$24.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.00
|
| Rate for Payer: Galaxy Health WC |
$25.50
|
| Rate for Payer: Global Benefits Group Commercial |
$18.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$27.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.00
|
| Rate for Payer: Multiplan Commercial |
$22.50
|
| Rate for Payer: Networks By Design Commercial |
$19.50
|
| Rate for Payer: Prime Health Services Commercial |
$25.50
|
|
|
HC SOM BK VIRUS DNA QUANT PCR
|
Facility
OP
|
$65.90
|
|
|
Service Code
|
CPT 87799
|
| Hospital Charge Code |
900912559
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.18 |
| Max. Negotiated Rate |
$314.39 |
| Rate for Payer: Adventist Health Medi-Cal |
$42.84
|
| Rate for Payer: Aetna of CA HMO/PPO |
$314.39
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$64.26
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$47.12
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$42.84
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$188.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$229.58
|
| Rate for Payer: BCBS Transplant Transplant |
$39.54
|
| Rate for Payer: Blue Shield of California Commercial |
$40.73
|
| Rate for Payer: Blue Shield of California EPN |
$32.03
|
| Rate for Payer: Caremore Medicare Advantage |
$42.84
|
| Rate for Payer: Cash Price |
$29.66
|
| Rate for Payer: Cash Price |
$29.66
|
| Rate for Payer: Central Health Plan Commercial |
$52.72
|
| Rate for Payer: Cigna of CA HMO |
$42.18
|
| Rate for Payer: Cigna of CA PPO |
$48.77
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$64.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$57.83
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$42.84
|
| Rate for Payer: EPIC Health Plan Transplant |
$42.84
|
| Rate for Payer: Galaxy Health WC |
$56.02
|
| Rate for Payer: Global Benefits Group Commercial |
$39.54
|
| Rate for Payer: Health Management Network EPO/PPO |
$59.31
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$49.42
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$70.26
|
| Rate for Payer: IEHP medi-cal |
$70.69
|
| Rate for Payer: IEHP Medicare Advantage |
$42.84
|
| Rate for Payer: Innovage PACE Commercial |
$64.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$43.96
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$42.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.18
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$57.41
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$57.41
|
| Rate for Payer: Multiplan Commercial |
$49.42
|
| Rate for Payer: Networks By Design Commercial |
$42.84
|
| Rate for Payer: Prime Health Services Commercial |
$56.02
|
| Rate for Payer: Prime Health Services Medicare |
$45.41
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$39.54
|
| Rate for Payer: Riverside University Health MISP |
$47.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$39.54
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$39.54
|
| Rate for Payer: United Healthcare All Other Commercial |
$34.70
|
| Rate for Payer: United Healthcare All Other HMO |
$34.70
|
| Rate for Payer: United Healthcare HMO Rider |
$34.70
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$34.70
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$64.26
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$47.12
|
| Rate for Payer: Vantage Medical Group Senior |
$42.84
|
|
|
HC SOM BK VIRUS DNA QUANT PCR
|
Facility
IP
|
$65.90
|
|
|
Service Code
|
CPT 87799
|
| Hospital Charge Code |
900912559
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.18 |
| Max. Negotiated Rate |
$59.31 |
| Rate for Payer: Cash Price |
$29.66
|
| Rate for Payer: Central Health Plan Commercial |
$52.72
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.36
|
| Rate for Payer: Galaxy Health WC |
$56.02
|
| Rate for Payer: Global Benefits Group Commercial |
$39.54
|
| Rate for Payer: Health Management Network EPO/PPO |
$59.31
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$43.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.18
|
| Rate for Payer: Multiplan Commercial |
$49.42
|
| Rate for Payer: Networks By Design Commercial |
$42.84
|
| Rate for Payer: Prime Health Services Commercial |
$56.02
|
|
|
HC SOM BLASTOMYCES AB EIA
|
Facility
OP
|
$244.50
|
|
|
Service Code
|
CPT 86612
|
| Hospital Charge Code |
900915370
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.45 |
| Max. Negotiated Rate |
$220.05 |
| Rate for Payer: Adventist Health Medi-Cal |
$12.90
|
| Rate for Payer: Aetna of CA HMO/PPO |
$94.74
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$19.35
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$14.19
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$12.90
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$95.95
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$117.03
|
| Rate for Payer: BCBS Transplant Transplant |
$146.70
|
| Rate for Payer: Blue Shield of California Commercial |
$151.10
|
| Rate for Payer: Blue Shield of California EPN |
$118.83
|
| Rate for Payer: Caremore Medicare Advantage |
$12.90
|
| Rate for Payer: Cash Price |
$110.03
|
| Rate for Payer: Cash Price |
$110.03
|
| Rate for Payer: Central Health Plan Commercial |
$195.60
|
| Rate for Payer: Cigna of CA HMO |
$156.48
|
| Rate for Payer: Cigna of CA PPO |
$180.93
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$17.42
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$12.90
|
| Rate for Payer: EPIC Health Plan Transplant |
$12.90
|
| Rate for Payer: Galaxy Health WC |
$207.82
|
| Rate for Payer: Global Benefits Group Commercial |
$146.70
|
| Rate for Payer: Health Management Network EPO/PPO |
$220.05
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$183.38
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$21.16
|
| Rate for Payer: IEHP medi-cal |
$21.28
|
| Rate for Payer: IEHP Medicare Advantage |
$12.90
|
| Rate for Payer: Innovage PACE Commercial |
$19.35
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$163.08
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$48.90
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17.29
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17.29
|
| Rate for Payer: Multiplan Commercial |
$183.38
|
| Rate for Payer: Networks By Design Commercial |
$158.92
|
| Rate for Payer: Prime Health Services Commercial |
$207.82
|
| Rate for Payer: Prime Health Services Medicare |
$13.67
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$146.70
|
| Rate for Payer: Riverside University Health MISP |
$14.19
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$146.70
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$146.70
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.45
|
| Rate for Payer: United Healthcare All Other HMO |
$10.45
|
| Rate for Payer: United Healthcare HMO Rider |
$10.45
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.45
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.19
|
| Rate for Payer: Vantage Medical Group Senior |
$12.90
|
|
|
HC SOM BLASTOMYCES AB EIA
|
Facility
IP
|
$244.50
|
|
|
Service Code
|
CPT 86612
|
| Hospital Charge Code |
900915370
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$48.90 |
| Max. Negotiated Rate |
$220.05 |
| Rate for Payer: Cash Price |
$110.03
|
| Rate for Payer: Central Health Plan Commercial |
$195.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$97.80
|
| Rate for Payer: Galaxy Health WC |
$207.82
|
| Rate for Payer: Global Benefits Group Commercial |
$146.70
|
| Rate for Payer: Health Management Network EPO/PPO |
$220.05
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$163.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$48.90
|
| Rate for Payer: Multiplan Commercial |
$183.38
|
| Rate for Payer: Networks By Design Commercial |
$158.92
|
| Rate for Payer: Prime Health Services Commercial |
$207.82
|
|
|
HC SOM BLASTOMYCES AB IMMUNODIFFUSION
|
Facility
IP
|
$45.00
|
|
|
Service Code
|
CPT 86612
|
| Hospital Charge Code |
900912686
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.00 |
| Max. Negotiated Rate |
$40.50 |
| Rate for Payer: Cash Price |
$20.25
|
| Rate for Payer: Central Health Plan Commercial |
$36.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$18.00
|
| Rate for Payer: Galaxy Health WC |
$38.25
|
| Rate for Payer: Global Benefits Group Commercial |
$27.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$40.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$30.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.00
|
| Rate for Payer: Multiplan Commercial |
$33.75
|
| Rate for Payer: Networks By Design Commercial |
$29.25
|
| Rate for Payer: Prime Health Services Commercial |
$38.25
|
|
|
HC SOM BLASTOMYCES AB IMMUNODIFFUSION
|
Facility
OP
|
$45.00
|
|
|
Service Code
|
CPT 86612
|
| Hospital Charge Code |
900912686
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.00 |
| Max. Negotiated Rate |
$117.03 |
| Rate for Payer: Adventist Health Medi-Cal |
$12.90
|
| Rate for Payer: Aetna of CA HMO/PPO |
$94.74
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$19.35
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$14.19
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$12.90
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$95.95
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$117.03
|
| Rate for Payer: BCBS Transplant Transplant |
$27.00
|
| Rate for Payer: Blue Shield of California Commercial |
$27.81
|
| Rate for Payer: Blue Shield of California EPN |
$21.87
|
| Rate for Payer: Caremore Medicare Advantage |
$12.90
|
| Rate for Payer: Cash Price |
$20.25
|
| Rate for Payer: Cash Price |
$20.25
|
| Rate for Payer: Central Health Plan Commercial |
$36.00
|
| Rate for Payer: Cigna of CA HMO |
$28.80
|
| Rate for Payer: Cigna of CA PPO |
$33.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$17.42
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$12.90
|
| Rate for Payer: EPIC Health Plan Transplant |
$12.90
|
| Rate for Payer: Galaxy Health WC |
$38.25
|
| Rate for Payer: Global Benefits Group Commercial |
$27.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$40.50
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$33.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$21.16
|
| Rate for Payer: IEHP medi-cal |
$21.28
|
| Rate for Payer: IEHP Medicare Advantage |
$12.90
|
| Rate for Payer: Innovage PACE Commercial |
$19.35
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$30.02
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17.29
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17.29
|
| Rate for Payer: Multiplan Commercial |
$33.75
|
| Rate for Payer: Networks By Design Commercial |
$29.25
|
| Rate for Payer: Prime Health Services Commercial |
$38.25
|
| Rate for Payer: Prime Health Services Medicare |
$13.67
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$27.00
|
| Rate for Payer: Riverside University Health MISP |
$14.19
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$27.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$27.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.45
|
| Rate for Payer: United Healthcare All Other HMO |
$10.45
|
| Rate for Payer: United Healthcare HMO Rider |
$10.45
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.45
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.19
|
| Rate for Payer: Vantage Medical Group Senior |
$12.90
|
|
|
HC SOM BLOOM CULTURE 01
|
Facility
OP
|
$937.09
|
|
|
Service Code
|
CPT 88230
|
| Hospital Charge Code |
900915282
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$94.36 |
| Max. Negotiated Rate |
$9,435.60 |
| Rate for Payer: Adventist Health Medi-Cal |
$116.49
|
| Rate for Payer: Aetna of CA HMO/PPO |
$855.01
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$174.74
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$128.14
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$116.49
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$719.52
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$877.64
|
| Rate for Payer: BCBS Transplant Transplant |
$562.25
|
| Rate for Payer: Blue Shield of California Commercial |
$579.12
|
| Rate for Payer: Blue Shield of California EPN |
$455.43
|
| Rate for Payer: Caremore Medicare Advantage |
$116.49
|
| Rate for Payer: Cash Price |
$421.69
|
| Rate for Payer: Cash Price |
$421.69
|
| Rate for Payer: Central Health Plan Commercial |
$749.67
|
| Rate for Payer: Cigna of CA HMO |
$599.74
|
| Rate for Payer: Cigna of CA PPO |
$693.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$174.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$157.26
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$116.49
|
| Rate for Payer: EPIC Health Plan Transplant |
$116.49
|
| Rate for Payer: Galaxy Health WC |
$796.53
|
| Rate for Payer: Global Benefits Group Commercial |
$562.25
|
| Rate for Payer: Health Management Network EPO/PPO |
$843.38
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$702.82
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$191.04
|
| Rate for Payer: IEHP medi-cal |
$192.21
|
| Rate for Payer: IEHP Medicare Advantage |
$116.49
|
| Rate for Payer: Innovage PACE Commercial |
$174.74
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$625.04
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$116.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$187.42
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$156.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$156.10
|
| Rate for Payer: Multiplan Commercial |
$702.82
|
| Rate for Payer: Networks By Design Commercial |
$609.11
|
| Rate for Payer: Prime Health Services Commercial |
$796.53
|
| Rate for Payer: Prime Health Services Medicare |
$123.48
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$562.25
|
| Rate for Payer: Riverside University Health MISP |
$128.14
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$562.25
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$562.25
|
| Rate for Payer: United Healthcare All Other Commercial |
$94.36
|
| Rate for Payer: United Healthcare All Other HMO |
$94.36
|
| Rate for Payer: United Healthcare HMO Rider |
$94.36
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9,435.60
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$174.74
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$128.14
|
| Rate for Payer: Vantage Medical Group Senior |
$116.49
|
|
|
HC SOM BLOOM CULTURE 01
|
Facility
IP
|
$937.09
|
|
|
Service Code
|
CPT 88230
|
| Hospital Charge Code |
900915282
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$187.42 |
| Max. Negotiated Rate |
$843.38 |
| Rate for Payer: Cash Price |
$421.69
|
| Rate for Payer: Central Health Plan Commercial |
$749.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$374.84
|
| Rate for Payer: Galaxy Health WC |
$796.53
|
| Rate for Payer: Global Benefits Group Commercial |
$562.25
|
| Rate for Payer: Health Management Network EPO/PPO |
$843.38
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$625.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$187.42
|
| Rate for Payer: Multiplan Commercial |
$702.82
|
| Rate for Payer: Networks By Design Commercial |
$609.11
|
| Rate for Payer: Prime Health Services Commercial |
$796.53
|
|
|
HC SOM BNP 83880
|
Facility
IP
|
$170.78
|
|
|
Service Code
|
CPT 83880
|
| Hospital Charge Code |
900914724
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$34.16 |
| Max. Negotiated Rate |
$153.70 |
| Rate for Payer: Cash Price |
$76.85
|
| Rate for Payer: Central Health Plan Commercial |
$136.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$68.31
|
| Rate for Payer: Galaxy Health WC |
$145.16
|
| Rate for Payer: Global Benefits Group Commercial |
$102.47
|
| Rate for Payer: Health Management Network EPO/PPO |
$153.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$113.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$34.16
|
| Rate for Payer: Multiplan Commercial |
$128.08
|
| Rate for Payer: Networks By Design Commercial |
$111.01
|
| Rate for Payer: Prime Health Services Commercial |
$145.16
|
|
|
HC SOM BNP 83880
|
Facility
OP
|
$170.78
|
|
|
Service Code
|
CPT 83880
|
| Hospital Charge Code |
900914724
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$31.80 |
| Max. Negotiated Rate |
$301.27 |
| Rate for Payer: Adventist Health Medi-Cal |
$39.26
|
| Rate for Payer: Aetna of CA HMO/PPO |
$249.11
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$58.89
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$43.19
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$39.26
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$246.99
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$301.27
|
| Rate for Payer: BCBS Transplant Transplant |
$102.47
|
| Rate for Payer: Blue Shield of California Commercial |
$105.54
|
| Rate for Payer: Blue Shield of California EPN |
$83.00
|
| Rate for Payer: Caremore Medicare Advantage |
$39.26
|
| Rate for Payer: Cash Price |
$76.85
|
| Rate for Payer: Cash Price |
$76.85
|
| Rate for Payer: Central Health Plan Commercial |
$136.62
|
| Rate for Payer: Cigna of CA HMO |
$109.30
|
| Rate for Payer: Cigna of CA PPO |
$126.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$58.89
|
| Rate for Payer: EPIC Health Plan Commercial |
$53.00
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$39.26
|
| Rate for Payer: EPIC Health Plan Transplant |
$39.26
|
| Rate for Payer: Galaxy Health WC |
$145.16
|
| Rate for Payer: Global Benefits Group Commercial |
$102.47
|
| Rate for Payer: Health Management Network EPO/PPO |
$153.70
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$128.08
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$64.39
|
| Rate for Payer: IEHP medi-cal |
$64.78
|
| Rate for Payer: IEHP Medicare Advantage |
$39.26
|
| Rate for Payer: Innovage PACE Commercial |
$58.89
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$113.91
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$39.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$34.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$52.61
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$52.61
|
| Rate for Payer: Multiplan Commercial |
$128.08
|
| Rate for Payer: Networks By Design Commercial |
$111.01
|
| Rate for Payer: Prime Health Services Commercial |
$145.16
|
| Rate for Payer: Prime Health Services Medicare |
$41.62
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$102.47
|
| Rate for Payer: Riverside University Health MISP |
$43.19
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$102.47
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$102.47
|
| Rate for Payer: United Healthcare All Other Commercial |
$31.80
|
| Rate for Payer: United Healthcare All Other HMO |
$31.80
|
| Rate for Payer: United Healthcare HMO Rider |
$31.80
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$31.80
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$58.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$43.19
|
| Rate for Payer: Vantage Medical Group Senior |
$39.26
|
|
|
HC SOM BONE ALKALINE PHOSPHATASE
|
Facility
OP
|
$24.00
|
|
|
Service Code
|
CPT 84080
|
| Hospital Charge Code |
900915326
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.80 |
| Max. Negotiated Rate |
$131.25 |
| Rate for Payer: Adventist Health Medi-Cal |
$14.78
|
| Rate for Payer: Aetna of CA HMO/PPO |
$108.60
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$22.17
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$16.26
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$14.78
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$107.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$131.25
|
| Rate for Payer: BCBS Transplant Transplant |
$14.40
|
| Rate for Payer: Blue Shield of California Commercial |
$14.83
|
| Rate for Payer: Blue Shield of California EPN |
$11.66
|
| Rate for Payer: Caremore Medicare Advantage |
$14.78
|
| Rate for Payer: Cash Price |
$10.80
|
| Rate for Payer: Cash Price |
$10.80
|
| Rate for Payer: Central Health Plan Commercial |
$19.20
|
| Rate for Payer: Cigna of CA HMO |
$15.36
|
| Rate for Payer: Cigna of CA PPO |
$17.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$22.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.95
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$14.78
|
| Rate for Payer: EPIC Health Plan Transplant |
$14.78
|
| Rate for Payer: Galaxy Health WC |
$20.40
|
| Rate for Payer: Global Benefits Group Commercial |
$14.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$21.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$18.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$24.24
|
| Rate for Payer: IEHP medi-cal |
$24.39
|
| Rate for Payer: IEHP Medicare Advantage |
$14.78
|
| Rate for Payer: Innovage PACE Commercial |
$22.17
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16.01
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$19.81
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$19.81
|
| Rate for Payer: Multiplan Commercial |
$18.00
|
| Rate for Payer: Networks By Design Commercial |
$15.60
|
| Rate for Payer: Prime Health Services Commercial |
$20.40
|
| Rate for Payer: Prime Health Services Medicare |
$15.67
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$14.40
|
| Rate for Payer: Riverside University Health MISP |
$16.26
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$14.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$14.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$11.97
|
| Rate for Payer: United Healthcare All Other HMO |
$11.97
|
| Rate for Payer: United Healthcare HMO Rider |
$11.97
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.97
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$22.17
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$16.26
|
| Rate for Payer: Vantage Medical Group Senior |
$14.78
|
|
|
HC SOM BONE ALKALINE PHOSPHATASE
|
Facility
IP
|
$24.00
|
|
|
Service Code
|
CPT 84080
|
| Hospital Charge Code |
900915326
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.80 |
| Max. Negotiated Rate |
$21.60 |
| Rate for Payer: Cash Price |
$10.80
|
| Rate for Payer: Central Health Plan Commercial |
$19.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.60
|
| Rate for Payer: Galaxy Health WC |
$20.40
|
| Rate for Payer: Global Benefits Group Commercial |
$14.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$21.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.80
|
| Rate for Payer: Multiplan Commercial |
$18.00
|
| Rate for Payer: Networks By Design Commercial |
$15.60
|
| Rate for Payer: Prime Health Services Commercial |
$20.40
|
|
|
HC SOM BORDETELLA PCR
|
Facility
IP
|
$38.80
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
900914165
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$7.76 |
| Max. Negotiated Rate |
$34.92 |
| Rate for Payer: Cash Price |
$17.46
|
| Rate for Payer: Central Health Plan Commercial |
$31.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.52
|
| Rate for Payer: Galaxy Health WC |
$32.98
|
| Rate for Payer: Global Benefits Group Commercial |
$23.28
|
| Rate for Payer: Health Management Network EPO/PPO |
$34.92
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$25.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.76
|
| Rate for Payer: Multiplan Commercial |
$29.10
|
| Rate for Payer: Networks By Design Commercial |
$25.22
|
| Rate for Payer: Prime Health Services Commercial |
$32.98
|
|
|
HC SOM BORDETELLA PCR
|
Facility
OP
|
$38.80
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
900914165
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$7.76 |
| Max. Negotiated Rate |
$301.33 |
| Rate for Payer: Adventist Health Medi-Cal |
$35.09
|
| Rate for Payer: Aetna of CA HMO/PPO |
$257.58
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$52.64
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$38.60
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$35.09
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$247.04
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$301.33
|
| Rate for Payer: BCBS Transplant Transplant |
$23.28
|
| Rate for Payer: Blue Shield of California Commercial |
$23.98
|
| Rate for Payer: Blue Shield of California EPN |
$18.86
|
| Rate for Payer: Caremore Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$17.46
|
| Rate for Payer: Cash Price |
$17.46
|
| Rate for Payer: Central Health Plan Commercial |
$31.04
|
| Rate for Payer: Cigna of CA HMO |
$24.83
|
| Rate for Payer: Cigna of CA PPO |
$28.71
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$52.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$47.37
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$35.09
|
| Rate for Payer: EPIC Health Plan Transplant |
$35.09
|
| Rate for Payer: Galaxy Health WC |
$32.98
|
| Rate for Payer: Global Benefits Group Commercial |
$23.28
|
| Rate for Payer: Health Management Network EPO/PPO |
$34.92
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$29.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$57.55
|
| Rate for Payer: IEHP medi-cal |
$57.90
|
| Rate for Payer: IEHP Medicare Advantage |
$35.09
|
| Rate for Payer: Innovage PACE Commercial |
$52.64
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$25.88
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$35.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.76
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$47.02
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$47.02
|
| Rate for Payer: Multiplan Commercial |
$29.10
|
| Rate for Payer: Networks By Design Commercial |
$25.22
|
| Rate for Payer: Prime Health Services Commercial |
$32.98
|
| Rate for Payer: Prime Health Services Medicare |
$37.20
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$23.28
|
| Rate for Payer: Riverside University Health MISP |
$38.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$23.28
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$23.28
|
| Rate for Payer: United Healthcare All Other Commercial |
$28.42
|
| Rate for Payer: United Healthcare All Other HMO |
$28.42
|
| Rate for Payer: United Healthcare HMO Rider |
$28.42
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$28.42
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$52.64
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$38.60
|
| Rate for Payer: Vantage Medical Group Senior |
$35.09
|
|
|
HC SOM BORIC ACID
|
Facility
OP
|
$85.00
|
|
|
Service Code
|
CPT 83018
|
| Hospital Charge Code |
900911050
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$17.00 |
| Max. Negotiated Rate |
$165.36 |
| Rate for Payer: Adventist Health Medi-Cal |
$21.96
|
| Rate for Payer: Aetna of CA HMO/PPO |
$161.18
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$32.94
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$24.16
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$21.96
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$135.57
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$165.36
|
| Rate for Payer: BCBS Transplant Transplant |
$51.00
|
| Rate for Payer: Blue Shield of California Commercial |
$52.53
|
| Rate for Payer: Blue Shield of California EPN |
$41.31
|
| Rate for Payer: Caremore Medicare Advantage |
$21.96
|
| Rate for Payer: Cash Price |
$38.25
|
| Rate for Payer: Cash Price |
$38.25
|
| Rate for Payer: Central Health Plan Commercial |
$68.00
|
| Rate for Payer: Cigna of CA HMO |
$54.40
|
| Rate for Payer: Cigna of CA PPO |
$62.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$32.94
|
| Rate for Payer: EPIC Health Plan Commercial |
$29.65
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$21.96
|
| Rate for Payer: EPIC Health Plan Transplant |
$21.96
|
| Rate for Payer: Galaxy Health WC |
$72.25
|
| Rate for Payer: Global Benefits Group Commercial |
$51.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$76.50
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$63.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$36.01
|
| Rate for Payer: IEHP medi-cal |
$36.23
|
| Rate for Payer: IEHP Medicare Advantage |
$21.96
|
| Rate for Payer: Innovage PACE Commercial |
$32.94
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$56.70
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$17.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$29.43
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$29.43
|
| Rate for Payer: Multiplan Commercial |
$63.75
|
| Rate for Payer: Networks By Design Commercial |
$55.25
|
| Rate for Payer: Prime Health Services Commercial |
$72.25
|
| Rate for Payer: Prime Health Services Medicare |
$23.28
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$51.00
|
| Rate for Payer: Riverside University Health MISP |
$24.16
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$51.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$51.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$17.78
|
| Rate for Payer: United Healthcare All Other HMO |
$17.78
|
| Rate for Payer: United Healthcare HMO Rider |
$17.78
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$17.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$32.94
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$24.16
|
| Rate for Payer: Vantage Medical Group Senior |
$21.96
|
|
