|
HC SOM CELIAC COMP HLA TYPING 1
|
Facility
OP
|
$85.17
|
|
|
Service Code
|
CPT 81376
|
| Hospital Charge Code |
900915327
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$17.03 |
| Max. Negotiated Rate |
$9,900.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$122.22
|
| Rate for Payer: Aetna of CA HMO/PPO |
$348.75
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$183.33
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$134.44
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$122.22
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$550.16
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$671.06
|
| Rate for Payer: BCBS Transplant Transplant |
$51.10
|
| Rate for Payer: Blue Shield of California Commercial |
$52.64
|
| Rate for Payer: Blue Shield of California EPN |
$41.39
|
| Rate for Payer: Caremore Medicare Advantage |
$122.22
|
| Rate for Payer: Cash Price |
$38.33
|
| Rate for Payer: Cash Price |
$38.33
|
| Rate for Payer: Central Health Plan Commercial |
$68.14
|
| Rate for Payer: Cigna of CA HMO |
$54.51
|
| Rate for Payer: Cigna of CA PPO |
$63.03
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$183.33
|
| Rate for Payer: EPIC Health Plan Commercial |
$165.00
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$122.22
|
| Rate for Payer: EPIC Health Plan Transplant |
$122.22
|
| Rate for Payer: Galaxy Health WC |
$72.39
|
| Rate for Payer: Global Benefits Group Commercial |
$51.10
|
| Rate for Payer: Health Management Network EPO/PPO |
$76.65
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$63.88
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$200.44
|
| Rate for Payer: IEHP medi-cal |
$201.66
|
| Rate for Payer: IEHP Medicare Advantage |
$122.22
|
| Rate for Payer: Innovage PACE Commercial |
$183.33
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$56.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$122.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$17.03
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$163.77
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$163.77
|
| Rate for Payer: Multiplan Commercial |
$63.88
|
| Rate for Payer: Networks By Design Commercial |
$55.36
|
| Rate for Payer: Prime Health Services Commercial |
$72.39
|
| Rate for Payer: Prime Health Services Medicare |
$129.55
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$51.10
|
| Rate for Payer: Riverside University Health MISP |
$134.44
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$51.10
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$51.10
|
| Rate for Payer: United Healthcare All Other Commercial |
$99.00
|
| Rate for Payer: United Healthcare All Other HMO |
$99.00
|
| Rate for Payer: United Healthcare HMO Rider |
$99.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9,900.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$183.33
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$134.44
|
| Rate for Payer: Vantage Medical Group Senior |
$122.22
|
|
|
HC SOM CELIAC COMP HLA TYPING 1
|
Facility
IP
|
$85.17
|
|
|
Service Code
|
CPT 81376
|
| Hospital Charge Code |
900915327
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$17.03 |
| Max. Negotiated Rate |
$76.65 |
| Rate for Payer: Cash Price |
$38.33
|
| Rate for Payer: Central Health Plan Commercial |
$68.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$34.07
|
| Rate for Payer: Galaxy Health WC |
$72.39
|
| Rate for Payer: Global Benefits Group Commercial |
$51.10
|
| Rate for Payer: Health Management Network EPO/PPO |
$76.65
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$56.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$17.03
|
| Rate for Payer: Multiplan Commercial |
$63.88
|
| Rate for Payer: Networks By Design Commercial |
$55.36
|
| Rate for Payer: Prime Health Services Commercial |
$72.39
|
|
|
HC SOM CELIAC COMP HLA TYPING 2
|
Facility
OP
|
$85.18
|
|
|
Service Code
|
CPT 81376
|
| Hospital Charge Code |
900915328
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$17.04 |
| Max. Negotiated Rate |
$9,900.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$122.22
|
| Rate for Payer: Aetna of CA HMO/PPO |
$348.75
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$183.33
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$134.44
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$122.22
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$550.16
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$671.06
|
| Rate for Payer: BCBS Transplant Transplant |
$51.11
|
| Rate for Payer: Blue Shield of California Commercial |
$52.64
|
| Rate for Payer: Blue Shield of California EPN |
$41.40
|
| Rate for Payer: Caremore Medicare Advantage |
$122.22
|
| Rate for Payer: Cash Price |
$38.33
|
| Rate for Payer: Cash Price |
$38.33
|
| Rate for Payer: Central Health Plan Commercial |
$68.14
|
| Rate for Payer: Cigna of CA HMO |
$54.52
|
| Rate for Payer: Cigna of CA PPO |
$63.03
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$183.33
|
| Rate for Payer: EPIC Health Plan Commercial |
$165.00
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$122.22
|
| Rate for Payer: EPIC Health Plan Transplant |
$122.22
|
| Rate for Payer: Galaxy Health WC |
$72.40
|
| Rate for Payer: Global Benefits Group Commercial |
$51.11
|
| Rate for Payer: Health Management Network EPO/PPO |
$76.66
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$63.88
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$200.44
|
| Rate for Payer: IEHP medi-cal |
$201.66
|
| Rate for Payer: IEHP Medicare Advantage |
$122.22
|
| Rate for Payer: Innovage PACE Commercial |
$183.33
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$56.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$122.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$17.04
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$163.77
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$163.77
|
| Rate for Payer: Multiplan Commercial |
$63.88
|
| Rate for Payer: Networks By Design Commercial |
$55.37
|
| Rate for Payer: Prime Health Services Commercial |
$72.40
|
| Rate for Payer: Prime Health Services Medicare |
$129.55
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$51.11
|
| Rate for Payer: Riverside University Health MISP |
$134.44
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$51.11
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$51.11
|
| Rate for Payer: United Healthcare All Other Commercial |
$99.00
|
| Rate for Payer: United Healthcare All Other HMO |
$99.00
|
| Rate for Payer: United Healthcare HMO Rider |
$99.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9,900.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$183.33
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$134.44
|
| Rate for Payer: Vantage Medical Group Senior |
$122.22
|
|
|
HC SOM CELIAC COMP HLA TYPING 2
|
Facility
IP
|
$85.18
|
|
|
Service Code
|
CPT 81376
|
| Hospital Charge Code |
900915328
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$17.04 |
| Max. Negotiated Rate |
$76.66 |
| Rate for Payer: Cash Price |
$38.33
|
| Rate for Payer: Central Health Plan Commercial |
$68.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$34.07
|
| Rate for Payer: Galaxy Health WC |
$72.40
|
| Rate for Payer: Global Benefits Group Commercial |
$51.11
|
| Rate for Payer: Health Management Network EPO/PPO |
$76.66
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$56.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$17.04
|
| Rate for Payer: Multiplan Commercial |
$63.88
|
| Rate for Payer: Networks By Design Commercial |
$55.37
|
| Rate for Payer: Prime Health Services Commercial |
$72.40
|
|
|
HC SOM CELIAC COMP IGA
|
Facility
IP
|
$6.48
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
900914382
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$1.30 |
| Max. Negotiated Rate |
$5.83 |
| Rate for Payer: Cash Price |
$2.92
|
| Rate for Payer: Central Health Plan Commercial |
$5.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.59
|
| Rate for Payer: Galaxy Health WC |
$5.51
|
| Rate for Payer: Global Benefits Group Commercial |
$3.89
|
| Rate for Payer: Health Management Network EPO/PPO |
$5.83
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.30
|
| Rate for Payer: Multiplan Commercial |
$4.86
|
| Rate for Payer: Networks By Design Commercial |
$4.21
|
| Rate for Payer: Prime Health Services Commercial |
$5.51
|
|
|
HC SOM CELIAC COMP IGA
|
Facility
OP
|
$6.48
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
900914382
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$1.30 |
| Max. Negotiated Rate |
$68.76 |
| Rate for Payer: Adventist Health Medi-Cal |
$9.30
|
| Rate for Payer: Aetna of CA HMO/PPO |
$48.10
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$13.95
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$10.23
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$9.30
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$56.37
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$68.76
|
| Rate for Payer: BCBS Transplant Transplant |
$3.89
|
| Rate for Payer: Blue Shield of California Commercial |
$4.00
|
| Rate for Payer: Blue Shield of California EPN |
$3.15
|
| Rate for Payer: Caremore Medicare Advantage |
$9.30
|
| Rate for Payer: Cash Price |
$2.92
|
| Rate for Payer: Cash Price |
$2.92
|
| Rate for Payer: Central Health Plan Commercial |
$5.18
|
| Rate for Payer: Cigna of CA HMO |
$4.15
|
| Rate for Payer: Cigna of CA PPO |
$4.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.56
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$9.30
|
| Rate for Payer: EPIC Health Plan Transplant |
$9.30
|
| Rate for Payer: Galaxy Health WC |
$5.51
|
| Rate for Payer: Global Benefits Group Commercial |
$3.89
|
| Rate for Payer: Health Management Network EPO/PPO |
$5.83
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$4.86
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$15.25
|
| Rate for Payer: IEHP medi-cal |
$15.34
|
| Rate for Payer: IEHP Medicare Advantage |
$9.30
|
| Rate for Payer: Innovage PACE Commercial |
$13.95
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4.32
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.30
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$12.46
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$12.46
|
| Rate for Payer: Multiplan Commercial |
$4.86
|
| Rate for Payer: Networks By Design Commercial |
$4.21
|
| Rate for Payer: Prime Health Services Commercial |
$5.51
|
| Rate for Payer: Prime Health Services Medicare |
$9.86
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$3.89
|
| Rate for Payer: Riverside University Health MISP |
$10.23
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3.89
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3.89
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.53
|
| Rate for Payer: United Healthcare All Other HMO |
$7.53
|
| Rate for Payer: United Healthcare HMO Rider |
$7.53
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.53
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.23
|
| Rate for Payer: Vantage Medical Group Senior |
$9.30
|
|
|
HC SOM CERULOPLASMIN
|
Facility
IP
|
$12.00
|
|
|
Service Code
|
CPT 82390
|
| Hospital Charge Code |
900915329
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.40 |
| Max. Negotiated Rate |
$10.80 |
| Rate for Payer: Cash Price |
$5.40
|
| Rate for Payer: Central Health Plan Commercial |
$9.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.80
|
| Rate for Payer: Galaxy Health WC |
$10.20
|
| Rate for Payer: Global Benefits Group Commercial |
$7.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$10.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.40
|
| Rate for Payer: Multiplan Commercial |
$9.00
|
| Rate for Payer: Networks By Design Commercial |
$7.80
|
| Rate for Payer: Prime Health Services Commercial |
$10.20
|
|
|
HC SOM CERULOPLASMIN
|
Facility
OP
|
$12.00
|
|
|
Service Code
|
CPT 82390
|
| Hospital Charge Code |
900915329
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.40 |
| Max. Negotiated Rate |
$95.29 |
| Rate for Payer: Adventist Health Medi-Cal |
$10.74
|
| Rate for Payer: Aetna of CA HMO/PPO |
$78.84
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$16.11
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$11.81
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$10.74
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$78.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$95.29
|
| Rate for Payer: BCBS Transplant Transplant |
$7.20
|
| Rate for Payer: Blue Shield of California Commercial |
$7.42
|
| Rate for Payer: Blue Shield of California EPN |
$5.83
|
| Rate for Payer: Caremore Medicare Advantage |
$10.74
|
| Rate for Payer: Cash Price |
$5.40
|
| Rate for Payer: Cash Price |
$5.40
|
| Rate for Payer: Central Health Plan Commercial |
$9.60
|
| Rate for Payer: Cigna of CA HMO |
$7.68
|
| Rate for Payer: Cigna of CA PPO |
$8.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$16.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.50
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$10.74
|
| Rate for Payer: EPIC Health Plan Transplant |
$10.74
|
| Rate for Payer: Galaxy Health WC |
$10.20
|
| Rate for Payer: Global Benefits Group Commercial |
$7.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$10.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$9.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$17.61
|
| Rate for Payer: IEHP medi-cal |
$17.72
|
| Rate for Payer: IEHP Medicare Advantage |
$10.74
|
| Rate for Payer: Innovage PACE Commercial |
$16.11
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$14.39
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14.39
|
| Rate for Payer: Multiplan Commercial |
$9.00
|
| Rate for Payer: Networks By Design Commercial |
$7.80
|
| Rate for Payer: Prime Health Services Commercial |
$10.20
|
| Rate for Payer: Prime Health Services Medicare |
$11.38
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$7.20
|
| Rate for Payer: Riverside University Health MISP |
$11.81
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$8.70
|
| Rate for Payer: United Healthcare All Other HMO |
$8.70
|
| Rate for Payer: United Healthcare HMO Rider |
$8.70
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8.70
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$16.11
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11.81
|
| Rate for Payer: Vantage Medical Group Senior |
$10.74
|
|
|
HC SOM CHESTNUT IGE
|
Facility
IP
|
$7.47
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
900914685
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$1.49 |
| Max. Negotiated Rate |
$6.72 |
| Rate for Payer: Cash Price |
$3.36
|
| Rate for Payer: Central Health Plan Commercial |
$5.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.99
|
| Rate for Payer: Galaxy Health WC |
$6.35
|
| Rate for Payer: Global Benefits Group Commercial |
$4.48
|
| Rate for Payer: Health Management Network EPO/PPO |
$6.72
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.49
|
| Rate for Payer: Multiplan Commercial |
$5.60
|
| Rate for Payer: Networks By Design Commercial |
$4.86
|
| Rate for Payer: Prime Health Services Commercial |
$6.35
|
|
|
HC SOM CHESTNUT IGE
|
Facility
OP
|
$7.47
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
900914685
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$1.49 |
| Max. Negotiated Rate |
$140.27 |
| Rate for Payer: Adventist Health Medi-Cal |
$5.22
|
| Rate for Payer: Aetna of CA HMO/PPO |
$38.29
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$7.83
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$5.74
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$5.22
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$115.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$140.27
|
| Rate for Payer: BCBS Transplant Transplant |
$4.48
|
| Rate for Payer: Blue Shield of California Commercial |
$4.62
|
| Rate for Payer: Blue Shield of California EPN |
$3.63
|
| Rate for Payer: Caremore Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$3.36
|
| Rate for Payer: Cash Price |
$3.36
|
| Rate for Payer: Central Health Plan Commercial |
$5.98
|
| Rate for Payer: Cigna of CA HMO |
$4.78
|
| Rate for Payer: Cigna of CA PPO |
$5.53
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.83
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.05
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$5.22
|
| Rate for Payer: EPIC Health Plan Transplant |
$5.22
|
| Rate for Payer: Galaxy Health WC |
$6.35
|
| Rate for Payer: Global Benefits Group Commercial |
$4.48
|
| Rate for Payer: Health Management Network EPO/PPO |
$6.72
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$5.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$8.56
|
| Rate for Payer: IEHP medi-cal |
$8.61
|
| Rate for Payer: IEHP Medicare Advantage |
$5.22
|
| Rate for Payer: Innovage PACE Commercial |
$7.83
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.49
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.99
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.99
|
| Rate for Payer: Multiplan Commercial |
$5.60
|
| Rate for Payer: Networks By Design Commercial |
$4.86
|
| Rate for Payer: Prime Health Services Commercial |
$6.35
|
| Rate for Payer: Prime Health Services Medicare |
$5.53
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$4.48
|
| Rate for Payer: Riverside University Health MISP |
$5.74
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4.48
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4.48
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.23
|
| Rate for Payer: United Healthcare All Other HMO |
$4.23
|
| Rate for Payer: United Healthcare HMO Rider |
$4.23
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.23
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.74
|
| Rate for Payer: Vantage Medical Group Senior |
$5.22
|
|
|
HC SOM CHLORDIAZEPOXIDE (LIBRIUM)
|
Facility
OP
|
$280.10
|
|
|
Service Code
|
CPT 80346
|
| Hospital Charge Code |
900911081
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$0.06 |
| Max. Negotiated Rate |
$252.09 |
| Rate for Payer: Aetna of CA HMO/PPO |
$0.06
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$238.08
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$154.06
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$154.06
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$129.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$157.41
|
| Rate for Payer: BCBS Transplant Transplant |
$168.06
|
| Rate for Payer: Blue Shield of California Commercial |
$173.10
|
| Rate for Payer: Blue Shield of California EPN |
$136.13
|
| Rate for Payer: Cash Price |
$126.05
|
| Rate for Payer: Cash Price |
$126.05
|
| Rate for Payer: Central Health Plan Commercial |
$224.08
|
| Rate for Payer: Cigna of CA HMO |
$179.26
|
| Rate for Payer: Cigna of CA PPO |
$207.27
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$238.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$112.04
|
| Rate for Payer: EPIC Health Plan Transplant |
$112.04
|
| Rate for Payer: Galaxy Health WC |
$238.08
|
| Rate for Payer: Global Benefits Group Commercial |
$168.06
|
| Rate for Payer: Health Management Network EPO/PPO |
$252.09
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$210.08
|
| Rate for Payer: IEHP medi-cal |
$98.04
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$186.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$56.02
|
| Rate for Payer: Multiplan Commercial |
$210.08
|
| Rate for Payer: Networks By Design Commercial |
$182.06
|
| Rate for Payer: Prime Health Services Commercial |
$238.08
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$168.06
|
| Rate for Payer: Riverside University Health MISP |
$112.04
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$168.06
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$168.06
|
| Rate for Payer: United Healthcare All Other Commercial |
$140.05
|
| Rate for Payer: United Healthcare All Other HMO |
$140.05
|
| Rate for Payer: United Healthcare HMO Rider |
$140.05
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$140.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$238.08
|
| Rate for Payer: Vantage Medical Group Senior |
$238.08
|
|
|
HC SOM CHLORDIAZEPOXIDE (LIBRIUM)
|
Facility
IP
|
$280.10
|
|
|
Service Code
|
CPT 80346
|
| Hospital Charge Code |
900911081
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$56.02 |
| Max. Negotiated Rate |
$252.09 |
| Rate for Payer: Cash Price |
$126.05
|
| Rate for Payer: Central Health Plan Commercial |
$224.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$112.04
|
| Rate for Payer: Galaxy Health WC |
$238.08
|
| Rate for Payer: Global Benefits Group Commercial |
$168.06
|
| Rate for Payer: Health Management Network EPO/PPO |
$252.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$186.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$56.02
|
| Rate for Payer: Multiplan Commercial |
$210.08
|
| Rate for Payer: Networks By Design Commercial |
$182.06
|
| Rate for Payer: Prime Health Services Commercial |
$238.08
|
|
|
HC SOM CHLORIDE BF
|
Facility
OP
|
$7.01
|
|
|
Service Code
|
CPT 82438
|
| Hospital Charge Code |
900914683
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$1.40 |
| Max. Negotiated Rate |
$43.37 |
| Rate for Payer: Adventist Health Medi-Cal |
$5.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$35.89
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$7.50
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$5.50
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$5.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$35.56
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$43.37
|
| Rate for Payer: BCBS Transplant Transplant |
$4.21
|
| Rate for Payer: Blue Shield of California Commercial |
$4.33
|
| Rate for Payer: Blue Shield of California EPN |
$3.41
|
| Rate for Payer: Caremore Medicare Advantage |
$5.00
|
| Rate for Payer: Cash Price |
$3.15
|
| Rate for Payer: Cash Price |
$3.15
|
| Rate for Payer: Central Health Plan Commercial |
$5.61
|
| Rate for Payer: Cigna of CA HMO |
$4.49
|
| Rate for Payer: Cigna of CA PPO |
$5.19
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.75
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$5.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$5.00
|
| Rate for Payer: Galaxy Health WC |
$5.96
|
| Rate for Payer: Global Benefits Group Commercial |
$4.21
|
| Rate for Payer: Health Management Network EPO/PPO |
$6.31
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$5.26
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$8.20
|
| Rate for Payer: IEHP medi-cal |
$8.25
|
| Rate for Payer: IEHP Medicare Advantage |
$5.00
|
| Rate for Payer: Innovage PACE Commercial |
$7.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.70
|
| Rate for Payer: Multiplan Commercial |
$5.26
|
| Rate for Payer: Networks By Design Commercial |
$4.56
|
| Rate for Payer: Prime Health Services Commercial |
$5.96
|
| Rate for Payer: Prime Health Services Medicare |
$5.30
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$4.21
|
| Rate for Payer: Riverside University Health MISP |
$5.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4.21
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4.21
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.05
|
| Rate for Payer: United Healthcare All Other HMO |
$4.05
|
| Rate for Payer: United Healthcare HMO Rider |
$4.05
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.50
|
| Rate for Payer: Vantage Medical Group Senior |
$5.00
|
|
|
HC SOM CHLORIDE BF
|
Facility
IP
|
$7.01
|
|
|
Service Code
|
CPT 82438
|
| Hospital Charge Code |
900914683
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$1.40 |
| Max. Negotiated Rate |
$6.31 |
| Rate for Payer: Cash Price |
$3.15
|
| Rate for Payer: Central Health Plan Commercial |
$5.61
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.80
|
| Rate for Payer: Galaxy Health WC |
$5.96
|
| Rate for Payer: Global Benefits Group Commercial |
$4.21
|
| Rate for Payer: Health Management Network EPO/PPO |
$6.31
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.40
|
| Rate for Payer: Multiplan Commercial |
$5.26
|
| Rate for Payer: Networks By Design Commercial |
$4.56
|
| Rate for Payer: Prime Health Services Commercial |
$5.96
|
|
|
HC SOM CHOLESTEROL BF
|
Facility
IP
|
$165.00
|
|
|
Service Code
|
CPT 84311
|
| Hospital Charge Code |
900914682
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$33.00 |
| Max. Negotiated Rate |
$148.50 |
| Rate for Payer: Cash Price |
$74.25
|
| Rate for Payer: Central Health Plan Commercial |
$132.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$66.00
|
| Rate for Payer: Galaxy Health WC |
$140.25
|
| Rate for Payer: Global Benefits Group Commercial |
$99.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$148.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$110.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$33.00
|
| Rate for Payer: Multiplan Commercial |
$123.75
|
| Rate for Payer: Networks By Design Commercial |
$107.25
|
| Rate for Payer: Prime Health Services Commercial |
$140.25
|
|
|
HC SOM CHOLESTEROL BF
|
Facility
OP
|
$165.00
|
|
|
Service Code
|
CPT 84311
|
| Hospital Charge Code |
900914682
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.56 |
| Max. Negotiated Rate |
$148.50 |
| Rate for Payer: Adventist Health Medi-Cal |
$8.10
|
| Rate for Payer: Aetna of CA HMO/PPO |
$51.29
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$12.15
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$8.91
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$8.10
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$50.89
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$62.07
|
| Rate for Payer: BCBS Transplant Transplant |
$99.00
|
| Rate for Payer: Blue Shield of California Commercial |
$101.97
|
| Rate for Payer: Blue Shield of California EPN |
$80.19
|
| Rate for Payer: Caremore Medicare Advantage |
$8.10
|
| Rate for Payer: Cash Price |
$74.25
|
| Rate for Payer: Cash Price |
$74.25
|
| Rate for Payer: Central Health Plan Commercial |
$132.00
|
| Rate for Payer: Cigna of CA HMO |
$105.60
|
| Rate for Payer: Cigna of CA PPO |
$122.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.94
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$8.10
|
| Rate for Payer: EPIC Health Plan Transplant |
$8.10
|
| Rate for Payer: Galaxy Health WC |
$140.25
|
| Rate for Payer: Global Benefits Group Commercial |
$99.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$148.50
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$123.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$13.28
|
| Rate for Payer: IEHP medi-cal |
$13.36
|
| Rate for Payer: IEHP Medicare Advantage |
$8.10
|
| Rate for Payer: Innovage PACE Commercial |
$12.15
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$110.06
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$33.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.85
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10.85
|
| Rate for Payer: Multiplan Commercial |
$123.75
|
| Rate for Payer: Networks By Design Commercial |
$107.25
|
| Rate for Payer: Prime Health Services Commercial |
$140.25
|
| Rate for Payer: Prime Health Services Medicare |
$8.59
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$99.00
|
| Rate for Payer: Riverside University Health MISP |
$8.91
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$99.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$99.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.56
|
| Rate for Payer: United Healthcare All Other HMO |
$6.56
|
| Rate for Payer: United Healthcare HMO Rider |
$6.56
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.56
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.91
|
| Rate for Payer: Vantage Medical Group Senior |
$8.10
|
|
|
HC SOM CHOLINESTERASE PSEUDO
|
Facility
OP
|
$107.03
|
|
|
Service Code
|
CPT 82480
|
| Hospital Charge Code |
900911160
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.37 |
| Max. Negotiated Rate |
$96.33 |
| Rate for Payer: Adventist Health Medi-Cal |
$7.87
|
| Rate for Payer: Aetna of CA HMO/PPO |
$57.86
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$11.80
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$8.66
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$7.87
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$57.30
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$69.90
|
| Rate for Payer: BCBS Transplant Transplant |
$64.22
|
| Rate for Payer: Blue Shield of California Commercial |
$66.14
|
| Rate for Payer: Blue Shield of California EPN |
$52.02
|
| Rate for Payer: Caremore Medicare Advantage |
$7.87
|
| Rate for Payer: Cash Price |
$48.16
|
| Rate for Payer: Cash Price |
$48.16
|
| Rate for Payer: Central Health Plan Commercial |
$85.62
|
| Rate for Payer: Cigna of CA HMO |
$68.50
|
| Rate for Payer: Cigna of CA PPO |
$79.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.62
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$7.87
|
| Rate for Payer: EPIC Health Plan Transplant |
$7.87
|
| Rate for Payer: Galaxy Health WC |
$90.98
|
| Rate for Payer: Global Benefits Group Commercial |
$64.22
|
| Rate for Payer: Health Management Network EPO/PPO |
$96.33
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$80.27
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$12.91
|
| Rate for Payer: IEHP medi-cal |
$12.99
|
| Rate for Payer: IEHP Medicare Advantage |
$7.87
|
| Rate for Payer: Innovage PACE Commercial |
$11.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$71.39
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$21.41
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.55
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10.55
|
| Rate for Payer: Multiplan Commercial |
$80.27
|
| Rate for Payer: Networks By Design Commercial |
$69.57
|
| Rate for Payer: Prime Health Services Commercial |
$90.98
|
| Rate for Payer: Prime Health Services Medicare |
$8.34
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$64.22
|
| Rate for Payer: Riverside University Health MISP |
$8.66
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$64.22
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$64.22
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.37
|
| Rate for Payer: United Healthcare All Other HMO |
$6.37
|
| Rate for Payer: United Healthcare HMO Rider |
$6.37
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.37
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.66
|
| Rate for Payer: Vantage Medical Group Senior |
$7.87
|
|
|
HC SOM CHOLINESTERASE PSEUDO
|
Facility
IP
|
$107.03
|
|
|
Service Code
|
CPT 82480
|
| Hospital Charge Code |
900911160
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$21.41 |
| Max. Negotiated Rate |
$96.33 |
| Rate for Payer: Cash Price |
$48.16
|
| Rate for Payer: Central Health Plan Commercial |
$85.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$42.81
|
| Rate for Payer: Galaxy Health WC |
$90.98
|
| Rate for Payer: Global Benefits Group Commercial |
$64.22
|
| Rate for Payer: Health Management Network EPO/PPO |
$96.33
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$71.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$21.41
|
| Rate for Payer: Multiplan Commercial |
$80.27
|
| Rate for Payer: Networks By Design Commercial |
$69.57
|
| Rate for Payer: Prime Health Services Commercial |
$90.98
|
|
|
HC SOM CHRAF CULTURE 03
|
Facility
IP
|
$137.52
|
|
|
Service Code
|
CPT 88235
|
| Hospital Charge Code |
900915285
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$27.50 |
| Max. Negotiated Rate |
$123.77 |
| Rate for Payer: Cash Price |
$61.88
|
| Rate for Payer: Central Health Plan Commercial |
$110.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$55.01
|
| Rate for Payer: Galaxy Health WC |
$116.89
|
| Rate for Payer: Global Benefits Group Commercial |
$82.51
|
| Rate for Payer: Health Management Network EPO/PPO |
$123.77
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$91.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27.50
|
| Rate for Payer: Multiplan Commercial |
$103.14
|
| Rate for Payer: Networks By Design Commercial |
$89.39
|
| Rate for Payer: Prime Health Services Commercial |
$116.89
|
|
|
HC SOM CHRAF CULTURE 03
|
Facility
OP
|
$137.52
|
|
|
Service Code
|
CPT 88235
|
| Hospital Charge Code |
900915285
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$27.50 |
| Max. Negotiated Rate |
$12,174.30 |
| Rate for Payer: Adventist Health Medi-Cal |
$150.30
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,080.74
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$225.45
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$165.33
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$150.30
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$803.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$979.74
|
| Rate for Payer: BCBS Transplant Transplant |
$82.51
|
| Rate for Payer: Blue Shield of California Commercial |
$84.99
|
| Rate for Payer: Blue Shield of California EPN |
$66.83
|
| Rate for Payer: Caremore Medicare Advantage |
$150.30
|
| Rate for Payer: Cash Price |
$61.88
|
| Rate for Payer: Cash Price |
$61.88
|
| Rate for Payer: Central Health Plan Commercial |
$110.02
|
| Rate for Payer: Cigna of CA HMO |
$88.01
|
| Rate for Payer: Cigna of CA PPO |
$101.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$225.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$202.90
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$150.30
|
| Rate for Payer: EPIC Health Plan Transplant |
$150.30
|
| Rate for Payer: Galaxy Health WC |
$116.89
|
| Rate for Payer: Global Benefits Group Commercial |
$82.51
|
| Rate for Payer: Health Management Network EPO/PPO |
$123.77
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$103.14
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$246.49
|
| Rate for Payer: IEHP medi-cal |
$248.00
|
| Rate for Payer: IEHP Medicare Advantage |
$150.30
|
| Rate for Payer: Innovage PACE Commercial |
$225.45
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$91.73
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$150.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$201.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$201.40
|
| Rate for Payer: Multiplan Commercial |
$103.14
|
| Rate for Payer: Networks By Design Commercial |
$89.39
|
| Rate for Payer: Prime Health Services Commercial |
$116.89
|
| Rate for Payer: Prime Health Services Medicare |
$159.32
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$82.51
|
| Rate for Payer: Riverside University Health MISP |
$165.33
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$82.51
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$82.51
|
| Rate for Payer: United Healthcare All Other Commercial |
$121.74
|
| Rate for Payer: United Healthcare All Other HMO |
$121.74
|
| Rate for Payer: United Healthcare HMO Rider |
$121.74
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$12,174.30
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$225.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$165.33
|
| Rate for Payer: Vantage Medical Group Senior |
$150.30
|
|
|
HC SOM CHRBM CULTURE 04
|
Facility
OP
|
$101.87
|
|
|
Service Code
|
CPT 88237
|
| Hospital Charge Code |
900915318
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$20.37 |
| Max. Negotiated Rate |
$11,644.20 |
| Rate for Payer: Adventist Health Medi-Cal |
$143.75
|
| Rate for Payer: Aetna of CA HMO/PPO |
$926.98
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$215.62
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$158.12
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$143.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$780.06
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$951.48
|
| Rate for Payer: BCBS Transplant Transplant |
$61.12
|
| Rate for Payer: Blue Shield of California Commercial |
$62.96
|
| Rate for Payer: Blue Shield of California EPN |
$49.51
|
| Rate for Payer: Caremore Medicare Advantage |
$143.75
|
| Rate for Payer: Cash Price |
$45.84
|
| Rate for Payer: Cash Price |
$45.84
|
| Rate for Payer: Central Health Plan Commercial |
$81.50
|
| Rate for Payer: Cigna of CA HMO |
$65.20
|
| Rate for Payer: Cigna of CA PPO |
$75.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$215.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$194.06
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$143.75
|
| Rate for Payer: EPIC Health Plan Transplant |
$143.75
|
| Rate for Payer: Galaxy Health WC |
$86.59
|
| Rate for Payer: Global Benefits Group Commercial |
$61.12
|
| Rate for Payer: Health Management Network EPO/PPO |
$91.68
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$76.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$235.75
|
| Rate for Payer: IEHP medi-cal |
$237.19
|
| Rate for Payer: IEHP Medicare Advantage |
$143.75
|
| Rate for Payer: Innovage PACE Commercial |
$215.62
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$67.95
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$143.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.37
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$192.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$192.62
|
| Rate for Payer: Multiplan Commercial |
$76.40
|
| Rate for Payer: Networks By Design Commercial |
$66.22
|
| Rate for Payer: Prime Health Services Commercial |
$86.59
|
| Rate for Payer: Prime Health Services Medicare |
$152.38
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$61.12
|
| Rate for Payer: Riverside University Health MISP |
$158.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$61.12
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$61.12
|
| Rate for Payer: United Healthcare All Other Commercial |
$116.44
|
| Rate for Payer: United Healthcare All Other HMO |
$116.44
|
| Rate for Payer: United Healthcare HMO Rider |
$116.44
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,644.20
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$215.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$158.12
|
| Rate for Payer: Vantage Medical Group Senior |
$143.75
|
|
|
HC SOM CHRBM CULTURE 04
|
Facility
IP
|
$101.87
|
|
|
Service Code
|
CPT 88237
|
| Hospital Charge Code |
900915318
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$20.37 |
| Max. Negotiated Rate |
$91.68 |
| Rate for Payer: Cash Price |
$45.84
|
| Rate for Payer: Central Health Plan Commercial |
$81.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$40.75
|
| Rate for Payer: Galaxy Health WC |
$86.59
|
| Rate for Payer: Global Benefits Group Commercial |
$61.12
|
| Rate for Payer: Health Management Network EPO/PPO |
$91.68
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$67.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.37
|
| Rate for Payer: Multiplan Commercial |
$76.40
|
| Rate for Payer: Networks By Design Commercial |
$66.22
|
| Rate for Payer: Prime Health Services Commercial |
$86.59
|
|
|
HC SOM CHRCB CULTURE 01
|
Facility
OP
|
$89.11
|
|
|
Service Code
|
CPT 88230
|
| Hospital Charge Code |
900915319
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$17.82 |
| Max. Negotiated Rate |
$9,435.60 |
| Rate for Payer: Adventist Health Medi-Cal |
$116.49
|
| Rate for Payer: Aetna of CA HMO/PPO |
$855.01
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$174.74
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$128.14
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$116.49
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$719.52
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$877.64
|
| Rate for Payer: BCBS Transplant Transplant |
$53.47
|
| Rate for Payer: Blue Shield of California Commercial |
$55.07
|
| Rate for Payer: Blue Shield of California EPN |
$43.31
|
| Rate for Payer: Caremore Medicare Advantage |
$116.49
|
| Rate for Payer: Cash Price |
$40.10
|
| Rate for Payer: Cash Price |
$40.10
|
| Rate for Payer: Central Health Plan Commercial |
$71.29
|
| Rate for Payer: Cigna of CA HMO |
$57.03
|
| Rate for Payer: Cigna of CA PPO |
$65.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$174.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$157.26
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$116.49
|
| Rate for Payer: EPIC Health Plan Transplant |
$116.49
|
| Rate for Payer: Galaxy Health WC |
$75.74
|
| Rate for Payer: Global Benefits Group Commercial |
$53.47
|
| Rate for Payer: Health Management Network EPO/PPO |
$80.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$66.83
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$191.04
|
| Rate for Payer: IEHP medi-cal |
$192.21
|
| Rate for Payer: IEHP Medicare Advantage |
$116.49
|
| Rate for Payer: Innovage PACE Commercial |
$174.74
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$59.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$116.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$17.82
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$156.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$156.10
|
| Rate for Payer: Multiplan Commercial |
$66.83
|
| Rate for Payer: Networks By Design Commercial |
$57.92
|
| Rate for Payer: Prime Health Services Commercial |
$75.74
|
| Rate for Payer: Prime Health Services Medicare |
$123.48
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$53.47
|
| Rate for Payer: Riverside University Health MISP |
$128.14
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$53.47
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$53.47
|
| Rate for Payer: United Healthcare All Other Commercial |
$94.36
|
| Rate for Payer: United Healthcare All Other HMO |
$94.36
|
| Rate for Payer: United Healthcare HMO Rider |
$94.36
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9,435.60
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$174.74
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$128.14
|
| Rate for Payer: Vantage Medical Group Senior |
$116.49
|
|
|
HC SOM CHRCB CULTURE 01
|
Facility
IP
|
$89.11
|
|
|
Service Code
|
CPT 88230
|
| Hospital Charge Code |
900915319
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$17.82 |
| Max. Negotiated Rate |
$80.20 |
| Rate for Payer: Cash Price |
$40.10
|
| Rate for Payer: Central Health Plan Commercial |
$71.29
|
| Rate for Payer: EPIC Health Plan Commercial |
$35.64
|
| Rate for Payer: Galaxy Health WC |
$75.74
|
| Rate for Payer: Global Benefits Group Commercial |
$53.47
|
| Rate for Payer: Health Management Network EPO/PPO |
$80.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$59.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$17.82
|
| Rate for Payer: Multiplan Commercial |
$66.83
|
| Rate for Payer: Networks By Design Commercial |
$57.92
|
| Rate for Payer: Prime Health Services Commercial |
$75.74
|
|
|
HC SOM CHRCV CULTURE 03
|
Facility
OP
|
$354.50
|
|
|
Service Code
|
CPT 88235
|
| Hospital Charge Code |
900915316
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$70.90 |
| Max. Negotiated Rate |
$12,174.30 |
| Rate for Payer: Adventist Health Medi-Cal |
$150.30
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,080.74
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$225.45
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$165.33
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$150.30
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$803.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$979.74
|
| Rate for Payer: BCBS Transplant Transplant |
$212.70
|
| Rate for Payer: Blue Shield of California Commercial |
$219.08
|
| Rate for Payer: Blue Shield of California EPN |
$172.29
|
| Rate for Payer: Caremore Medicare Advantage |
$150.30
|
| Rate for Payer: Cash Price |
$159.53
|
| Rate for Payer: Cash Price |
$159.53
|
| Rate for Payer: Central Health Plan Commercial |
$283.60
|
| Rate for Payer: Cigna of CA HMO |
$226.88
|
| Rate for Payer: Cigna of CA PPO |
$262.33
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$225.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$202.90
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$150.30
|
| Rate for Payer: EPIC Health Plan Transplant |
$150.30
|
| Rate for Payer: Galaxy Health WC |
$301.32
|
| Rate for Payer: Global Benefits Group Commercial |
$212.70
|
| Rate for Payer: Health Management Network EPO/PPO |
$319.05
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$265.88
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$246.49
|
| Rate for Payer: IEHP medi-cal |
$248.00
|
| Rate for Payer: IEHP Medicare Advantage |
$150.30
|
| Rate for Payer: Innovage PACE Commercial |
$225.45
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$236.45
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$150.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$70.90
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$201.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$201.40
|
| Rate for Payer: Multiplan Commercial |
$265.88
|
| Rate for Payer: Networks By Design Commercial |
$230.42
|
| Rate for Payer: Prime Health Services Commercial |
$301.32
|
| Rate for Payer: Prime Health Services Medicare |
$159.32
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$212.70
|
| Rate for Payer: Riverside University Health MISP |
$165.33
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$212.70
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$212.70
|
| Rate for Payer: United Healthcare All Other Commercial |
$121.74
|
| Rate for Payer: United Healthcare All Other HMO |
$121.74
|
| Rate for Payer: United Healthcare HMO Rider |
$121.74
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$12,174.30
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$225.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$165.33
|
| Rate for Payer: Vantage Medical Group Senior |
$150.30
|
|
