|
HC SOM BORIC ACID
|
Facility
IP
|
$85.00
|
|
|
Service Code
|
CPT 83018
|
| Hospital Charge Code |
900911050
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$17.00 |
| Max. Negotiated Rate |
$76.50 |
| Rate for Payer: Cash Price |
$38.25
|
| Rate for Payer: Central Health Plan Commercial |
$68.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$34.00
|
| 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: Kaiser Permanente of CA Commercial/Self Funded |
$56.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$17.00
|
| 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
|
|
|
HC SOM BORON
|
Facility
IP
|
$73.00
|
|
|
Service Code
|
CPT 83018
|
| Hospital Charge Code |
900914503
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.60 |
| Max. Negotiated Rate |
$65.70 |
| Rate for Payer: Cash Price |
$32.85
|
| Rate for Payer: Central Health Plan Commercial |
$58.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$29.20
|
| Rate for Payer: Galaxy Health WC |
$62.05
|
| Rate for Payer: Global Benefits Group Commercial |
$43.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$65.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$48.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.60
|
| Rate for Payer: Multiplan Commercial |
$54.75
|
| Rate for Payer: Networks By Design Commercial |
$47.45
|
| Rate for Payer: Prime Health Services Commercial |
$62.05
|
|
|
HC SOM BORON
|
Facility
OP
|
$73.00
|
|
|
Service Code
|
CPT 83018
|
| Hospital Charge Code |
900914503
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.60 |
| 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 |
$43.80
|
| Rate for Payer: Blue Shield of California Commercial |
$45.11
|
| Rate for Payer: Blue Shield of California EPN |
$35.48
|
| Rate for Payer: Caremore Medicare Advantage |
$21.96
|
| Rate for Payer: Cash Price |
$32.85
|
| Rate for Payer: Cash Price |
$32.85
|
| Rate for Payer: Central Health Plan Commercial |
$58.40
|
| Rate for Payer: Cigna of CA HMO |
$46.72
|
| Rate for Payer: Cigna of CA PPO |
$54.02
|
| 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 |
$62.05
|
| Rate for Payer: Global Benefits Group Commercial |
$43.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$65.70
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$54.75
|
| 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 |
$48.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.60
|
| 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 |
$54.75
|
| Rate for Payer: Networks By Design Commercial |
$47.45
|
| Rate for Payer: Prime Health Services Commercial |
$62.05
|
| Rate for Payer: Prime Health Services Medicare |
$23.28
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$43.80
|
| Rate for Payer: Riverside University Health MISP |
$24.16
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$43.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$43.80
|
| 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
|
|
|
HC SOM BORRELIA BURGDORFERI PCR DETECT
|
Facility
IP
|
$26.67
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
900915376
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.33 |
| Max. Negotiated Rate |
$24.00 |
| Rate for Payer: Cash Price |
$12.00
|
| Rate for Payer: Central Health Plan Commercial |
$21.34
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.67
|
| Rate for Payer: Galaxy Health WC |
$22.67
|
| Rate for Payer: Global Benefits Group Commercial |
$16.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$24.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.33
|
| Rate for Payer: Multiplan Commercial |
$20.00
|
| Rate for Payer: Networks By Design Commercial |
$17.34
|
| Rate for Payer: Prime Health Services Commercial |
$22.67
|
|
|
HC SOM BORRELIA BURGDORFERI PCR DETECT
|
Facility
OP
|
$26.67
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
900915376
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.33 |
| 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 |
$16.00
|
| Rate for Payer: Blue Shield of California Commercial |
$16.48
|
| Rate for Payer: Blue Shield of California EPN |
$12.96
|
| Rate for Payer: Caremore Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$12.00
|
| Rate for Payer: Cash Price |
$12.00
|
| Rate for Payer: Central Health Plan Commercial |
$21.34
|
| Rate for Payer: Cigna of CA HMO |
$17.07
|
| Rate for Payer: Cigna of CA PPO |
$19.74
|
| 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 |
$22.67
|
| Rate for Payer: Global Benefits Group Commercial |
$16.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$24.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$20.00
|
| 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 |
$17.79
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$35.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.33
|
| 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 |
$20.00
|
| Rate for Payer: Networks By Design Commercial |
$17.34
|
| Rate for Payer: Prime Health Services Commercial |
$22.67
|
| Rate for Payer: Prime Health Services Medicare |
$37.20
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$16.00
|
| Rate for Payer: Riverside University Health MISP |
$38.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$16.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$16.00
|
| 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 BORRELIA BURGDORFERI PCR PROBE
|
Facility
OP
|
$26.66
|
|
|
Service Code
|
CPT 87476
|
| Hospital Charge Code |
900912513
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$5.33 |
| 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 |
$16.00
|
| Rate for Payer: Blue Shield of California Commercial |
$16.48
|
| Rate for Payer: Blue Shield of California EPN |
$12.96
|
| Rate for Payer: Caremore Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$12.00
|
| Rate for Payer: Cash Price |
$12.00
|
| Rate for Payer: Central Health Plan Commercial |
$21.33
|
| Rate for Payer: Cigna of CA HMO |
$17.06
|
| Rate for Payer: Cigna of CA PPO |
$19.73
|
| 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 |
$22.66
|
| Rate for Payer: Global Benefits Group Commercial |
$16.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$23.99
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$20.00
|
| 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 |
$17.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$35.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.33
|
| 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 |
$20.00
|
| Rate for Payer: Networks By Design Commercial |
$17.33
|
| Rate for Payer: Prime Health Services Commercial |
$22.66
|
| Rate for Payer: Prime Health Services Medicare |
$37.20
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$16.00
|
| Rate for Payer: Riverside University Health MISP |
$38.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$16.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$16.00
|
| 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 BORRELIA BURGDORFERI PCR PROBE
|
Facility
IP
|
$26.66
|
|
|
Service Code
|
CPT 87476
|
| Hospital Charge Code |
900912513
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$5.33 |
| Max. Negotiated Rate |
$23.99 |
| Rate for Payer: Cash Price |
$12.00
|
| Rate for Payer: Central Health Plan Commercial |
$21.33
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.66
|
| Rate for Payer: Galaxy Health WC |
$22.66
|
| Rate for Payer: Global Benefits Group Commercial |
$16.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$23.99
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.33
|
| Rate for Payer: Multiplan Commercial |
$20.00
|
| Rate for Payer: Networks By Design Commercial |
$17.33
|
| Rate for Payer: Prime Health Services Commercial |
$22.66
|
|
|
HC SOM BRUCELLA AB CONFIRMATION
|
Facility
OP
|
$116.41
|
|
|
Service Code
|
CPT 86622
|
| Hospital Charge Code |
900912841
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.24 |
| Max. Negotiated Rate |
$104.77 |
| Rate for Payer: Adventist Health Medi-Cal |
$8.93
|
| Rate for Payer: Aetna of CA HMO/PPO |
$65.53
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$13.40
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$9.82
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$8.93
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$58.67
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$71.57
|
| Rate for Payer: BCBS Transplant Transplant |
$69.85
|
| Rate for Payer: Blue Shield of California Commercial |
$71.94
|
| Rate for Payer: Blue Shield of California EPN |
$56.58
|
| Rate for Payer: Caremore Medicare Advantage |
$8.93
|
| Rate for Payer: Cash Price |
$52.38
|
| Rate for Payer: Cash Price |
$52.38
|
| Rate for Payer: Central Health Plan Commercial |
$93.13
|
| Rate for Payer: Cigna of CA HMO |
$74.50
|
| Rate for Payer: Cigna of CA PPO |
$86.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.06
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$8.93
|
| Rate for Payer: EPIC Health Plan Transplant |
$8.93
|
| Rate for Payer: Galaxy Health WC |
$98.95
|
| Rate for Payer: Global Benefits Group Commercial |
$69.85
|
| Rate for Payer: Health Management Network EPO/PPO |
$104.77
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$87.31
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$14.65
|
| Rate for Payer: IEHP medi-cal |
$14.73
|
| Rate for Payer: IEHP Medicare Advantage |
$8.93
|
| Rate for Payer: Innovage PACE Commercial |
$13.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$77.65
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11.97
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11.97
|
| Rate for Payer: Multiplan Commercial |
$87.31
|
| Rate for Payer: Networks By Design Commercial |
$75.67
|
| Rate for Payer: Prime Health Services Commercial |
$98.95
|
| Rate for Payer: Prime Health Services Medicare |
$9.47
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$69.85
|
| Rate for Payer: Riverside University Health MISP |
$9.82
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$69.85
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$69.85
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.24
|
| Rate for Payer: United Healthcare All Other HMO |
$7.24
|
| Rate for Payer: United Healthcare HMO Rider |
$7.24
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.24
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.82
|
| Rate for Payer: Vantage Medical Group Senior |
$8.93
|
|
|
HC SOM BRUCELLA AB CONFIRMATION
|
Facility
IP
|
$116.41
|
|
|
Service Code
|
CPT 86622
|
| Hospital Charge Code |
900912841
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$23.28 |
| Max. Negotiated Rate |
$104.77 |
| Rate for Payer: Cash Price |
$52.38
|
| Rate for Payer: Central Health Plan Commercial |
$93.13
|
| Rate for Payer: EPIC Health Plan Commercial |
$46.56
|
| Rate for Payer: Galaxy Health WC |
$98.95
|
| Rate for Payer: Global Benefits Group Commercial |
$69.85
|
| Rate for Payer: Health Management Network EPO/PPO |
$104.77
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$77.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23.28
|
| Rate for Payer: Multiplan Commercial |
$87.31
|
| Rate for Payer: Networks By Design Commercial |
$75.67
|
| Rate for Payer: Prime Health Services Commercial |
$98.95
|
|
|
HC SOM BRUCELLA AB IGG
|
Facility
OP
|
$20.74
|
|
|
Service Code
|
CPT 86622
|
| Hospital Charge Code |
900911628
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.15 |
| Max. Negotiated Rate |
$71.57 |
| Rate for Payer: Adventist Health Medi-Cal |
$8.93
|
| Rate for Payer: Aetna of CA HMO/PPO |
$65.53
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$13.40
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$9.82
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$8.93
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$58.67
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$71.57
|
| Rate for Payer: BCBS Transplant Transplant |
$12.44
|
| Rate for Payer: Blue Shield of California Commercial |
$12.82
|
| Rate for Payer: Blue Shield of California EPN |
$10.08
|
| Rate for Payer: Caremore Medicare Advantage |
$8.93
|
| Rate for Payer: Cash Price |
$9.33
|
| Rate for Payer: Cash Price |
$9.33
|
| Rate for Payer: Central Health Plan Commercial |
$16.59
|
| Rate for Payer: Cigna of CA HMO |
$13.27
|
| Rate for Payer: Cigna of CA PPO |
$15.35
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.06
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$8.93
|
| Rate for Payer: EPIC Health Plan Transplant |
$8.93
|
| Rate for Payer: Galaxy Health WC |
$17.63
|
| Rate for Payer: Global Benefits Group Commercial |
$12.44
|
| Rate for Payer: Health Management Network EPO/PPO |
$18.67
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$15.56
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$14.65
|
| Rate for Payer: IEHP medi-cal |
$14.73
|
| Rate for Payer: IEHP Medicare Advantage |
$8.93
|
| Rate for Payer: Innovage PACE Commercial |
$13.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$13.83
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.15
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11.97
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11.97
|
| Rate for Payer: Multiplan Commercial |
$15.56
|
| Rate for Payer: Networks By Design Commercial |
$13.48
|
| Rate for Payer: Prime Health Services Commercial |
$17.63
|
| Rate for Payer: Prime Health Services Medicare |
$9.47
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$12.44
|
| Rate for Payer: Riverside University Health MISP |
$9.82
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$12.44
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$12.44
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.24
|
| Rate for Payer: United Healthcare All Other HMO |
$7.24
|
| Rate for Payer: United Healthcare HMO Rider |
$7.24
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.24
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.82
|
| Rate for Payer: Vantage Medical Group Senior |
$8.93
|
|
|
HC SOM BRUCELLA AB IGG
|
Facility
IP
|
$20.74
|
|
|
Service Code
|
CPT 86622
|
| Hospital Charge Code |
900911628
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.15 |
| Max. Negotiated Rate |
$18.67 |
| Rate for Payer: Cash Price |
$9.33
|
| Rate for Payer: Central Health Plan Commercial |
$16.59
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.30
|
| Rate for Payer: Galaxy Health WC |
$17.63
|
| Rate for Payer: Global Benefits Group Commercial |
$12.44
|
| Rate for Payer: Health Management Network EPO/PPO |
$18.67
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$13.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.15
|
| Rate for Payer: Multiplan Commercial |
$15.56
|
| Rate for Payer: Networks By Design Commercial |
$13.48
|
| Rate for Payer: Prime Health Services Commercial |
$17.63
|
|
|
HC SOM BRUCELLA AB IGM
|
Facility
IP
|
$20.74
|
|
|
Service Code
|
CPT 86622
|
| Hospital Charge Code |
900912667
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.15 |
| Max. Negotiated Rate |
$18.67 |
| Rate for Payer: Cash Price |
$9.33
|
| Rate for Payer: Central Health Plan Commercial |
$16.59
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.30
|
| Rate for Payer: Galaxy Health WC |
$17.63
|
| Rate for Payer: Global Benefits Group Commercial |
$12.44
|
| Rate for Payer: Health Management Network EPO/PPO |
$18.67
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$13.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.15
|
| Rate for Payer: Multiplan Commercial |
$15.56
|
| Rate for Payer: Networks By Design Commercial |
$13.48
|
| Rate for Payer: Prime Health Services Commercial |
$17.63
|
|
|
HC SOM BRUCELLA AB IGM
|
Facility
OP
|
$20.74
|
|
|
Service Code
|
CPT 86622
|
| Hospital Charge Code |
900912667
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.15 |
| Max. Negotiated Rate |
$71.57 |
| Rate for Payer: Adventist Health Medi-Cal |
$8.93
|
| Rate for Payer: Aetna of CA HMO/PPO |
$65.53
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$13.40
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$9.82
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$8.93
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$58.67
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$71.57
|
| Rate for Payer: BCBS Transplant Transplant |
$12.44
|
| Rate for Payer: Blue Shield of California Commercial |
$12.82
|
| Rate for Payer: Blue Shield of California EPN |
$10.08
|
| Rate for Payer: Caremore Medicare Advantage |
$8.93
|
| Rate for Payer: Cash Price |
$9.33
|
| Rate for Payer: Cash Price |
$9.33
|
| Rate for Payer: Central Health Plan Commercial |
$16.59
|
| Rate for Payer: Cigna of CA HMO |
$13.27
|
| Rate for Payer: Cigna of CA PPO |
$15.35
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.06
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$8.93
|
| Rate for Payer: EPIC Health Plan Transplant |
$8.93
|
| Rate for Payer: Galaxy Health WC |
$17.63
|
| Rate for Payer: Global Benefits Group Commercial |
$12.44
|
| Rate for Payer: Health Management Network EPO/PPO |
$18.67
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$15.56
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$14.65
|
| Rate for Payer: IEHP medi-cal |
$14.73
|
| Rate for Payer: IEHP Medicare Advantage |
$8.93
|
| Rate for Payer: Innovage PACE Commercial |
$13.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$13.83
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.15
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11.97
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11.97
|
| Rate for Payer: Multiplan Commercial |
$15.56
|
| Rate for Payer: Networks By Design Commercial |
$13.48
|
| Rate for Payer: Prime Health Services Commercial |
$17.63
|
| Rate for Payer: Prime Health Services Medicare |
$9.47
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$12.44
|
| Rate for Payer: Riverside University Health MISP |
$9.82
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$12.44
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$12.44
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.24
|
| Rate for Payer: United Healthcare All Other HMO |
$7.24
|
| Rate for Payer: United Healthcare HMO Rider |
$7.24
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.24
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.82
|
| Rate for Payer: Vantage Medical Group Senior |
$8.93
|
|
|
HC SOM C-1 ESTERASE INHIBITOR ACTIVIT
|
Facility
IP
|
$18.00
|
|
|
Service Code
|
CPT 83883
|
| Hospital Charge Code |
900911175
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.60 |
| Max. Negotiated Rate |
$16.20 |
| Rate for Payer: Cash Price |
$8.10
|
| Rate for Payer: Central Health Plan Commercial |
$14.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.20
|
| Rate for Payer: Galaxy Health WC |
$15.30
|
| Rate for Payer: Global Benefits Group Commercial |
$10.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$16.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.60
|
| Rate for Payer: Multiplan Commercial |
$13.50
|
| Rate for Payer: Networks By Design Commercial |
$11.70
|
| Rate for Payer: Prime Health Services Commercial |
$15.30
|
|
|
HC SOM C-1 ESTERASE INHIBITOR ACTIVIT
|
Facility
OP
|
$18.00
|
|
|
Service Code
|
CPT 83883
|
| Hospital Charge Code |
900911175
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.60 |
| Max. Negotiated Rate |
$120.79 |
| Rate for Payer: Adventist Health Medi-Cal |
$13.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$99.77
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$20.40
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$14.96
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$13.60
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$99.03
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$120.79
|
| Rate for Payer: BCBS Transplant Transplant |
$10.80
|
| Rate for Payer: Blue Shield of California Commercial |
$11.12
|
| Rate for Payer: Blue Shield of California EPN |
$8.75
|
| Rate for Payer: Caremore Medicare Advantage |
$13.60
|
| Rate for Payer: Cash Price |
$8.10
|
| Rate for Payer: Cash Price |
$8.10
|
| Rate for Payer: Central Health Plan Commercial |
$14.40
|
| Rate for Payer: Cigna of CA HMO |
$11.52
|
| Rate for Payer: Cigna of CA PPO |
$13.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$18.36
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$13.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$13.60
|
| Rate for Payer: Galaxy Health WC |
$15.30
|
| Rate for Payer: Global Benefits Group Commercial |
$10.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$16.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$13.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$22.30
|
| Rate for Payer: IEHP medi-cal |
$22.44
|
| Rate for Payer: IEHP Medicare Advantage |
$13.60
|
| Rate for Payer: Innovage PACE Commercial |
$20.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12.01
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18.22
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18.22
|
| Rate for Payer: Multiplan Commercial |
$13.50
|
| Rate for Payer: Networks By Design Commercial |
$11.70
|
| Rate for Payer: Prime Health Services Commercial |
$15.30
|
| Rate for Payer: Prime Health Services Medicare |
$14.42
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$10.80
|
| Rate for Payer: Riverside University Health MISP |
$14.96
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$10.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$11.02
|
| Rate for Payer: United Healthcare All Other HMO |
$11.02
|
| Rate for Payer: United Healthcare HMO Rider |
$11.02
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.02
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.96
|
| Rate for Payer: Vantage Medical Group Senior |
$13.60
|
|
|
HC SOM C1 EXTERASE INHIBITOR FUNCTION
|
Facility
IP
|
$30.00
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
900912844
|
|
Hospital Revenue Code
|
302
|
| 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 C1 EXTERASE INHIBITOR FUNCTION
|
Facility
OP
|
$30.00
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
900912844
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.00 |
| Max. Negotiated Rate |
$114.88 |
| Rate for Payer: Adventist Health Medi-Cal |
$17.27
|
| Rate for Payer: Aetna of CA HMO/PPO |
$95.04
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$25.90
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$19.00
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$17.27
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$94.18
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$114.88
|
| Rate for Payer: BCBS Transplant Transplant |
$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 |
$17.27
|
| 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 |
$25.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$23.31
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$17.27
|
| Rate for Payer: EPIC Health Plan Transplant |
$17.27
|
| Rate for Payer: Galaxy Health WC |
$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 |
$28.32
|
| Rate for Payer: IEHP medi-cal |
$28.50
|
| Rate for Payer: IEHP Medicare Advantage |
$17.27
|
| Rate for Payer: Innovage PACE Commercial |
$25.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20.01
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$17.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$23.14
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$23.14
|
| Rate for Payer: Multiplan Commercial |
$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 |
$18.31
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$18.00
|
| Rate for Payer: Riverside University Health MISP |
$19.00
|
| 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 |
$13.99
|
| Rate for Payer: United Healthcare All Other HMO |
$13.99
|
| Rate for Payer: United Healthcare HMO Rider |
$13.99
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$13.99
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$25.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.00
|
| Rate for Payer: Vantage Medical Group Senior |
$17.27
|
|
|
HC SOM CA 27.29
|
Facility
IP
|
$14.75
|
|
|
Service Code
|
CPT 86300
|
| Hospital Charge Code |
900911430
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.95 |
| Max. Negotiated Rate |
$13.28 |
| Rate for Payer: Cash Price |
$6.64
|
| Rate for Payer: Central Health Plan Commercial |
$11.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.90
|
| Rate for Payer: Galaxy Health WC |
$12.54
|
| Rate for Payer: Global Benefits Group Commercial |
$8.85
|
| Rate for Payer: Health Management Network EPO/PPO |
$13.28
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.95
|
| Rate for Payer: Multiplan Commercial |
$11.06
|
| Rate for Payer: Networks By Design Commercial |
$9.59
|
| Rate for Payer: Prime Health Services Commercial |
$12.54
|
|
|
HC SOM CA 27.29
|
Facility
OP
|
$14.75
|
|
|
Service Code
|
CPT 86300
|
| Hospital Charge Code |
900911430
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.95 |
| Max. Negotiated Rate |
$184.54 |
| Rate for Payer: Adventist Health Medi-Cal |
$20.81
|
| Rate for Payer: Aetna of CA HMO/PPO |
$152.78
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$31.22
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$22.89
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$20.81
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$151.29
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$184.54
|
| Rate for Payer: BCBS Transplant Transplant |
$8.85
|
| Rate for Payer: Blue Shield of California Commercial |
$9.12
|
| Rate for Payer: Blue Shield of California EPN |
$7.17
|
| Rate for Payer: Caremore Medicare Advantage |
$20.81
|
| Rate for Payer: Cash Price |
$6.64
|
| Rate for Payer: Cash Price |
$6.64
|
| Rate for Payer: Central Health Plan Commercial |
$11.80
|
| Rate for Payer: Cigna of CA HMO |
$9.44
|
| Rate for Payer: Cigna of CA PPO |
$10.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$31.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$28.09
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$20.81
|
| Rate for Payer: EPIC Health Plan Transplant |
$20.81
|
| Rate for Payer: Galaxy Health WC |
$12.54
|
| Rate for Payer: Global Benefits Group Commercial |
$8.85
|
| Rate for Payer: Health Management Network EPO/PPO |
$13.28
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$11.06
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$34.13
|
| Rate for Payer: IEHP medi-cal |
$34.34
|
| Rate for Payer: IEHP Medicare Advantage |
$20.81
|
| Rate for Payer: Innovage PACE Commercial |
$31.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9.84
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$20.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.95
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$27.89
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$27.89
|
| Rate for Payer: Multiplan Commercial |
$11.06
|
| Rate for Payer: Networks By Design Commercial |
$9.59
|
| Rate for Payer: Prime Health Services Commercial |
$12.54
|
| Rate for Payer: Prime Health Services Medicare |
$22.06
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$8.85
|
| Rate for Payer: Riverside University Health MISP |
$22.89
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8.85
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$8.85
|
| Rate for Payer: United Healthcare All Other Commercial |
$16.86
|
| Rate for Payer: United Healthcare All Other HMO |
$16.86
|
| Rate for Payer: United Healthcare HMO Rider |
$16.86
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16.86
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$31.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$22.89
|
| Rate for Payer: Vantage Medical Group Senior |
$20.81
|
|
|
HC SOM CADMIUM WHOLE BLOOD
|
Facility
OP
|
$30.00
|
|
|
Service Code
|
CPT 82300
|
| Hospital Charge Code |
900911051
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.00 |
| Max. Negotiated Rate |
$205.27 |
| Rate for Payer: Adventist Health Medi-Cal |
$23.64
|
| Rate for Payer: Aetna of CA HMO/PPO |
$169.84
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$35.46
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$26.00
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$23.64
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$168.28
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$205.27
|
| 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 |
$23.64
|
| 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 |
$35.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$31.91
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$23.64
|
| Rate for Payer: EPIC Health Plan Transplant |
$23.64
|
| 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 |
$38.77
|
| Rate for Payer: IEHP medi-cal |
$39.01
|
| Rate for Payer: IEHP Medicare Advantage |
$23.64
|
| Rate for Payer: Innovage PACE Commercial |
$35.46
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20.01
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$23.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$31.68
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$31.68
|
| 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 |
$25.06
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$18.00
|
| Rate for Payer: Riverside University Health MISP |
$26.00
|
| 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 |
$19.15
|
| Rate for Payer: United Healthcare All Other HMO |
$19.15
|
| Rate for Payer: United Healthcare HMO Rider |
$19.15
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$19.15
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$35.46
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$26.00
|
| Rate for Payer: Vantage Medical Group Senior |
$23.64
|
|
|
HC SOM CADMIUM WHOLE BLOOD
|
Facility
IP
|
$30.00
|
|
|
Service Code
|
CPT 82300
|
| Hospital Charge Code |
900911051
|
|
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 CAH 11-DESOXYCORTISOL
|
Facility
OP
|
$76.96
|
|
|
Service Code
|
CPT 82634
|
| Hospital Charge Code |
900912775
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.39 |
| Max. Negotiated Rate |
$259.69 |
| Rate for Payer: Adventist Health Medi-Cal |
$29.28
|
| Rate for Payer: Aetna of CA HMO/PPO |
$214.87
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$43.92
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$32.21
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$29.28
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$212.90
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$259.69
|
| Rate for Payer: BCBS Transplant Transplant |
$46.18
|
| Rate for Payer: Blue Shield of California Commercial |
$47.56
|
| Rate for Payer: Blue Shield of California EPN |
$37.40
|
| Rate for Payer: Caremore Medicare Advantage |
$29.28
|
| Rate for Payer: Cash Price |
$34.63
|
| Rate for Payer: Cash Price |
$34.63
|
| Rate for Payer: Central Health Plan Commercial |
$61.57
|
| Rate for Payer: Cigna of CA HMO |
$49.25
|
| Rate for Payer: Cigna of CA PPO |
$56.95
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$43.92
|
| Rate for Payer: EPIC Health Plan Commercial |
$39.53
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$29.28
|
| Rate for Payer: EPIC Health Plan Transplant |
$29.28
|
| Rate for Payer: Galaxy Health WC |
$65.42
|
| Rate for Payer: Global Benefits Group Commercial |
$46.18
|
| Rate for Payer: Health Management Network EPO/PPO |
$69.26
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$57.72
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$48.02
|
| Rate for Payer: IEHP medi-cal |
$48.31
|
| Rate for Payer: IEHP Medicare Advantage |
$29.28
|
| Rate for Payer: Innovage PACE Commercial |
$43.92
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$51.33
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.39
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$39.24
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$39.24
|
| Rate for Payer: Multiplan Commercial |
$57.72
|
| Rate for Payer: Networks By Design Commercial |
$50.02
|
| Rate for Payer: Prime Health Services Commercial |
$65.42
|
| Rate for Payer: Prime Health Services Medicare |
$31.04
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$46.18
|
| Rate for Payer: Riverside University Health MISP |
$32.21
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$46.18
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$46.18
|
| Rate for Payer: United Healthcare All Other Commercial |
$23.72
|
| Rate for Payer: United Healthcare All Other HMO |
$23.72
|
| Rate for Payer: United Healthcare HMO Rider |
$23.72
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$23.72
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$43.92
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$32.21
|
| Rate for Payer: Vantage Medical Group Senior |
$29.28
|
|
|
HC SOM CAH 11-DESOXYCORTISOL
|
Facility
IP
|
$76.96
|
|
|
Service Code
|
CPT 82634
|
| Hospital Charge Code |
900912775
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.39 |
| Max. Negotiated Rate |
$69.26 |
| Rate for Payer: Cash Price |
$34.63
|
| Rate for Payer: Central Health Plan Commercial |
$61.57
|
| Rate for Payer: EPIC Health Plan Commercial |
$30.78
|
| Rate for Payer: Galaxy Health WC |
$65.42
|
| Rate for Payer: Global Benefits Group Commercial |
$46.18
|
| Rate for Payer: Health Management Network EPO/PPO |
$69.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$51.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.39
|
| Rate for Payer: Multiplan Commercial |
$57.72
|
| Rate for Payer: Networks By Design Commercial |
$50.02
|
| Rate for Payer: Prime Health Services Commercial |
$65.42
|
|
|
HC SOM CAH 17-ALPHA-OH PROGESTERONE
|
Facility
IP
|
$71.41
|
|
|
Service Code
|
CPT 83498
|
| Hospital Charge Code |
900912778
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.28 |
| Max. Negotiated Rate |
$64.27 |
| Rate for Payer: Cash Price |
$32.13
|
| Rate for Payer: Central Health Plan Commercial |
$57.13
|
| Rate for Payer: EPIC Health Plan Commercial |
$28.56
|
| Rate for Payer: Galaxy Health WC |
$60.70
|
| Rate for Payer: Global Benefits Group Commercial |
$42.85
|
| Rate for Payer: Health Management Network EPO/PPO |
$64.27
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$47.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.28
|
| Rate for Payer: Multiplan Commercial |
$53.56
|
| Rate for Payer: Networks By Design Commercial |
$46.42
|
| Rate for Payer: Prime Health Services Commercial |
$60.70
|
|
|
HC SOM CAH 17-ALPHA-OH PROGESTERONE
|
Facility
OP
|
$71.41
|
|
|
Service Code
|
CPT 83498
|
| Hospital Charge Code |
900912778
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.28 |
| Max. Negotiated Rate |
$241.05 |
| Rate for Payer: Adventist Health Medi-Cal |
$27.17
|
| Rate for Payer: Aetna of CA HMO/PPO |
$199.41
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$40.76
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$29.89
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$27.17
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$197.62
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$241.05
|
| Rate for Payer: BCBS Transplant Transplant |
$42.85
|
| Rate for Payer: Blue Shield of California Commercial |
$44.13
|
| Rate for Payer: Blue Shield of California EPN |
$34.71
|
| Rate for Payer: Caremore Medicare Advantage |
$27.17
|
| Rate for Payer: Cash Price |
$32.13
|
| Rate for Payer: Cash Price |
$32.13
|
| Rate for Payer: Central Health Plan Commercial |
$57.13
|
| Rate for Payer: Cigna of CA HMO |
$45.70
|
| Rate for Payer: Cigna of CA PPO |
$52.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$40.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$36.68
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$27.17
|
| Rate for Payer: EPIC Health Plan Transplant |
$27.17
|
| Rate for Payer: Galaxy Health WC |
$60.70
|
| Rate for Payer: Global Benefits Group Commercial |
$42.85
|
| Rate for Payer: Health Management Network EPO/PPO |
$64.27
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$53.56
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$44.56
|
| Rate for Payer: IEHP medi-cal |
$44.83
|
| Rate for Payer: IEHP Medicare Advantage |
$27.17
|
| Rate for Payer: Innovage PACE Commercial |
$40.76
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$47.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$27.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$36.41
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$36.41
|
| Rate for Payer: Multiplan Commercial |
$53.56
|
| Rate for Payer: Networks By Design Commercial |
$46.42
|
| Rate for Payer: Prime Health Services Commercial |
$60.70
|
| Rate for Payer: Prime Health Services Medicare |
$28.80
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$42.85
|
| Rate for Payer: Riverside University Health MISP |
$29.89
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$42.85
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$42.85
|
| Rate for Payer: United Healthcare All Other Commercial |
$22.00
|
| Rate for Payer: United Healthcare All Other HMO |
$22.00
|
| Rate for Payer: United Healthcare HMO Rider |
$22.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$22.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$40.76
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$29.89
|
| Rate for Payer: Vantage Medical Group Senior |
$27.17
|
|
