|
HC SOM CAH 17-OH PREGNENOLONE
|
Facility
IP
|
$59.95
|
|
|
Service Code
|
CPT 84143
|
| Hospital Charge Code |
900912776
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.99 |
| Max. Negotiated Rate |
$53.96 |
| Rate for Payer: Cash Price |
$26.98
|
| Rate for Payer: Central Health Plan Commercial |
$47.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$23.98
|
| Rate for Payer: Galaxy Health WC |
$50.96
|
| Rate for Payer: Global Benefits Group Commercial |
$35.97
|
| Rate for Payer: Health Management Network EPO/PPO |
$53.96
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$39.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.99
|
| Rate for Payer: Multiplan Commercial |
$44.96
|
| Rate for Payer: Networks By Design Commercial |
$38.97
|
| Rate for Payer: Prime Health Services Commercial |
$50.96
|
|
|
HC SOM CAH 17-OH PREGNENOLONE
|
Facility
OP
|
$59.95
|
|
|
Service Code
|
CPT 84143
|
| Hospital Charge Code |
900912776
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.99 |
| Max. Negotiated Rate |
$202.52 |
| Rate for Payer: Adventist Health Medi-Cal |
$22.81
|
| Rate for Payer: Aetna of CA HMO/PPO |
$167.50
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$34.22
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$25.09
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$22.81
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$166.03
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$202.52
|
| Rate for Payer: BCBS Transplant Transplant |
$35.97
|
| Rate for Payer: Blue Shield of California Commercial |
$37.05
|
| Rate for Payer: Blue Shield of California EPN |
$29.14
|
| Rate for Payer: Caremore Medicare Advantage |
$22.81
|
| Rate for Payer: Cash Price |
$26.98
|
| Rate for Payer: Cash Price |
$26.98
|
| Rate for Payer: Central Health Plan Commercial |
$47.96
|
| Rate for Payer: Cigna of CA HMO |
$38.37
|
| Rate for Payer: Cigna of CA PPO |
$44.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$34.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$30.79
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$22.81
|
| Rate for Payer: EPIC Health Plan Transplant |
$22.81
|
| Rate for Payer: Galaxy Health WC |
$50.96
|
| Rate for Payer: Global Benefits Group Commercial |
$35.97
|
| Rate for Payer: Health Management Network EPO/PPO |
$53.96
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$44.96
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$37.41
|
| Rate for Payer: IEHP medi-cal |
$37.64
|
| Rate for Payer: IEHP Medicare Advantage |
$22.81
|
| Rate for Payer: Innovage PACE Commercial |
$34.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$39.99
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.99
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$30.57
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$30.57
|
| Rate for Payer: Multiplan Commercial |
$44.96
|
| Rate for Payer: Networks By Design Commercial |
$38.97
|
| Rate for Payer: Prime Health Services Commercial |
$50.96
|
| Rate for Payer: Prime Health Services Medicare |
$24.18
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$35.97
|
| Rate for Payer: Riverside University Health MISP |
$25.09
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$35.97
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$35.97
|
| Rate for Payer: United Healthcare All Other Commercial |
$18.48
|
| Rate for Payer: United Healthcare All Other HMO |
$18.48
|
| Rate for Payer: United Healthcare HMO Rider |
$18.48
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$18.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$34.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25.09
|
| Rate for Payer: Vantage Medical Group Senior |
$22.81
|
|
|
HC SOM CAH ANDROSTENEDIONE
|
Facility
OP
|
$76.95
|
|
|
Service Code
|
CPT 82157
|
| Hospital Charge Code |
900912771
|
|
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 |
$46.17
|
| 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 |
$61.56
|
| Rate for Payer: Cigna of CA HMO |
$49.25
|
| Rate for Payer: Cigna of CA PPO |
$56.94
|
| 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 |
$65.41
|
| Rate for Payer: Global Benefits Group Commercial |
$46.17
|
| Rate for Payer: Health Management Network EPO/PPO |
$69.26
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$57.71
|
| 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 |
$57.71
|
| Rate for Payer: Networks By Design Commercial |
$50.02
|
| Rate for Payer: Prime Health Services Commercial |
$65.41
|
| Rate for Payer: Prime Health Services Medicare |
$31.04
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$46.17
|
| Rate for Payer: Riverside University Health MISP |
$32.21
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$46.17
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$46.17
|
| 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 ANDROSTENEDIONE
|
Facility
IP
|
$76.95
|
|
|
Service Code
|
CPT 82157
|
| Hospital Charge Code |
900912771
|
|
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 |
$61.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$30.78
|
| Rate for Payer: Galaxy Health WC |
$65.41
|
| Rate for Payer: Global Benefits Group Commercial |
$46.17
|
| 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 |
$57.71
|
| Rate for Payer: Networks By Design Commercial |
$50.02
|
| Rate for Payer: Prime Health Services Commercial |
$65.41
|
|
|
HC SOM CAH CORTISOL
|
Facility
IP
|
$42.84
|
|
|
Service Code
|
CPT 82533
|
| Hospital Charge Code |
900912772
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.57 |
| Max. Negotiated Rate |
$38.56 |
| Rate for Payer: Cash Price |
$19.28
|
| Rate for Payer: Central Health Plan Commercial |
$34.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$17.14
|
| Rate for Payer: Galaxy Health WC |
$36.41
|
| Rate for Payer: Global Benefits Group Commercial |
$25.70
|
| Rate for Payer: Health Management Network EPO/PPO |
$38.56
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$28.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.57
|
| Rate for Payer: Multiplan Commercial |
$32.13
|
| Rate for Payer: Networks By Design Commercial |
$27.85
|
| Rate for Payer: Prime Health Services Commercial |
$36.41
|
|
|
HC SOM CAH CORTISOL
|
Facility
OP
|
$42.84
|
|
|
Service Code
|
CPT 82533
|
| Hospital Charge Code |
900912772
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.57 |
| Max. Negotiated Rate |
$144.81 |
| Rate for Payer: Adventist Health Medi-Cal |
$16.30
|
| Rate for Payer: Aetna of CA HMO/PPO |
$119.71
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$24.45
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$17.93
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$16.30
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$118.72
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$144.81
|
| Rate for Payer: BCBS Transplant Transplant |
$25.70
|
| Rate for Payer: Blue Shield of California Commercial |
$26.48
|
| Rate for Payer: Blue Shield of California EPN |
$20.82
|
| Rate for Payer: Caremore Medicare Advantage |
$16.30
|
| Rate for Payer: Cash Price |
$19.28
|
| Rate for Payer: Cash Price |
$19.28
|
| Rate for Payer: Central Health Plan Commercial |
$34.27
|
| Rate for Payer: Cigna of CA HMO |
$27.42
|
| Rate for Payer: Cigna of CA PPO |
$31.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$24.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$22.00
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$16.30
|
| Rate for Payer: EPIC Health Plan Transplant |
$16.30
|
| Rate for Payer: Galaxy Health WC |
$36.41
|
| Rate for Payer: Global Benefits Group Commercial |
$25.70
|
| Rate for Payer: Health Management Network EPO/PPO |
$38.56
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$32.13
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$26.73
|
| Rate for Payer: IEHP medi-cal |
$26.90
|
| Rate for Payer: IEHP Medicare Advantage |
$16.30
|
| Rate for Payer: Innovage PACE Commercial |
$24.45
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$28.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.57
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$21.84
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$21.84
|
| Rate for Payer: Multiplan Commercial |
$32.13
|
| Rate for Payer: Networks By Design Commercial |
$27.85
|
| Rate for Payer: Prime Health Services Commercial |
$36.41
|
| Rate for Payer: Prime Health Services Medicare |
$17.28
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$25.70
|
| Rate for Payer: Riverside University Health MISP |
$17.93
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$25.70
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$25.70
|
| Rate for Payer: United Healthcare All Other Commercial |
$13.20
|
| Rate for Payer: United Healthcare All Other HMO |
$13.20
|
| Rate for Payer: United Healthcare HMO Rider |
$13.20
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$13.20
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$24.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$17.93
|
| Rate for Payer: Vantage Medical Group Senior |
$16.30
|
|
|
HC SOM CAH DEHYDROEPIANDROSTERONE
|
Facility
IP
|
$66.41
|
|
|
Service Code
|
CPT 82626
|
| Hospital Charge Code |
900912774
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.28 |
| Max. Negotiated Rate |
$59.77 |
| Rate for Payer: Cash Price |
$29.88
|
| Rate for Payer: Central Health Plan Commercial |
$53.13
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.56
|
| Rate for Payer: Galaxy Health WC |
$56.45
|
| Rate for Payer: Global Benefits Group Commercial |
$39.85
|
| Rate for Payer: Health Management Network EPO/PPO |
$59.77
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$44.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.28
|
| Rate for Payer: Multiplan Commercial |
$49.81
|
| Rate for Payer: Networks By Design Commercial |
$43.17
|
| Rate for Payer: Prime Health Services Commercial |
$56.45
|
|
|
HC SOM CAH DEHYDROEPIANDROSTERONE
|
Facility
OP
|
$66.41
|
|
|
Service Code
|
CPT 82626
|
| Hospital Charge Code |
900912774
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.28 |
| Max. Negotiated Rate |
$224.26 |
| Rate for Payer: Adventist Health Medi-Cal |
$25.27
|
| Rate for Payer: Aetna of CA HMO/PPO |
$185.48
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$37.90
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$27.80
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$25.27
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$183.86
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$224.26
|
| Rate for Payer: BCBS Transplant Transplant |
$39.85
|
| Rate for Payer: Blue Shield of California Commercial |
$41.04
|
| Rate for Payer: Blue Shield of California EPN |
$32.28
|
| Rate for Payer: Caremore Medicare Advantage |
$25.27
|
| Rate for Payer: Cash Price |
$29.88
|
| Rate for Payer: Cash Price |
$29.88
|
| Rate for Payer: Central Health Plan Commercial |
$53.13
|
| Rate for Payer: Cigna of CA HMO |
$42.50
|
| Rate for Payer: Cigna of CA PPO |
$49.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$37.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$34.11
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$25.27
|
| Rate for Payer: EPIC Health Plan Transplant |
$25.27
|
| Rate for Payer: Galaxy Health WC |
$56.45
|
| Rate for Payer: Global Benefits Group Commercial |
$39.85
|
| Rate for Payer: Health Management Network EPO/PPO |
$59.77
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$49.81
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$41.44
|
| Rate for Payer: IEHP medi-cal |
$41.70
|
| Rate for Payer: IEHP Medicare Advantage |
$25.27
|
| Rate for Payer: Innovage PACE Commercial |
$37.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$44.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$33.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$33.86
|
| Rate for Payer: Multiplan Commercial |
$49.81
|
| Rate for Payer: Networks By Design Commercial |
$43.17
|
| Rate for Payer: Prime Health Services Commercial |
$56.45
|
| Rate for Payer: Prime Health Services Medicare |
$26.79
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$39.85
|
| Rate for Payer: Riverside University Health MISP |
$27.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$39.85
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$39.85
|
| Rate for Payer: United Healthcare All Other Commercial |
$20.47
|
| Rate for Payer: United Healthcare All Other HMO |
$20.47
|
| Rate for Payer: United Healthcare HMO Rider |
$20.47
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$20.47
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$37.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$27.80
|
| Rate for Payer: Vantage Medical Group Senior |
$25.27
|
|
|
HC SOM CAH DEOXYCORTICOSTERONE
|
Facility
OP
|
$81.42
|
|
|
Service Code
|
CPT 82633
|
| Hospital Charge Code |
900912773
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$16.28 |
| Max. Negotiated Rate |
$265.96 |
| Rate for Payer: Adventist Health Medi-Cal |
$30.98
|
| Rate for Payer: Aetna of CA HMO/PPO |
$227.33
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$46.47
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$34.08
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$30.98
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$218.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$265.96
|
| Rate for Payer: BCBS Transplant Transplant |
$48.85
|
| Rate for Payer: Blue Shield of California Commercial |
$50.32
|
| Rate for Payer: Blue Shield of California EPN |
$39.57
|
| Rate for Payer: Caremore Medicare Advantage |
$30.98
|
| Rate for Payer: Cash Price |
$36.64
|
| Rate for Payer: Cash Price |
$36.64
|
| Rate for Payer: Central Health Plan Commercial |
$65.14
|
| Rate for Payer: Cigna of CA HMO |
$52.11
|
| Rate for Payer: Cigna of CA PPO |
$60.25
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$46.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$41.82
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$30.98
|
| Rate for Payer: EPIC Health Plan Transplant |
$30.98
|
| Rate for Payer: Galaxy Health WC |
$69.21
|
| Rate for Payer: Global Benefits Group Commercial |
$48.85
|
| Rate for Payer: Health Management Network EPO/PPO |
$73.28
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$61.06
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$50.81
|
| Rate for Payer: IEHP medi-cal |
$51.12
|
| Rate for Payer: IEHP Medicare Advantage |
$30.98
|
| Rate for Payer: Innovage PACE Commercial |
$46.47
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$54.31
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$30.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$41.51
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$41.51
|
| Rate for Payer: Multiplan Commercial |
$61.06
|
| Rate for Payer: Networks By Design Commercial |
$52.92
|
| Rate for Payer: Prime Health Services Commercial |
$69.21
|
| Rate for Payer: Prime Health Services Medicare |
$32.84
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$48.85
|
| Rate for Payer: Riverside University Health MISP |
$34.08
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$48.85
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$48.85
|
| Rate for Payer: United Healthcare All Other Commercial |
$25.09
|
| Rate for Payer: United Healthcare All Other HMO |
$25.09
|
| Rate for Payer: United Healthcare HMO Rider |
$25.09
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$25.09
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$46.47
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$34.08
|
| Rate for Payer: Vantage Medical Group Senior |
$30.98
|
|
|
HC SOM CAH DEOXYCORTICOSTERONE
|
Facility
IP
|
$81.42
|
|
|
Service Code
|
CPT 82633
|
| Hospital Charge Code |
900912773
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$16.28 |
| Max. Negotiated Rate |
$73.28 |
| Rate for Payer: Cash Price |
$36.64
|
| Rate for Payer: Central Health Plan Commercial |
$65.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$32.57
|
| Rate for Payer: Galaxy Health WC |
$69.21
|
| Rate for Payer: Global Benefits Group Commercial |
$48.85
|
| Rate for Payer: Health Management Network EPO/PPO |
$73.28
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$54.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.28
|
| Rate for Payer: Multiplan Commercial |
$61.06
|
| Rate for Payer: Networks By Design Commercial |
$52.92
|
| Rate for Payer: Prime Health Services Commercial |
$69.21
|
|
|
HC SOM CAH PROGESTERONE
|
Facility
OP
|
$54.83
|
|
|
Service Code
|
CPT 84144
|
| Hospital Charge Code |
900912777
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.97 |
| Max. Negotiated Rate |
$185.13 |
| Rate for Payer: Adventist Health Medi-Cal |
$20.86
|
| Rate for Payer: Aetna of CA HMO/PPO |
$153.15
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$31.29
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$22.95
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$20.86
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$151.78
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$185.13
|
| Rate for Payer: BCBS Transplant Transplant |
$32.90
|
| Rate for Payer: Blue Shield of California Commercial |
$33.88
|
| Rate for Payer: Blue Shield of California EPN |
$26.65
|
| Rate for Payer: Caremore Medicare Advantage |
$20.86
|
| Rate for Payer: Cash Price |
$24.67
|
| Rate for Payer: Cash Price |
$24.67
|
| Rate for Payer: Central Health Plan Commercial |
$43.86
|
| Rate for Payer: Cigna of CA HMO |
$35.09
|
| Rate for Payer: Cigna of CA PPO |
$40.57
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$31.29
|
| Rate for Payer: EPIC Health Plan Commercial |
$28.16
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$20.86
|
| Rate for Payer: EPIC Health Plan Transplant |
$20.86
|
| Rate for Payer: Galaxy Health WC |
$46.61
|
| Rate for Payer: Global Benefits Group Commercial |
$32.90
|
| Rate for Payer: Health Management Network EPO/PPO |
$49.35
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$41.12
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$34.21
|
| Rate for Payer: IEHP medi-cal |
$34.42
|
| Rate for Payer: IEHP Medicare Advantage |
$20.86
|
| Rate for Payer: Innovage PACE Commercial |
$31.29
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$36.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$20.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.97
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$27.95
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$27.95
|
| Rate for Payer: Multiplan Commercial |
$41.12
|
| Rate for Payer: Networks By Design Commercial |
$35.64
|
| Rate for Payer: Prime Health Services Commercial |
$46.61
|
| Rate for Payer: Prime Health Services Medicare |
$22.11
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$32.90
|
| Rate for Payer: Riverside University Health MISP |
$22.95
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$32.90
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$32.90
|
| Rate for Payer: United Healthcare All Other Commercial |
$16.89
|
| Rate for Payer: United Healthcare All Other HMO |
$16.89
|
| Rate for Payer: United Healthcare HMO Rider |
$16.89
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16.89
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$31.29
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$22.95
|
| Rate for Payer: Vantage Medical Group Senior |
$20.86
|
|
|
HC SOM CAH PROGESTERONE
|
Facility
IP
|
$54.83
|
|
|
Service Code
|
CPT 84144
|
| Hospital Charge Code |
900912777
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.97 |
| Max. Negotiated Rate |
$49.35 |
| Rate for Payer: Cash Price |
$24.67
|
| Rate for Payer: Central Health Plan Commercial |
$43.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$21.93
|
| Rate for Payer: Galaxy Health WC |
$46.61
|
| Rate for Payer: Global Benefits Group Commercial |
$32.90
|
| Rate for Payer: Health Management Network EPO/PPO |
$49.35
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$36.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.97
|
| Rate for Payer: Multiplan Commercial |
$41.12
|
| Rate for Payer: Networks By Design Commercial |
$35.64
|
| Rate for Payer: Prime Health Services Commercial |
$46.61
|
|
|
HC SOM CAH TESTOSTERONE
|
Facility
OP
|
$67.83
|
|
|
Service Code
|
CPT 84403
|
| Hospital Charge Code |
900912779
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.57 |
| Max. Negotiated Rate |
$229.04 |
| Rate for Payer: Adventist Health Medi-Cal |
$25.81
|
| Rate for Payer: Aetna of CA HMO/PPO |
$189.47
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$38.72
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$28.39
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$25.81
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$187.78
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$229.04
|
| Rate for Payer: BCBS Transplant Transplant |
$40.70
|
| Rate for Payer: Blue Shield of California Commercial |
$41.92
|
| Rate for Payer: Blue Shield of California EPN |
$32.97
|
| Rate for Payer: Caremore Medicare Advantage |
$25.81
|
| Rate for Payer: Cash Price |
$30.52
|
| Rate for Payer: Cash Price |
$30.52
|
| Rate for Payer: Central Health Plan Commercial |
$54.26
|
| Rate for Payer: Cigna of CA HMO |
$43.41
|
| Rate for Payer: Cigna of CA PPO |
$50.19
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$38.72
|
| Rate for Payer: EPIC Health Plan Commercial |
$34.84
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$25.81
|
| Rate for Payer: EPIC Health Plan Transplant |
$25.81
|
| Rate for Payer: Galaxy Health WC |
$57.66
|
| Rate for Payer: Global Benefits Group Commercial |
$40.70
|
| Rate for Payer: Health Management Network EPO/PPO |
$61.05
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$50.87
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$42.33
|
| Rate for Payer: IEHP medi-cal |
$42.59
|
| Rate for Payer: IEHP Medicare Advantage |
$25.81
|
| Rate for Payer: Innovage PACE Commercial |
$38.72
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$45.24
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.57
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$34.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$34.59
|
| Rate for Payer: Multiplan Commercial |
$50.87
|
| Rate for Payer: Networks By Design Commercial |
$44.09
|
| Rate for Payer: Prime Health Services Commercial |
$57.66
|
| Rate for Payer: Prime Health Services Medicare |
$27.36
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$40.70
|
| Rate for Payer: Riverside University Health MISP |
$28.39
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$40.70
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$40.70
|
| Rate for Payer: United Healthcare All Other Commercial |
$20.91
|
| Rate for Payer: United Healthcare All Other HMO |
$20.91
|
| Rate for Payer: United Healthcare HMO Rider |
$20.91
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$20.91
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$38.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$28.39
|
| Rate for Payer: Vantage Medical Group Senior |
$25.81
|
|
|
HC SOM CAH TESTOSTERONE
|
Facility
IP
|
$67.83
|
|
|
Service Code
|
CPT 84403
|
| Hospital Charge Code |
900912779
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.57 |
| Max. Negotiated Rate |
$61.05 |
| Rate for Payer: Cash Price |
$30.52
|
| Rate for Payer: Central Health Plan Commercial |
$54.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$27.13
|
| Rate for Payer: Galaxy Health WC |
$57.66
|
| Rate for Payer: Global Benefits Group Commercial |
$40.70
|
| Rate for Payer: Health Management Network EPO/PPO |
$61.05
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$45.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.57
|
| Rate for Payer: Multiplan Commercial |
$50.87
|
| Rate for Payer: Networks By Design Commercial |
$44.09
|
| Rate for Payer: Prime Health Services Commercial |
$57.66
|
|
|
HC SOM CALCITONIN
|
Facility
OP
|
$20.00
|
|
|
Service Code
|
CPT 82308
|
| Hospital Charge Code |
900911003
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.00 |
| Max. Negotiated Rate |
$237.65 |
| Rate for Payer: Adventist Health Medi-Cal |
$26.79
|
| Rate for Payer: Aetna of CA HMO/PPO |
$196.59
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$40.18
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$29.47
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$26.79
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$194.83
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$237.65
|
| Rate for Payer: BCBS Transplant Transplant |
$12.00
|
| Rate for Payer: Blue Shield of California Commercial |
$12.36
|
| Rate for Payer: Blue Shield of California EPN |
$9.72
|
| Rate for Payer: Caremore Medicare Advantage |
$26.79
|
| 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 |
$40.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$36.17
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$26.79
|
| Rate for Payer: EPIC Health Plan Transplant |
$26.79
|
| 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 |
$43.94
|
| Rate for Payer: IEHP medi-cal |
$44.20
|
| Rate for Payer: IEHP Medicare Advantage |
$26.79
|
| Rate for Payer: Innovage PACE Commercial |
$40.18
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$13.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$26.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$35.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$35.90
|
| 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 |
$28.40
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$12.00
|
| Rate for Payer: Riverside University Health MISP |
$29.47
|
| 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 |
$21.70
|
| Rate for Payer: United Healthcare All Other HMO |
$21.70
|
| Rate for Payer: United Healthcare HMO Rider |
$21.70
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$21.70
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$40.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$29.47
|
| Rate for Payer: Vantage Medical Group Senior |
$26.79
|
|
|
HC SOM CALCITONIN
|
Facility
IP
|
$20.00
|
|
|
Service Code
|
CPT 82308
|
| Hospital Charge Code |
900911003
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.00 |
| Max. Negotiated Rate |
$18.00 |
| Rate for Payer: Cash Price |
$9.00
|
| Rate for Payer: Central Health Plan Commercial |
$16.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.00
|
| Rate for Payer: Galaxy Health WC |
$17.00
|
| Rate for Payer: Global Benefits Group Commercial |
$12.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$18.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$13.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.00
|
| Rate for Payer: Multiplan Commercial |
$15.00
|
| Rate for Payer: Networks By Design Commercial |
$13.00
|
| Rate for Payer: Prime Health Services Commercial |
$17.00
|
|
|
HC SOM CALPROTECTIN
|
Facility
OP
|
$90.00
|
|
|
Service Code
|
CPT 83993
|
| Hospital Charge Code |
900912938
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.90 |
| Max. Negotiated Rate |
$174.14 |
| Rate for Payer: Adventist Health Medi-Cal |
$19.63
|
| Rate for Payer: Aetna of CA HMO/PPO |
$144.07
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$29.44
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$21.59
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$19.63
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$142.77
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$174.14
|
| Rate for Payer: BCBS Transplant Transplant |
$54.00
|
| Rate for Payer: Blue Shield of California Commercial |
$55.62
|
| Rate for Payer: Blue Shield of California EPN |
$43.74
|
| Rate for Payer: Caremore Medicare Advantage |
$19.63
|
| Rate for Payer: Cash Price |
$40.50
|
| Rate for Payer: Cash Price |
$40.50
|
| Rate for Payer: Central Health Plan Commercial |
$72.00
|
| Rate for Payer: Cigna of CA HMO |
$57.60
|
| Rate for Payer: Cigna of CA PPO |
$66.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$29.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.50
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$19.63
|
| Rate for Payer: EPIC Health Plan Transplant |
$19.63
|
| Rate for Payer: Galaxy Health WC |
$76.50
|
| Rate for Payer: Global Benefits Group Commercial |
$54.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$81.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$67.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$32.19
|
| Rate for Payer: IEHP medi-cal |
$32.39
|
| Rate for Payer: IEHP Medicare Advantage |
$19.63
|
| Rate for Payer: Innovage PACE Commercial |
$29.44
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$60.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$19.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$26.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$26.30
|
| Rate for Payer: Multiplan Commercial |
$67.50
|
| Rate for Payer: Networks By Design Commercial |
$58.50
|
| Rate for Payer: Prime Health Services Commercial |
$76.50
|
| Rate for Payer: Prime Health Services Medicare |
$20.81
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$54.00
|
| Rate for Payer: Riverside University Health MISP |
$21.59
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$54.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$54.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$15.90
|
| Rate for Payer: United Healthcare All Other HMO |
$15.90
|
| Rate for Payer: United Healthcare HMO Rider |
$15.90
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15.90
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$29.44
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$21.59
|
| Rate for Payer: Vantage Medical Group Senior |
$19.63
|
|
|
HC SOM CALPROTECTIN
|
Facility
IP
|
$90.00
|
|
|
Service Code
|
CPT 83993
|
| Hospital Charge Code |
900912938
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$18.00 |
| Max. Negotiated Rate |
$81.00 |
| Rate for Payer: Cash Price |
$40.50
|
| Rate for Payer: Central Health Plan Commercial |
$72.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$36.00
|
| Rate for Payer: Galaxy Health WC |
$76.50
|
| Rate for Payer: Global Benefits Group Commercial |
$54.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$81.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$60.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18.00
|
| Rate for Payer: Multiplan Commercial |
$67.50
|
| Rate for Payer: Networks By Design Commercial |
$58.50
|
| Rate for Payer: Prime Health Services Commercial |
$76.50
|
|
|
HC SOM CARBAPEN MOD HODGE TEST
|
Facility
IP
|
$164.70
|
|
|
Service Code
|
CPT 87185
|
| Hospital Charge Code |
900914208
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$32.94 |
| Max. Negotiated Rate |
$148.23 |
| Rate for Payer: Cash Price |
$74.12
|
| Rate for Payer: Central Health Plan Commercial |
$131.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$65.88
|
| Rate for Payer: Galaxy Health WC |
$140.00
|
| Rate for Payer: Global Benefits Group Commercial |
$98.82
|
| Rate for Payer: Health Management Network EPO/PPO |
$148.23
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$109.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$32.94
|
| Rate for Payer: Multiplan Commercial |
$123.52
|
| Rate for Payer: Networks By Design Commercial |
$107.06
|
| Rate for Payer: Prime Health Services Commercial |
$140.00
|
|
|
HC SOM CARBAPEN MOD HODGE TEST
|
Facility
OP
|
$164.70
|
|
|
Service Code
|
CPT 87185
|
| Hospital Charge Code |
900914208
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$3.85 |
| Max. Negotiated Rate |
$148.23 |
| Rate for Payer: Adventist Health Medi-Cal |
$4.75
|
| Rate for Payer: Aetna of CA HMO/PPO |
$11.96
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$7.12
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$5.22
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$4.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$20.96
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$25.57
|
| Rate for Payer: BCBS Transplant Transplant |
$98.82
|
| Rate for Payer: Blue Shield of California Commercial |
$101.78
|
| Rate for Payer: Blue Shield of California EPN |
$80.04
|
| Rate for Payer: Caremore Medicare Advantage |
$4.75
|
| Rate for Payer: Cash Price |
$74.12
|
| Rate for Payer: Cash Price |
$74.12
|
| Rate for Payer: Central Health Plan Commercial |
$131.76
|
| Rate for Payer: Cigna of CA HMO |
$105.41
|
| Rate for Payer: Cigna of CA PPO |
$121.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.41
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4.75
|
| Rate for Payer: EPIC Health Plan Transplant |
$4.75
|
| Rate for Payer: Galaxy Health WC |
$140.00
|
| Rate for Payer: Global Benefits Group Commercial |
$98.82
|
| Rate for Payer: Health Management Network EPO/PPO |
$148.23
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$123.52
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7.79
|
| Rate for Payer: IEHP medi-cal |
$7.84
|
| Rate for Payer: IEHP Medicare Advantage |
$4.75
|
| Rate for Payer: Innovage PACE Commercial |
$7.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$109.85
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$32.94
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.36
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.36
|
| Rate for Payer: Multiplan Commercial |
$123.52
|
| Rate for Payer: Networks By Design Commercial |
$107.06
|
| Rate for Payer: Prime Health Services Commercial |
$140.00
|
| Rate for Payer: Prime Health Services Medicare |
$5.04
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$98.82
|
| Rate for Payer: Riverside University Health MISP |
$5.22
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$98.82
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$98.82
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.85
|
| Rate for Payer: United Healthcare All Other HMO |
$3.85
|
| Rate for Payer: United Healthcare HMO Rider |
$3.85
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.85
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.22
|
| Rate for Payer: Vantage Medical Group Senior |
$4.75
|
|
|
HC SOM CARB DEF TRANS CONGENITAL
|
Facility
OP
|
$200.00
|
|
|
Service Code
|
CPT 82373
|
| Hospital Charge Code |
900912514
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.62 |
| Max. Negotiated Rate |
$180.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$18.06
|
| Rate for Payer: Aetna of CA HMO/PPO |
$132.53
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$27.09
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$19.87
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$18.06
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$52.36
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$63.86
|
| Rate for Payer: BCBS Transplant Transplant |
$120.00
|
| Rate for Payer: Blue Shield of California Commercial |
$123.60
|
| Rate for Payer: Blue Shield of California EPN |
$97.20
|
| Rate for Payer: Caremore Medicare Advantage |
$18.06
|
| Rate for Payer: Cash Price |
$90.00
|
| Rate for Payer: Cash Price |
$90.00
|
| Rate for Payer: Central Health Plan Commercial |
$160.00
|
| Rate for Payer: Cigna of CA HMO |
$128.00
|
| Rate for Payer: Cigna of CA PPO |
$148.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$27.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$24.38
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$18.06
|
| Rate for Payer: EPIC Health Plan Transplant |
$18.06
|
| Rate for Payer: Galaxy Health WC |
$170.00
|
| Rate for Payer: Global Benefits Group Commercial |
$120.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$180.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$150.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$29.62
|
| Rate for Payer: IEHP medi-cal |
$29.80
|
| Rate for Payer: IEHP Medicare Advantage |
$18.06
|
| Rate for Payer: Innovage PACE Commercial |
$27.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$133.40
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$40.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$24.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$24.20
|
| Rate for Payer: Multiplan Commercial |
$150.00
|
| Rate for Payer: Networks By Design Commercial |
$130.00
|
| Rate for Payer: Prime Health Services Commercial |
$170.00
|
| Rate for Payer: Prime Health Services Medicare |
$19.14
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$120.00
|
| Rate for Payer: Riverside University Health MISP |
$19.87
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$120.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$120.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.62
|
| Rate for Payer: United Healthcare All Other HMO |
$14.62
|
| Rate for Payer: United Healthcare HMO Rider |
$14.62
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.62
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$27.09
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.87
|
| Rate for Payer: Vantage Medical Group Senior |
$18.06
|
|
|
HC SOM CARB DEF TRANS CONGENITAL
|
Facility
IP
|
$200.00
|
|
|
Service Code
|
CPT 82373
|
| Hospital Charge Code |
900912514
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$40.00 |
| Max. Negotiated Rate |
$180.00 |
| Rate for Payer: Cash Price |
$90.00
|
| Rate for Payer: Central Health Plan Commercial |
$160.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$80.00
|
| Rate for Payer: Galaxy Health WC |
$170.00
|
| Rate for Payer: Global Benefits Group Commercial |
$120.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$180.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$133.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$40.00
|
| Rate for Payer: Multiplan Commercial |
$150.00
|
| Rate for Payer: Networks By Design Commercial |
$130.00
|
| Rate for Payer: Prime Health Services Commercial |
$170.00
|
|
|
HC SOM CARB DEF TRANSFERRIN ADULT
|
Facility
OP
|
$342.30
|
|
|
Service Code
|
CPT 82373
|
| Hospital Charge Code |
900912717
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.62 |
| Max. Negotiated Rate |
$308.07 |
| Rate for Payer: Adventist Health Medi-Cal |
$18.06
|
| Rate for Payer: Aetna of CA HMO/PPO |
$132.53
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$27.09
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$19.87
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$18.06
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$52.36
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$63.86
|
| Rate for Payer: BCBS Transplant Transplant |
$205.38
|
| Rate for Payer: Blue Shield of California Commercial |
$211.54
|
| Rate for Payer: Blue Shield of California EPN |
$166.36
|
| Rate for Payer: Caremore Medicare Advantage |
$18.06
|
| Rate for Payer: Cash Price |
$154.04
|
| Rate for Payer: Cash Price |
$154.04
|
| Rate for Payer: Central Health Plan Commercial |
$273.84
|
| Rate for Payer: Cigna of CA HMO |
$219.07
|
| Rate for Payer: Cigna of CA PPO |
$253.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$27.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$24.38
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$18.06
|
| Rate for Payer: EPIC Health Plan Transplant |
$18.06
|
| Rate for Payer: Galaxy Health WC |
$290.96
|
| Rate for Payer: Global Benefits Group Commercial |
$205.38
|
| Rate for Payer: Health Management Network EPO/PPO |
$308.07
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$256.72
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$29.62
|
| Rate for Payer: IEHP medi-cal |
$29.80
|
| Rate for Payer: IEHP Medicare Advantage |
$18.06
|
| Rate for Payer: Innovage PACE Commercial |
$27.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$228.31
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$68.46
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$24.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$24.20
|
| Rate for Payer: Multiplan Commercial |
$256.72
|
| Rate for Payer: Networks By Design Commercial |
$222.50
|
| Rate for Payer: Prime Health Services Commercial |
$290.96
|
| Rate for Payer: Prime Health Services Medicare |
$19.14
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$205.38
|
| Rate for Payer: Riverside University Health MISP |
$19.87
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$205.38
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$205.38
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.62
|
| Rate for Payer: United Healthcare All Other HMO |
$14.62
|
| Rate for Payer: United Healthcare HMO Rider |
$14.62
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.62
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$27.09
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.87
|
| Rate for Payer: Vantage Medical Group Senior |
$18.06
|
|
|
HC SOM CARB DEF TRANSFERRIN ADULT
|
Facility
IP
|
$342.30
|
|
|
Service Code
|
CPT 82373
|
| Hospital Charge Code |
900912717
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$68.46 |
| Max. Negotiated Rate |
$308.07 |
| Rate for Payer: Cash Price |
$154.04
|
| Rate for Payer: Central Health Plan Commercial |
$273.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$136.92
|
| Rate for Payer: Galaxy Health WC |
$290.96
|
| Rate for Payer: Global Benefits Group Commercial |
$205.38
|
| Rate for Payer: Health Management Network EPO/PPO |
$308.07
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$228.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$68.46
|
| Rate for Payer: Multiplan Commercial |
$256.72
|
| Rate for Payer: Networks By Design Commercial |
$222.50
|
| Rate for Payer: Prime Health Services Commercial |
$290.96
|
|
|
HC SOM CARBOXYHEMOGLOBIN
|
Facility
IP
|
$35.00
|
|
|
Service Code
|
CPT 82375
|
| Hospital Charge Code |
900911041
|
|
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
|
|
