|
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
|
|
|
HC SOM CARBOXY-THC CONFIRMATION, U
|
Facility
IP
|
$31.60
|
|
|
Service Code
|
CPT 80349
|
| Hospital Charge Code |
900915422
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.32 |
| Max. Negotiated Rate |
$28.44 |
| Rate for Payer: Cash Price |
$14.22
|
| Rate for Payer: Central Health Plan Commercial |
$25.28
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.64
|
| Rate for Payer: Galaxy Health WC |
$26.86
|
| Rate for Payer: Global Benefits Group Commercial |
$18.96
|
| Rate for Payer: Health Management Network EPO/PPO |
$28.44
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$21.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.32
|
| Rate for Payer: Multiplan Commercial |
$23.70
|
| Rate for Payer: Networks By Design Commercial |
$20.54
|
| Rate for Payer: Prime Health Services Commercial |
$26.86
|
|
|
HC SOM CARBOXY-THC CONFIRMATION, U
|
Facility
OP
|
$31.60
|
|
|
Service Code
|
CPT 80349
|
| Hospital Charge Code |
900915422
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$0.06 |
| Max. Negotiated Rate |
$201.62 |
| Rate for Payer: Aetna of CA HMO/PPO |
$0.06
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$26.86
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$17.38
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$17.38
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$165.30
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$201.62
|
| Rate for Payer: BCBS Transplant Transplant |
$18.96
|
| Rate for Payer: Blue Shield of California Commercial |
$19.53
|
| Rate for Payer: Blue Shield of California EPN |
$15.36
|
| Rate for Payer: Cash Price |
$14.22
|
| Rate for Payer: Cash Price |
$14.22
|
| Rate for Payer: Central Health Plan Commercial |
$25.28
|
| Rate for Payer: Cigna of CA HMO |
$20.22
|
| Rate for Payer: Cigna of CA PPO |
$23.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$26.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.64
|
| Rate for Payer: EPIC Health Plan Transplant |
$12.64
|
| Rate for Payer: Galaxy Health WC |
$26.86
|
| Rate for Payer: Global Benefits Group Commercial |
$18.96
|
| Rate for Payer: Health Management Network EPO/PPO |
$28.44
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$23.70
|
| Rate for Payer: IEHP medi-cal |
$11.06
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$21.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.32
|
| Rate for Payer: Multiplan Commercial |
$23.70
|
| Rate for Payer: Networks By Design Commercial |
$20.54
|
| Rate for Payer: Prime Health Services Commercial |
$26.86
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$18.96
|
| Rate for Payer: Riverside University Health MISP |
$12.64
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$18.96
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$18.96
|
| Rate for Payer: United Healthcare All Other Commercial |
$15.80
|
| Rate for Payer: United Healthcare All Other HMO |
$15.80
|
| Rate for Payer: United Healthcare HMO Rider |
$15.80
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$26.86
|
| Rate for Payer: Vantage Medical Group Senior |
$26.86
|
|
|
HC SOM CARNITINE PLASMA
|
Facility
OP
|
$25.00
|
|
|
Service Code
|
CPT 82379
|
| Hospital Charge Code |
900911103
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.00 |
| Max. Negotiated Rate |
$148.99 |
| Rate for Payer: Adventist Health Medi-Cal |
$16.87
|
| Rate for Payer: Aetna of CA HMO/PPO |
$123.82
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$25.30
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$18.56
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$16.87
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$122.15
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$148.99
|
| Rate for Payer: BCBS Transplant Transplant |
$15.00
|
| Rate for Payer: Blue Shield of California Commercial |
$15.45
|
| Rate for Payer: Blue Shield of California EPN |
$12.15
|
| Rate for Payer: Caremore Medicare Advantage |
$16.87
|
| Rate for Payer: Cash Price |
$11.25
|
| Rate for Payer: Cash Price |
$11.25
|
| Rate for Payer: Central Health Plan Commercial |
$20.00
|
| Rate for Payer: Cigna of CA HMO |
$16.00
|
| Rate for Payer: Cigna of CA PPO |
$18.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$25.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$22.77
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$16.87
|
| Rate for Payer: EPIC Health Plan Transplant |
$16.87
|
| Rate for Payer: Galaxy Health WC |
$21.25
|
| Rate for Payer: Global Benefits Group Commercial |
$15.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$22.50
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$18.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$27.67
|
| Rate for Payer: IEHP medi-cal |
$27.84
|
| Rate for Payer: IEHP Medicare Advantage |
$16.87
|
| Rate for Payer: Innovage PACE Commercial |
$25.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$22.61
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$22.61
|
| Rate for Payer: Multiplan Commercial |
$18.75
|
| Rate for Payer: Networks By Design Commercial |
$16.25
|
| Rate for Payer: Prime Health Services Commercial |
$21.25
|
| Rate for Payer: Prime Health Services Medicare |
$17.88
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$15.00
|
| Rate for Payer: Riverside University Health MISP |
$18.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$15.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$13.66
|
| Rate for Payer: United Healthcare All Other HMO |
$13.66
|
| Rate for Payer: United Healthcare HMO Rider |
$13.66
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$13.66
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$25.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$18.56
|
| Rate for Payer: Vantage Medical Group Senior |
$16.87
|
|
|
HC SOM CARNITINE PLASMA
|
Facility
IP
|
$25.00
|
|
|
Service Code
|
CPT 82379
|
| Hospital Charge Code |
900911103
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.00 |
| Max. Negotiated Rate |
$22.50 |
| Rate for Payer: Cash Price |
$11.25
|
| Rate for Payer: Central Health Plan Commercial |
$20.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.00
|
| Rate for Payer: Galaxy Health WC |
$21.25
|
| Rate for Payer: Global Benefits Group Commercial |
$15.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$22.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.00
|
| Rate for Payer: Multiplan Commercial |
$18.75
|
| Rate for Payer: Networks By Design Commercial |
$16.25
|
| Rate for Payer: Prime Health Services Commercial |
$21.25
|
|
|
HC SOM CARNITINE URINE
|
Facility
IP
|
$60.00
|
|
|
Service Code
|
CPT 82379
|
| Hospital Charge Code |
900910730
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.00 |
| Max. Negotiated Rate |
$54.00 |
| Rate for Payer: Cash Price |
$27.00
|
| Rate for Payer: Central Health Plan Commercial |
$48.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$24.00
|
| Rate for Payer: Galaxy Health WC |
$51.00
|
| Rate for Payer: Global Benefits Group Commercial |
$36.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$54.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$40.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.00
|
| Rate for Payer: Multiplan Commercial |
$45.00
|
| Rate for Payer: Networks By Design Commercial |
$39.00
|
| Rate for Payer: Prime Health Services Commercial |
$51.00
|
|
|
HC SOM CARNITINE URINE
|
Facility
OP
|
$60.00
|
|
|
Service Code
|
CPT 82379
|
| Hospital Charge Code |
900910730
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.00 |
| Max. Negotiated Rate |
$148.99 |
| Rate for Payer: Adventist Health Medi-Cal |
$16.87
|
| Rate for Payer: Aetna of CA HMO/PPO |
$123.82
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$25.30
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$18.56
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$16.87
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$122.15
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$148.99
|
| Rate for Payer: BCBS Transplant Transplant |
$36.00
|
| Rate for Payer: Blue Shield of California Commercial |
$37.08
|
| Rate for Payer: Blue Shield of California EPN |
$29.16
|
| Rate for Payer: Caremore Medicare Advantage |
$16.87
|
| Rate for Payer: Cash Price |
$27.00
|
| Rate for Payer: Cash Price |
$27.00
|
| Rate for Payer: Central Health Plan Commercial |
$48.00
|
| Rate for Payer: Cigna of CA HMO |
$38.40
|
| Rate for Payer: Cigna of CA PPO |
$44.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$25.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$22.77
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$16.87
|
| Rate for Payer: EPIC Health Plan Transplant |
$16.87
|
| Rate for Payer: Galaxy Health WC |
$51.00
|
| Rate for Payer: Global Benefits Group Commercial |
$36.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$54.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$45.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$27.67
|
| Rate for Payer: IEHP medi-cal |
$27.84
|
| Rate for Payer: IEHP Medicare Advantage |
$16.87
|
| Rate for Payer: Innovage PACE Commercial |
$25.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$40.02
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$22.61
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$22.61
|
| Rate for Payer: Multiplan Commercial |
$45.00
|
| Rate for Payer: Networks By Design Commercial |
$39.00
|
| Rate for Payer: Prime Health Services Commercial |
$51.00
|
| Rate for Payer: Prime Health Services Medicare |
$17.88
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$36.00
|
| Rate for Payer: Riverside University Health MISP |
$18.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$36.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$36.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$13.66
|
| Rate for Payer: United Healthcare All Other HMO |
$13.66
|
| Rate for Payer: United Healthcare HMO Rider |
$13.66
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$13.66
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$25.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$18.56
|
| Rate for Payer: Vantage Medical Group Senior |
$16.87
|
|
|
HC SOM CAROTENE
|
Facility
IP
|
$122.75
|
|
|
Service Code
|
CPT 82380
|
| Hospital Charge Code |
900911303
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$24.55 |
| Max. Negotiated Rate |
$110.48 |
| Rate for Payer: Cash Price |
$55.24
|
| Rate for Payer: Central Health Plan Commercial |
$98.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$49.10
|
| Rate for Payer: Galaxy Health WC |
$104.34
|
| Rate for Payer: Global Benefits Group Commercial |
$73.65
|
| Rate for Payer: Health Management Network EPO/PPO |
$110.48
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$81.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.55
|
| Rate for Payer: Multiplan Commercial |
$92.06
|
| Rate for Payer: Networks By Design Commercial |
$79.79
|
| Rate for Payer: Prime Health Services Commercial |
$104.34
|
|
|
HC SOM CAROTENE
|
Facility
OP
|
$122.75
|
|
|
Service Code
|
CPT 82380
|
| Hospital Charge Code |
900911303
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.47 |
| Max. Negotiated Rate |
$110.48 |
| Rate for Payer: Adventist Health Medi-Cal |
$9.22
|
| Rate for Payer: Aetna of CA HMO/PPO |
$67.68
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$13.83
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$10.14
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$9.22
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$67.15
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$81.90
|
| Rate for Payer: BCBS Transplant Transplant |
$73.65
|
| Rate for Payer: Blue Shield of California Commercial |
$75.86
|
| Rate for Payer: Blue Shield of California EPN |
$59.66
|
| Rate for Payer: Caremore Medicare Advantage |
$9.22
|
| Rate for Payer: Cash Price |
$55.24
|
| Rate for Payer: Cash Price |
$55.24
|
| Rate for Payer: Central Health Plan Commercial |
$98.20
|
| Rate for Payer: Cigna of CA HMO |
$78.56
|
| Rate for Payer: Cigna of CA PPO |
$90.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13.83
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.45
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$9.22
|
| Rate for Payer: EPIC Health Plan Transplant |
$9.22
|
| Rate for Payer: Galaxy Health WC |
$104.34
|
| Rate for Payer: Global Benefits Group Commercial |
$73.65
|
| Rate for Payer: Health Management Network EPO/PPO |
$110.48
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$92.06
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$15.12
|
| Rate for Payer: IEHP medi-cal |
$15.21
|
| Rate for Payer: IEHP Medicare Advantage |
$9.22
|
| Rate for Payer: Innovage PACE Commercial |
$13.83
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$81.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.55
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$12.35
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$12.35
|
| Rate for Payer: Multiplan Commercial |
$92.06
|
| Rate for Payer: Networks By Design Commercial |
$79.79
|
| Rate for Payer: Prime Health Services Commercial |
$104.34
|
| Rate for Payer: Prime Health Services Medicare |
$9.77
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$73.65
|
| Rate for Payer: Riverside University Health MISP |
$10.14
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$73.65
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$73.65
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.47
|
| Rate for Payer: United Healthcare All Other HMO |
$7.47
|
| Rate for Payer: United Healthcare HMO Rider |
$7.47
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.47
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.14
|
| Rate for Payer: Vantage Medical Group Senior |
$9.22
|
|
|
HC SOM CATECHOLAMINE FRACT FREE UR
|
Facility
IP
|
$30.00
|
|
|
Service Code
|
CPT 82384
|
| Hospital Charge Code |
900914081
|
|
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 CATECHOLAMINE FRACT FREE UR
|
Facility
OP
|
$30.00
|
|
|
Service Code
|
CPT 82384
|
| Hospital Charge Code |
900914081
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.00 |
| Max. Negotiated Rate |
$224.08 |
| Rate for Payer: Adventist Health Medi-Cal |
$25.25
|
| Rate for Payer: Aetna of CA HMO/PPO |
$185.30
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$37.88
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$27.78
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$25.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$183.71
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$224.08
|
| 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 |
$25.25
|
| 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 |
$37.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$34.09
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$25.25
|
| Rate for Payer: EPIC Health Plan Transplant |
$25.25
|
| 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 |
$41.41
|
| Rate for Payer: IEHP medi-cal |
$41.66
|
| Rate for Payer: IEHP Medicare Advantage |
$25.25
|
| Rate for Payer: Innovage PACE Commercial |
$37.88
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20.01
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$33.84
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$33.84
|
| 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 |
$26.76
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$18.00
|
| Rate for Payer: Riverside University Health MISP |
$27.78
|
| 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 |
$20.46
|
| Rate for Payer: United Healthcare All Other HMO |
$20.46
|
| Rate for Payer: United Healthcare HMO Rider |
$20.46
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$20.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$37.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$27.78
|
| Rate for Payer: Vantage Medical Group Senior |
$25.25
|
|
|
HC SOM CATECHOLAMINES PL
|
Facility
OP
|
$30.00
|
|
|
Service Code
|
CPT 82384
|
| Hospital Charge Code |
900910483
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.00 |
| Max. Negotiated Rate |
$224.08 |
| Rate for Payer: Adventist Health Medi-Cal |
$25.25
|
| Rate for Payer: Aetna of CA HMO/PPO |
$185.30
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$37.88
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$27.78
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$25.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$183.71
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$224.08
|
| 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 |
$25.25
|
| 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 |
$37.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$34.09
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$25.25
|
| Rate for Payer: EPIC Health Plan Transplant |
$25.25
|
| 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 |
$41.41
|
| Rate for Payer: IEHP medi-cal |
$41.66
|
| Rate for Payer: IEHP Medicare Advantage |
$25.25
|
| Rate for Payer: Innovage PACE Commercial |
$37.88
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20.01
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$33.84
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$33.84
|
| 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 |
$26.76
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$18.00
|
| Rate for Payer: Riverside University Health MISP |
$27.78
|
| 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 |
$20.46
|
| Rate for Payer: United Healthcare All Other HMO |
$20.46
|
| Rate for Payer: United Healthcare HMO Rider |
$20.46
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$20.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$37.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$27.78
|
| Rate for Payer: Vantage Medical Group Senior |
$25.25
|
|
|
HC SOM CATECHOLAMINES PL
|
Facility
IP
|
$30.00
|
|
|
Service Code
|
CPT 82384
|
| Hospital Charge Code |
900910483
|
|
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 CD4 T-CELL ABSOLUTE CT
|
Facility
OP
|
$31.88
|
|
|
Service Code
|
CPT 86360
|
| Hospital Charge Code |
900914709
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$6.38 |
| Max. Negotiated Rate |
$350.14 |
| Rate for Payer: Adventist Health Medi-Cal |
$46.98
|
| Rate for Payer: Aetna of CA HMO/PPO |
$344.83
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$70.47
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$51.68
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$46.98
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$287.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$350.14
|
| Rate for Payer: BCBS Transplant Transplant |
$19.13
|
| Rate for Payer: Blue Shield of California Commercial |
$19.70
|
| Rate for Payer: Blue Shield of California EPN |
$15.49
|
| Rate for Payer: Caremore Medicare Advantage |
$46.98
|
| Rate for Payer: Cash Price |
$14.35
|
| Rate for Payer: Cash Price |
$14.35
|
| Rate for Payer: Central Health Plan Commercial |
$25.50
|
| Rate for Payer: Cigna of CA HMO |
$20.40
|
| Rate for Payer: Cigna of CA PPO |
$23.59
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$70.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$63.42
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$46.98
|
| Rate for Payer: EPIC Health Plan Transplant |
$46.98
|
| Rate for Payer: Galaxy Health WC |
$27.10
|
| Rate for Payer: Global Benefits Group Commercial |
$19.13
|
| Rate for Payer: Health Management Network EPO/PPO |
$28.69
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$23.91
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$77.05
|
| Rate for Payer: IEHP medi-cal |
$77.52
|
| Rate for Payer: IEHP Medicare Advantage |
$46.98
|
| Rate for Payer: Innovage PACE Commercial |
$70.47
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$21.26
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$46.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.38
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$62.95
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$62.95
|
| Rate for Payer: Multiplan Commercial |
$23.91
|
| Rate for Payer: Networks By Design Commercial |
$20.72
|
| Rate for Payer: Prime Health Services Commercial |
$27.10
|
| Rate for Payer: Prime Health Services Medicare |
$49.80
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$19.13
|
| Rate for Payer: Riverside University Health MISP |
$51.68
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$19.13
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$19.13
|
| Rate for Payer: United Healthcare All Other Commercial |
$38.05
|
| Rate for Payer: United Healthcare All Other HMO |
$38.05
|
| Rate for Payer: United Healthcare HMO Rider |
$38.05
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$38.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$70.47
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$51.68
|
| Rate for Payer: Vantage Medical Group Senior |
$46.98
|
|
|
HC SOM CD4 T-CELL ABSOLUTE CT
|
Facility
IP
|
$31.88
|
|
|
Service Code
|
CPT 86360
|
| Hospital Charge Code |
900914709
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$6.38 |
| Max. Negotiated Rate |
$28.69 |
| Rate for Payer: Cash Price |
$14.35
|
| Rate for Payer: Central Health Plan Commercial |
$25.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.75
|
| Rate for Payer: Galaxy Health WC |
$27.10
|
| Rate for Payer: Global Benefits Group Commercial |
$19.13
|
| Rate for Payer: Health Management Network EPO/PPO |
$28.69
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$21.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.38
|
| Rate for Payer: Multiplan Commercial |
$23.91
|
| Rate for Payer: Networks By Design Commercial |
$20.72
|
| Rate for Payer: Prime Health Services Commercial |
$27.10
|
|
|
HC SOM CD4 T-CELL TOTAL CT
|
Facility
IP
|
$29.87
|
|
|
Service Code
|
CPT 86359
|
| Hospital Charge Code |
900914708
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$5.97 |
| Max. Negotiated Rate |
$26.88 |
| Rate for Payer: Cash Price |
$13.44
|
| Rate for Payer: Central Health Plan Commercial |
$23.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.95
|
| Rate for Payer: Galaxy Health WC |
$25.39
|
| Rate for Payer: Global Benefits Group Commercial |
$17.92
|
| Rate for Payer: Health Management Network EPO/PPO |
$26.88
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$19.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.97
|
| Rate for Payer: Multiplan Commercial |
$22.40
|
| Rate for Payer: Networks By Design Commercial |
$19.42
|
| Rate for Payer: Prime Health Services Commercial |
$25.39
|
|
|
HC SOM CD4 T-CELL TOTAL CT
|
Facility
OP
|
$29.87
|
|
|
Service Code
|
CPT 86359
|
| Hospital Charge Code |
900914708
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$5.97 |
| Max. Negotiated Rate |
$335.32 |
| Rate for Payer: Adventist Health Medi-Cal |
$37.73
|
| Rate for Payer: Aetna of CA HMO/PPO |
$276.84
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$56.60
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$41.50
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$37.73
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$274.91
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$335.32
|
| Rate for Payer: BCBS Transplant Transplant |
$17.92
|
| Rate for Payer: Blue Shield of California Commercial |
$18.46
|
| Rate for Payer: Blue Shield of California EPN |
$14.52
|
| Rate for Payer: Caremore Medicare Advantage |
$37.73
|
| Rate for Payer: Cash Price |
$13.44
|
| Rate for Payer: Cash Price |
$13.44
|
| Rate for Payer: Central Health Plan Commercial |
$23.90
|
| Rate for Payer: Cigna of CA HMO |
$19.12
|
| Rate for Payer: Cigna of CA PPO |
$22.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$56.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$50.94
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$37.73
|
| Rate for Payer: EPIC Health Plan Transplant |
$37.73
|
| Rate for Payer: Galaxy Health WC |
$25.39
|
| Rate for Payer: Global Benefits Group Commercial |
$17.92
|
| Rate for Payer: Health Management Network EPO/PPO |
$26.88
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$22.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$61.88
|
| Rate for Payer: IEHP medi-cal |
$62.25
|
| Rate for Payer: IEHP Medicare Advantage |
$37.73
|
| Rate for Payer: Innovage PACE Commercial |
$56.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$19.92
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$37.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.97
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$50.56
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$50.56
|
| Rate for Payer: Multiplan Commercial |
$22.40
|
| Rate for Payer: Networks By Design Commercial |
$19.42
|
| Rate for Payer: Prime Health Services Commercial |
$25.39
|
| Rate for Payer: Prime Health Services Medicare |
$39.99
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$17.92
|
| Rate for Payer: Riverside University Health MISP |
$41.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$17.92
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$17.92
|
| Rate for Payer: United Healthcare All Other Commercial |
$30.56
|
| Rate for Payer: United Healthcare All Other HMO |
$30.56
|
| Rate for Payer: United Healthcare HMO Rider |
$30.56
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$30.56
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$56.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$41.50
|
| Rate for Payer: Vantage Medical Group Senior |
$37.73
|
|
|
HC SOM C DIFF PCR STOOL
|
Facility
OP
|
$60.00
|
|
|
Service Code
|
CPT 87493
|
| Hospital Charge Code |
900914042
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$12.00 |
| Max. Negotiated Rate |
$381.98 |
| Rate for Payer: Adventist Health Medi-Cal |
$37.27
|
| Rate for Payer: Aetna of CA HMO/PPO |
$257.58
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$55.90
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$41.00
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$37.27
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$313.16
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$381.98
|
| Rate for Payer: BCBS Transplant Transplant |
$36.00
|
| Rate for Payer: Blue Shield of California Commercial |
$37.08
|
| Rate for Payer: Blue Shield of California EPN |
$29.16
|
| Rate for Payer: Caremore Medicare Advantage |
$37.27
|
| Rate for Payer: Cash Price |
$27.00
|
| Rate for Payer: Cash Price |
$27.00
|
| Rate for Payer: Central Health Plan Commercial |
$48.00
|
| Rate for Payer: Cigna of CA HMO |
$38.40
|
| Rate for Payer: Cigna of CA PPO |
$44.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$55.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$50.31
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$37.27
|
| Rate for Payer: EPIC Health Plan Transplant |
$37.27
|
| Rate for Payer: Galaxy Health WC |
$51.00
|
| Rate for Payer: Global Benefits Group Commercial |
$36.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$54.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$45.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$61.12
|
| Rate for Payer: IEHP medi-cal |
$61.50
|
| Rate for Payer: IEHP Medicare Advantage |
$37.27
|
| Rate for Payer: Innovage PACE Commercial |
$55.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$40.02
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$37.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$49.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$49.94
|
| Rate for Payer: Multiplan Commercial |
$45.00
|
| Rate for Payer: Networks By Design Commercial |
$39.00
|
| Rate for Payer: Prime Health Services Commercial |
$51.00
|
| Rate for Payer: Prime Health Services Medicare |
$39.51
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$36.00
|
| Rate for Payer: Riverside University Health MISP |
$41.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$36.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$36.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$30.19
|
| Rate for Payer: United Healthcare All Other HMO |
$30.19
|
| Rate for Payer: United Healthcare HMO Rider |
$30.19
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$30.19
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$55.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$41.00
|
| Rate for Payer: Vantage Medical Group Senior |
$37.27
|
|
|
HC SOM C DIFF PCR STOOL
|
Facility
IP
|
$60.00
|
|
|
Service Code
|
CPT 87493
|
| Hospital Charge Code |
900914042
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$12.00 |
| Max. Negotiated Rate |
$54.00 |
| Rate for Payer: Cash Price |
$27.00
|
| Rate for Payer: Central Health Plan Commercial |
$48.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$24.00
|
| Rate for Payer: Galaxy Health WC |
$51.00
|
| Rate for Payer: Global Benefits Group Commercial |
$36.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$54.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$40.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.00
|
| Rate for Payer: Multiplan Commercial |
$45.00
|
| Rate for Payer: Networks By Design Commercial |
$39.00
|
| Rate for Payer: Prime Health Services Commercial |
$51.00
|
|
|
HC SOM CEA PANCREATIC CYST
|
Facility
IP
|
$45.00
|
|
|
Service Code
|
CPT 82378
|
| Hospital Charge Code |
900912997
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.00 |
| Max. Negotiated Rate |
$40.50 |
| Rate for Payer: Cash Price |
$20.25
|
| Rate for Payer: Central Health Plan Commercial |
$36.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$18.00
|
| Rate for Payer: Galaxy Health WC |
$38.25
|
| Rate for Payer: Global Benefits Group Commercial |
$27.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$40.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$30.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.00
|
| Rate for Payer: Multiplan Commercial |
$33.75
|
| Rate for Payer: Networks By Design Commercial |
$29.25
|
| Rate for Payer: Prime Health Services Commercial |
$38.25
|
|
|
HC SOM CEA PANCREATIC CYST
|
Facility
OP
|
$45.00
|
|
|
Service Code
|
CPT 82378
|
| Hospital Charge Code |
900912997
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.00 |
| Max. Negotiated Rate |
$168.05 |
| Rate for Payer: Adventist Health Medi-Cal |
$18.96
|
| Rate for Payer: Aetna of CA HMO/PPO |
$139.28
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$28.44
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$20.86
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$18.96
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$137.77
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$168.05
|
| Rate for Payer: BCBS Transplant Transplant |
$27.00
|
| Rate for Payer: Blue Shield of California Commercial |
$27.81
|
| Rate for Payer: Blue Shield of California EPN |
$21.87
|
| Rate for Payer: Caremore Medicare Advantage |
$18.96
|
| Rate for Payer: Cash Price |
$20.25
|
| Rate for Payer: Cash Price |
$20.25
|
| Rate for Payer: Central Health Plan Commercial |
$36.00
|
| Rate for Payer: Cigna of CA HMO |
$28.80
|
| Rate for Payer: Cigna of CA PPO |
$33.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$28.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$25.60
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$18.96
|
| Rate for Payer: EPIC Health Plan Transplant |
$18.96
|
| Rate for Payer: Galaxy Health WC |
$38.25
|
| Rate for Payer: Global Benefits Group Commercial |
$27.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$40.50
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$33.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$31.09
|
| Rate for Payer: IEHP medi-cal |
$31.28
|
| Rate for Payer: IEHP Medicare Advantage |
$18.96
|
| Rate for Payer: Innovage PACE Commercial |
$28.44
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$30.02
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$25.41
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$25.41
|
| Rate for Payer: Multiplan Commercial |
$33.75
|
| Rate for Payer: Networks By Design Commercial |
$29.25
|
| Rate for Payer: Prime Health Services Commercial |
$38.25
|
| Rate for Payer: Prime Health Services Medicare |
$20.10
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$27.00
|
| Rate for Payer: Riverside University Health MISP |
$20.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$27.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$27.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$15.35
|
| Rate for Payer: United Healthcare All Other HMO |
$15.35
|
| Rate for Payer: United Healthcare HMO Rider |
$15.35
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15.35
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$28.44
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$20.86
|
| Rate for Payer: Vantage Medical Group Senior |
$18.96
|
|
|
HC SOM CEA PERITONEAL FLUID
|
Facility
OP
|
$45.00
|
|
|
Service Code
|
CPT 82378
|
| Hospital Charge Code |
900914706
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.00 |
| Max. Negotiated Rate |
$168.05 |
| Rate for Payer: Adventist Health Medi-Cal |
$18.96
|
| Rate for Payer: Aetna of CA HMO/PPO |
$139.28
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$28.44
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$20.86
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$18.96
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$137.77
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$168.05
|
| Rate for Payer: BCBS Transplant Transplant |
$27.00
|
| Rate for Payer: Blue Shield of California Commercial |
$27.81
|
| Rate for Payer: Blue Shield of California EPN |
$21.87
|
| Rate for Payer: Caremore Medicare Advantage |
$18.96
|
| Rate for Payer: Cash Price |
$20.25
|
| Rate for Payer: Cash Price |
$20.25
|
| Rate for Payer: Central Health Plan Commercial |
$36.00
|
| Rate for Payer: Cigna of CA HMO |
$28.80
|
| Rate for Payer: Cigna of CA PPO |
$33.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$28.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$25.60
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$18.96
|
| Rate for Payer: EPIC Health Plan Transplant |
$18.96
|
| Rate for Payer: Galaxy Health WC |
$38.25
|
| Rate for Payer: Global Benefits Group Commercial |
$27.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$40.50
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$33.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$31.09
|
| Rate for Payer: IEHP medi-cal |
$31.28
|
| Rate for Payer: IEHP Medicare Advantage |
$18.96
|
| Rate for Payer: Innovage PACE Commercial |
$28.44
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$30.02
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$25.41
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$25.41
|
| Rate for Payer: Multiplan Commercial |
$33.75
|
| Rate for Payer: Networks By Design Commercial |
$29.25
|
| Rate for Payer: Prime Health Services Commercial |
$38.25
|
| Rate for Payer: Prime Health Services Medicare |
$20.10
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$27.00
|
| Rate for Payer: Riverside University Health MISP |
$20.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$27.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$27.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$15.35
|
| Rate for Payer: United Healthcare All Other HMO |
$15.35
|
| Rate for Payer: United Healthcare HMO Rider |
$15.35
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15.35
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$28.44
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$20.86
|
| Rate for Payer: Vantage Medical Group Senior |
$18.96
|
|
|
HC SOM CEA PERITONEAL FLUID
|
Facility
IP
|
$45.00
|
|
|
Service Code
|
CPT 82378
|
| Hospital Charge Code |
900914706
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.00 |
| Max. Negotiated Rate |
$40.50 |
| Rate for Payer: Cash Price |
$20.25
|
| Rate for Payer: Central Health Plan Commercial |
$36.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$18.00
|
| Rate for Payer: Galaxy Health WC |
$38.25
|
| Rate for Payer: Global Benefits Group Commercial |
$27.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$40.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$30.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.00
|
| Rate for Payer: Multiplan Commercial |
$33.75
|
| Rate for Payer: Networks By Design Commercial |
$29.25
|
| Rate for Payer: Prime Health Services Commercial |
$38.25
|
|
|
HC SOM CEA PLEURAL FLUID
|
Facility
OP
|
$45.00
|
|
|
Service Code
|
CPT 82378
|
| Hospital Charge Code |
900915434
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$9.00 |
| Max. Negotiated Rate |
$168.05 |
| Rate for Payer: Adventist Health Medi-Cal |
$18.96
|
| Rate for Payer: Aetna of CA HMO/PPO |
$139.28
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$28.44
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$20.86
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$18.96
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$137.77
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$168.05
|
| Rate for Payer: BCBS Transplant Transplant |
$27.00
|
| Rate for Payer: Blue Shield of California Commercial |
$27.81
|
| Rate for Payer: Blue Shield of California EPN |
$21.87
|
| Rate for Payer: Caremore Medicare Advantage |
$18.96
|
| Rate for Payer: Cash Price |
$20.25
|
| Rate for Payer: Cash Price |
$20.25
|
| Rate for Payer: Central Health Plan Commercial |
$36.00
|
| Rate for Payer: Cigna of CA HMO |
$28.80
|
| Rate for Payer: Cigna of CA PPO |
$33.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$28.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$25.60
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$18.96
|
| Rate for Payer: EPIC Health Plan Transplant |
$18.96
|
| Rate for Payer: Galaxy Health WC |
$38.25
|
| Rate for Payer: Global Benefits Group Commercial |
$27.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$40.50
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$33.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$31.09
|
| Rate for Payer: IEHP medi-cal |
$31.28
|
| Rate for Payer: IEHP Medicare Advantage |
$18.96
|
| Rate for Payer: Innovage PACE Commercial |
$28.44
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$30.02
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$25.41
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$25.41
|
| Rate for Payer: Multiplan Commercial |
$33.75
|
| Rate for Payer: Networks By Design Commercial |
$29.25
|
| Rate for Payer: Prime Health Services Commercial |
$38.25
|
| Rate for Payer: Prime Health Services Medicare |
$20.10
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$27.00
|
| Rate for Payer: Riverside University Health MISP |
$20.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$27.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$27.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$15.35
|
| Rate for Payer: United Healthcare All Other HMO |
$15.35
|
| Rate for Payer: United Healthcare HMO Rider |
$15.35
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15.35
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$28.44
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$20.86
|
| Rate for Payer: Vantage Medical Group Senior |
$18.96
|
|
|
HC SOM CEA PLEURAL FLUID
|
Facility
IP
|
$45.00
|
|
|
Service Code
|
CPT 82378
|
| Hospital Charge Code |
900915434
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$9.00 |
| Max. Negotiated Rate |
$40.50 |
| Rate for Payer: Cash Price |
$20.25
|
| Rate for Payer: Central Health Plan Commercial |
$36.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$18.00
|
| Rate for Payer: Galaxy Health WC |
$38.25
|
| Rate for Payer: Global Benefits Group Commercial |
$27.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$40.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$30.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.00
|
| Rate for Payer: Multiplan Commercial |
$33.75
|
| Rate for Payer: Networks By Design Commercial |
$29.25
|
| Rate for Payer: Prime Health Services Commercial |
$38.25
|
|
