|
HC SOM CHRCV CULTURE 03
|
Facility
IP
|
$354.50
|
|
|
Service Code
|
CPT 88235
|
| Hospital Charge Code |
900915316
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$70.90 |
| Max. Negotiated Rate |
$319.05 |
| Rate for Payer: Cash Price |
$159.53
|
| Rate for Payer: Central Health Plan Commercial |
$283.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$141.80
|
| 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: Kaiser Permanente of CA Commercial/Self Funded |
$236.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$70.90
|
| 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
|
|
|
HC SOM CHRHB CULTURE 04
|
Facility
IP
|
$159.32
|
|
|
Service Code
|
CPT 88237
|
| Hospital Charge Code |
900915287
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$31.86 |
| Max. Negotiated Rate |
$143.39 |
| Rate for Payer: Cash Price |
$71.69
|
| Rate for Payer: Central Health Plan Commercial |
$127.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$63.73
|
| Rate for Payer: Galaxy Health WC |
$135.42
|
| Rate for Payer: Global Benefits Group Commercial |
$95.59
|
| Rate for Payer: Health Management Network EPO/PPO |
$143.39
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$106.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$31.86
|
| Rate for Payer: Multiplan Commercial |
$119.49
|
| Rate for Payer: Networks By Design Commercial |
$103.56
|
| Rate for Payer: Prime Health Services Commercial |
$135.42
|
|
|
HC SOM CHRHB CULTURE 04
|
Facility
OP
|
$159.32
|
|
|
Service Code
|
CPT 88237
|
| Hospital Charge Code |
900915287
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$31.86 |
| 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 |
$95.59
|
| Rate for Payer: Blue Shield of California Commercial |
$98.46
|
| Rate for Payer: Blue Shield of California EPN |
$77.43
|
| Rate for Payer: Caremore Medicare Advantage |
$143.75
|
| Rate for Payer: Cash Price |
$71.69
|
| Rate for Payer: Cash Price |
$71.69
|
| Rate for Payer: Central Health Plan Commercial |
$127.46
|
| Rate for Payer: Cigna of CA HMO |
$101.96
|
| Rate for Payer: Cigna of CA PPO |
$117.90
|
| 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 |
$135.42
|
| Rate for Payer: Global Benefits Group Commercial |
$95.59
|
| Rate for Payer: Health Management Network EPO/PPO |
$143.39
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$119.49
|
| 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 |
$106.27
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$143.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$31.86
|
| 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 |
$119.49
|
| Rate for Payer: Networks By Design Commercial |
$103.56
|
| Rate for Payer: Prime Health Services Commercial |
$135.42
|
| Rate for Payer: Prime Health Services Medicare |
$152.38
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$95.59
|
| Rate for Payer: Riverside University Health MISP |
$158.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$95.59
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$95.59
|
| 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 CHRLN CULTURE 04
|
Facility
OP
|
$178.44
|
|
|
Service Code
|
CPT 88239
|
| Hospital Charge Code |
900915317
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$35.69 |
| Max. Negotiated Rate |
$11,949.30 |
| Rate for Payer: Adventist Health Medi-Cal |
$147.52
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,082.71
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$221.28
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$162.27
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$147.52
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,038.51
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,266.73
|
| Rate for Payer: BCBS Transplant Transplant |
$107.06
|
| Rate for Payer: Blue Shield of California Commercial |
$110.28
|
| Rate for Payer: Blue Shield of California EPN |
$86.72
|
| Rate for Payer: Caremore Medicare Advantage |
$147.52
|
| Rate for Payer: Cash Price |
$80.30
|
| Rate for Payer: Cash Price |
$80.30
|
| Rate for Payer: Central Health Plan Commercial |
$142.75
|
| Rate for Payer: Cigna of CA HMO |
$114.20
|
| Rate for Payer: Cigna of CA PPO |
$132.05
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$221.28
|
| Rate for Payer: EPIC Health Plan Commercial |
$199.15
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$147.52
|
| Rate for Payer: EPIC Health Plan Transplant |
$147.52
|
| Rate for Payer: Galaxy Health WC |
$151.67
|
| Rate for Payer: Global Benefits Group Commercial |
$107.06
|
| Rate for Payer: Health Management Network EPO/PPO |
$160.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$133.83
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$241.93
|
| Rate for Payer: IEHP medi-cal |
$243.41
|
| Rate for Payer: IEHP Medicare Advantage |
$147.52
|
| Rate for Payer: Innovage PACE Commercial |
$221.28
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$119.02
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$147.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$35.69
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$197.68
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$197.68
|
| Rate for Payer: Multiplan Commercial |
$133.83
|
| Rate for Payer: Networks By Design Commercial |
$115.99
|
| Rate for Payer: Prime Health Services Commercial |
$151.67
|
| Rate for Payer: Prime Health Services Medicare |
$156.37
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$107.06
|
| Rate for Payer: Riverside University Health MISP |
$162.27
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$107.06
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$107.06
|
| Rate for Payer: United Healthcare All Other Commercial |
$119.49
|
| Rate for Payer: United Healthcare All Other HMO |
$119.49
|
| Rate for Payer: United Healthcare HMO Rider |
$119.49
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,949.30
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$221.28
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$162.27
|
| Rate for Payer: Vantage Medical Group Senior |
$147.52
|
|
|
HC SOM CHRLN CULTURE 04
|
Facility
IP
|
$178.44
|
|
|
Service Code
|
CPT 88239
|
| Hospital Charge Code |
900915317
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$35.69 |
| Max. Negotiated Rate |
$160.60 |
| Rate for Payer: Cash Price |
$80.30
|
| Rate for Payer: Central Health Plan Commercial |
$142.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$71.38
|
| Rate for Payer: Galaxy Health WC |
$151.67
|
| Rate for Payer: Global Benefits Group Commercial |
$107.06
|
| Rate for Payer: Health Management Network EPO/PPO |
$160.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$119.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$35.69
|
| Rate for Payer: Multiplan Commercial |
$133.83
|
| Rate for Payer: Networks By Design Commercial |
$115.99
|
| Rate for Payer: Prime Health Services Commercial |
$151.67
|
|
|
HC SOM CHROMIUM
|
Facility
OP
|
$25.00
|
|
|
Service Code
|
CPT 82495
|
| Hospital Charge Code |
900911190
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.00 |
| Max. Negotiated Rate |
$179.94 |
| Rate for Payer: Adventist Health Medi-Cal |
$20.28
|
| Rate for Payer: Aetna of CA HMO/PPO |
$148.85
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$30.42
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$22.31
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$20.28
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$147.52
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$179.94
|
| 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 |
$20.28
|
| 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 |
$30.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$27.38
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$20.28
|
| Rate for Payer: EPIC Health Plan Transplant |
$20.28
|
| 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 |
$33.26
|
| Rate for Payer: IEHP medi-cal |
$33.46
|
| Rate for Payer: IEHP Medicare Advantage |
$20.28
|
| Rate for Payer: Innovage PACE Commercial |
$30.42
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$20.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$27.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$27.18
|
| 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 |
$21.50
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$15.00
|
| Rate for Payer: Riverside University Health MISP |
$22.31
|
| 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 |
$16.42
|
| Rate for Payer: United Healthcare All Other HMO |
$16.42
|
| Rate for Payer: United Healthcare HMO Rider |
$16.42
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16.42
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$30.42
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$22.31
|
| Rate for Payer: Vantage Medical Group Senior |
$20.28
|
|
|
HC SOM CHROMIUM
|
Facility
IP
|
$25.00
|
|
|
Service Code
|
CPT 82495
|
| Hospital Charge Code |
900911190
|
|
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 CHROMIUM URINE
|
Facility
IP
|
$214.60
|
|
|
Service Code
|
CPT 82495
|
| Hospital Charge Code |
900910731
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$42.92 |
| Max. Negotiated Rate |
$193.14 |
| Rate for Payer: Cash Price |
$96.57
|
| Rate for Payer: Central Health Plan Commercial |
$171.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$85.84
|
| Rate for Payer: Galaxy Health WC |
$182.41
|
| Rate for Payer: Global Benefits Group Commercial |
$128.76
|
| Rate for Payer: Health Management Network EPO/PPO |
$193.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$143.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$42.92
|
| Rate for Payer: Multiplan Commercial |
$160.95
|
| Rate for Payer: Networks By Design Commercial |
$139.49
|
| Rate for Payer: Prime Health Services Commercial |
$182.41
|
|
|
HC SOM CHROMIUM URINE
|
Facility
OP
|
$214.60
|
|
|
Service Code
|
CPT 82495
|
| Hospital Charge Code |
900910731
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$16.42 |
| Max. Negotiated Rate |
$193.14 |
| Rate for Payer: Adventist Health Medi-Cal |
$20.28
|
| Rate for Payer: Aetna of CA HMO/PPO |
$148.85
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$30.42
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$22.31
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$20.28
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$147.52
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$179.94
|
| Rate for Payer: BCBS Transplant Transplant |
$128.76
|
| Rate for Payer: Blue Shield of California Commercial |
$132.62
|
| Rate for Payer: Blue Shield of California EPN |
$104.30
|
| Rate for Payer: Caremore Medicare Advantage |
$20.28
|
| Rate for Payer: Cash Price |
$96.57
|
| Rate for Payer: Cash Price |
$96.57
|
| Rate for Payer: Central Health Plan Commercial |
$171.68
|
| Rate for Payer: Cigna of CA HMO |
$137.34
|
| Rate for Payer: Cigna of CA PPO |
$158.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$30.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$27.38
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$20.28
|
| Rate for Payer: EPIC Health Plan Transplant |
$20.28
|
| Rate for Payer: Galaxy Health WC |
$182.41
|
| Rate for Payer: Global Benefits Group Commercial |
$128.76
|
| Rate for Payer: Health Management Network EPO/PPO |
$193.14
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$160.95
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$33.26
|
| Rate for Payer: IEHP medi-cal |
$33.46
|
| Rate for Payer: IEHP Medicare Advantage |
$20.28
|
| Rate for Payer: Innovage PACE Commercial |
$30.42
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$143.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$20.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$42.92
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$27.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$27.18
|
| Rate for Payer: Multiplan Commercial |
$160.95
|
| Rate for Payer: Networks By Design Commercial |
$139.49
|
| Rate for Payer: Prime Health Services Commercial |
$182.41
|
| Rate for Payer: Prime Health Services Medicare |
$21.50
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$128.76
|
| Rate for Payer: Riverside University Health MISP |
$22.31
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$128.76
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$128.76
|
| Rate for Payer: United Healthcare All Other Commercial |
$16.42
|
| Rate for Payer: United Healthcare All Other HMO |
$16.42
|
| Rate for Payer: United Healthcare HMO Rider |
$16.42
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16.42
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$30.42
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$22.31
|
| Rate for Payer: Vantage Medical Group Senior |
$20.28
|
|
|
HC SOM CHROMOGRANIN A
|
Facility
IP
|
$17.65
|
|
|
Service Code
|
CPT 86316
|
| Hospital Charge Code |
900911458
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.53 |
| Max. Negotiated Rate |
$15.88 |
| Rate for Payer: Cash Price |
$7.94
|
| Rate for Payer: Central Health Plan Commercial |
$14.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.06
|
| Rate for Payer: Galaxy Health WC |
$15.00
|
| Rate for Payer: Global Benefits Group Commercial |
$10.59
|
| Rate for Payer: Health Management Network EPO/PPO |
$15.88
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.53
|
| Rate for Payer: Multiplan Commercial |
$13.24
|
| Rate for Payer: Networks By Design Commercial |
$11.47
|
| Rate for Payer: Prime Health Services Commercial |
$15.00
|
|
|
HC SOM CHROMOGRANIN A
|
Facility
OP
|
$17.65
|
|
|
Service Code
|
CPT 86316
|
| Hospital Charge Code |
900911458
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.53 |
| Max. Negotiated Rate |
$184.66 |
| Rate for Payer: Adventist Health Medi-Cal |
$20.81
|
| Rate for Payer: Aetna of CA HMO/PPO |
$152.78
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$31.22
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$22.89
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$20.81
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$151.39
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$184.66
|
| Rate for Payer: BCBS Transplant Transplant |
$10.59
|
| Rate for Payer: Blue Shield of California Commercial |
$10.91
|
| Rate for Payer: Blue Shield of California EPN |
$8.58
|
| Rate for Payer: Caremore Medicare Advantage |
$20.81
|
| Rate for Payer: Cash Price |
$7.94
|
| Rate for Payer: Cash Price |
$7.94
|
| Rate for Payer: Central Health Plan Commercial |
$14.12
|
| Rate for Payer: Cigna of CA HMO |
$11.30
|
| Rate for Payer: Cigna of CA PPO |
$13.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$31.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$28.09
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$20.81
|
| Rate for Payer: EPIC Health Plan Transplant |
$20.81
|
| Rate for Payer: Galaxy Health WC |
$15.00
|
| Rate for Payer: Global Benefits Group Commercial |
$10.59
|
| Rate for Payer: Health Management Network EPO/PPO |
$15.88
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$13.24
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$34.13
|
| Rate for Payer: IEHP medi-cal |
$34.34
|
| Rate for Payer: IEHP Medicare Advantage |
$20.81
|
| Rate for Payer: Innovage PACE Commercial |
$31.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11.77
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$20.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.53
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$27.89
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$27.89
|
| Rate for Payer: Multiplan Commercial |
$13.24
|
| Rate for Payer: Networks By Design Commercial |
$11.47
|
| Rate for Payer: Prime Health Services Commercial |
$15.00
|
| Rate for Payer: Prime Health Services Medicare |
$22.06
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$10.59
|
| Rate for Payer: Riverside University Health MISP |
$22.89
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10.59
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$10.59
|
| Rate for Payer: United Healthcare All Other Commercial |
$16.86
|
| Rate for Payer: United Healthcare All Other HMO |
$16.86
|
| Rate for Payer: United Healthcare HMO Rider |
$16.86
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16.86
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$31.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$22.89
|
| Rate for Payer: Vantage Medical Group Senior |
$20.81
|
|
|
HC SOM CHROMOSOMAL MICROARRAY
|
Facility
IP
|
$950.00
|
|
|
Service Code
|
CPT 81229
|
| Hospital Charge Code |
900914668
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$190.00 |
| Max. Negotiated Rate |
$855.00 |
| Rate for Payer: Cash Price |
$427.50
|
| Rate for Payer: Central Health Plan Commercial |
$760.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$380.00
|
| Rate for Payer: Galaxy Health WC |
$807.50
|
| Rate for Payer: Global Benefits Group Commercial |
$570.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$855.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$633.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$190.00
|
| Rate for Payer: Multiplan Commercial |
$712.50
|
| Rate for Payer: Networks By Design Commercial |
$617.50
|
| Rate for Payer: Prime Health Services Commercial |
$807.50
|
|
|
HC SOM CHROMOSOMAL MICROARRAY
|
Facility
OP
|
$950.00
|
|
|
Service Code
|
CPT 81229
|
| Hospital Charge Code |
900914668
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$85.76 |
| Max. Negotiated Rate |
$1,914.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$1,160.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,126.51
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,740.00
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1,276.00
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1,160.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$85.76
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$104.60
|
| Rate for Payer: BCBS Transplant Transplant |
$570.00
|
| Rate for Payer: Blue Shield of California Commercial |
$587.10
|
| Rate for Payer: Blue Shield of California EPN |
$461.70
|
| Rate for Payer: Caremore Medicare Advantage |
$1,160.00
|
| Rate for Payer: Cash Price |
$427.50
|
| Rate for Payer: Cash Price |
$427.50
|
| Rate for Payer: Central Health Plan Commercial |
$760.00
|
| Rate for Payer: Cigna of CA HMO |
$608.00
|
| Rate for Payer: Cigna of CA PPO |
$703.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,740.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,566.00
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,160.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,160.00
|
| Rate for Payer: Galaxy Health WC |
$807.50
|
| Rate for Payer: Global Benefits Group Commercial |
$570.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$855.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$712.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,902.40
|
| Rate for Payer: IEHP medi-cal |
$1,914.00
|
| Rate for Payer: IEHP Medicare Advantage |
$1,160.00
|
| Rate for Payer: Innovage PACE Commercial |
$1,740.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$633.65
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,160.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$950.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,554.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,554.40
|
| Rate for Payer: Multiplan Commercial |
$712.50
|
| Rate for Payer: Networks By Design Commercial |
$617.50
|
| Rate for Payer: Prime Health Services Commercial |
$807.50
|
| Rate for Payer: Prime Health Services Medicare |
$1,229.60
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$570.00
|
| Rate for Payer: Riverside University Health MISP |
$1,276.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$570.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$570.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$939.60
|
| Rate for Payer: United Healthcare All Other HMO |
$939.60
|
| Rate for Payer: United Healthcare HMO Rider |
$939.60
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$939.60
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,740.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,276.00
|
| Rate for Payer: Vantage Medical Group Senior |
$1,160.00
|
|
|
HC SOM CHROMOSOME ANALYSIS BREAKAGE
|
Facility
IP
|
$243.11
|
|
|
Service Code
|
CPT 88291
|
| Hospital Charge Code |
900912554
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$48.62 |
| Max. Negotiated Rate |
$218.80 |
| Rate for Payer: Cash Price |
$109.40
|
| Rate for Payer: Central Health Plan Commercial |
$194.49
|
| Rate for Payer: EPIC Health Plan Commercial |
$97.24
|
| Rate for Payer: Galaxy Health WC |
$206.64
|
| Rate for Payer: Global Benefits Group Commercial |
$145.87
|
| Rate for Payer: Health Management Network EPO/PPO |
$218.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$162.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$48.62
|
| Rate for Payer: Multiplan Commercial |
$182.33
|
| Rate for Payer: Networks By Design Commercial |
$158.02
|
| Rate for Payer: Prime Health Services Commercial |
$206.64
|
|
|
HC SOM CHROMOSOME ANALYSIS BREAKAGE
|
Facility
OP
|
$243.11
|
|
|
Service Code
|
CPT 88291
|
| Hospital Charge Code |
900912554
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$27.19 |
| Max. Negotiated Rate |
$2,718.90 |
| Rate for Payer: Aetna of CA HMO/PPO |
$155.72
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$206.64
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$133.71
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$133.71
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$135.91
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$165.78
|
| Rate for Payer: BCBS Transplant Transplant |
$145.87
|
| Rate for Payer: Blue Shield of California Commercial |
$150.24
|
| Rate for Payer: Blue Shield of California EPN |
$118.15
|
| Rate for Payer: Cash Price |
$109.40
|
| Rate for Payer: Cash Price |
$109.40
|
| Rate for Payer: Central Health Plan Commercial |
$194.49
|
| Rate for Payer: Cigna of CA HMO |
$155.59
|
| Rate for Payer: Cigna of CA PPO |
$179.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$206.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$97.24
|
| Rate for Payer: EPIC Health Plan Transplant |
$97.24
|
| Rate for Payer: Galaxy Health WC |
$206.64
|
| Rate for Payer: Global Benefits Group Commercial |
$145.87
|
| Rate for Payer: Health Management Network EPO/PPO |
$218.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$182.33
|
| Rate for Payer: IEHP medi-cal |
$85.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$162.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$48.62
|
| Rate for Payer: Multiplan Commercial |
$182.33
|
| Rate for Payer: Networks By Design Commercial |
$158.02
|
| Rate for Payer: Prime Health Services Commercial |
$206.64
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$145.87
|
| Rate for Payer: Riverside University Health MISP |
$97.24
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$145.87
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$145.87
|
| Rate for Payer: United Healthcare All Other Commercial |
$27.19
|
| Rate for Payer: United Healthcare All Other HMO |
$27.19
|
| Rate for Payer: United Healthcare HMO Rider |
$27.19
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,718.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$206.64
|
| Rate for Payer: Vantage Medical Group Senior |
$206.64
|
|
|
HC SOM CHROMOSOME ANALYSIS MARROW
|
Facility
IP
|
$950.00
|
|
|
Service Code
|
CPT 88291
|
| Hospital Charge Code |
900910601
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$190.00 |
| Max. Negotiated Rate |
$855.00 |
| Rate for Payer: Cash Price |
$427.50
|
| Rate for Payer: Central Health Plan Commercial |
$760.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$380.00
|
| Rate for Payer: Galaxy Health WC |
$807.50
|
| Rate for Payer: Global Benefits Group Commercial |
$570.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$855.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$633.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$190.00
|
| Rate for Payer: Multiplan Commercial |
$712.50
|
| Rate for Payer: Networks By Design Commercial |
$617.50
|
| Rate for Payer: Prime Health Services Commercial |
$807.50
|
|
|
HC SOM CHROMOSOME ANALYSIS MARROW
|
Facility
OP
|
$950.00
|
|
|
Service Code
|
CPT 88291
|
| Hospital Charge Code |
900910601
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$27.19 |
| Max. Negotiated Rate |
$2,718.90 |
| Rate for Payer: Aetna of CA HMO/PPO |
$155.72
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$807.50
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$522.50
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$522.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$135.91
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$165.78
|
| Rate for Payer: BCBS Transplant Transplant |
$570.00
|
| Rate for Payer: Blue Shield of California Commercial |
$587.10
|
| Rate for Payer: Blue Shield of California EPN |
$461.70
|
| Rate for Payer: Cash Price |
$427.50
|
| Rate for Payer: Cash Price |
$427.50
|
| Rate for Payer: Central Health Plan Commercial |
$760.00
|
| Rate for Payer: Cigna of CA HMO |
$608.00
|
| Rate for Payer: Cigna of CA PPO |
$703.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$807.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$380.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$380.00
|
| Rate for Payer: Galaxy Health WC |
$807.50
|
| Rate for Payer: Global Benefits Group Commercial |
$570.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$855.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$712.50
|
| Rate for Payer: IEHP medi-cal |
$332.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$633.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$190.00
|
| Rate for Payer: Multiplan Commercial |
$712.50
|
| Rate for Payer: Networks By Design Commercial |
$617.50
|
| Rate for Payer: Prime Health Services Commercial |
$807.50
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$570.00
|
| Rate for Payer: Riverside University Health MISP |
$380.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$570.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$570.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$27.19
|
| Rate for Payer: United Healthcare All Other HMO |
$27.19
|
| Rate for Payer: United Healthcare HMO Rider |
$27.19
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,718.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$807.50
|
| Rate for Payer: Vantage Medical Group Senior |
$807.50
|
|
|
HC SOM CHROMOSOME ANALYSIS WHOLE BLOOD
|
Facility
OP
|
$391.00
|
|
|
Service Code
|
CPT 88291
|
| Hospital Charge Code |
900910752
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$27.19 |
| Max. Negotiated Rate |
$2,718.90 |
| Rate for Payer: Aetna of CA HMO/PPO |
$155.72
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$332.35
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$215.05
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$215.05
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$135.91
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$165.78
|
| Rate for Payer: BCBS Transplant Transplant |
$234.60
|
| Rate for Payer: Blue Shield of California Commercial |
$241.64
|
| Rate for Payer: Blue Shield of California EPN |
$190.03
|
| Rate for Payer: Cash Price |
$175.95
|
| Rate for Payer: Cash Price |
$175.95
|
| Rate for Payer: Central Health Plan Commercial |
$312.80
|
| Rate for Payer: Cigna of CA HMO |
$250.24
|
| Rate for Payer: Cigna of CA PPO |
$289.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$332.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$156.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$156.40
|
| Rate for Payer: Galaxy Health WC |
$332.35
|
| Rate for Payer: Global Benefits Group Commercial |
$234.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$351.90
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$293.25
|
| Rate for Payer: IEHP medi-cal |
$136.85
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$260.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$78.20
|
| Rate for Payer: Multiplan Commercial |
$293.25
|
| Rate for Payer: Networks By Design Commercial |
$254.15
|
| Rate for Payer: Prime Health Services Commercial |
$332.35
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$234.60
|
| Rate for Payer: Riverside University Health MISP |
$156.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$234.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$234.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$27.19
|
| Rate for Payer: United Healthcare All Other HMO |
$27.19
|
| Rate for Payer: United Healthcare HMO Rider |
$27.19
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,718.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$332.35
|
| Rate for Payer: Vantage Medical Group Senior |
$332.35
|
|
|
HC SOM CHROMOSOME ANALYSIS WHOLE BLOOD
|
Facility
IP
|
$391.00
|
|
|
Service Code
|
CPT 88291
|
| Hospital Charge Code |
900910752
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$78.20 |
| Max. Negotiated Rate |
$351.90 |
| Rate for Payer: Cash Price |
$175.95
|
| Rate for Payer: Central Health Plan Commercial |
$312.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$156.40
|
| Rate for Payer: Galaxy Health WC |
$332.35
|
| Rate for Payer: Global Benefits Group Commercial |
$234.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$351.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$260.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$78.20
|
| Rate for Payer: Multiplan Commercial |
$293.25
|
| Rate for Payer: Networks By Design Commercial |
$254.15
|
| Rate for Payer: Prime Health Services Commercial |
$332.35
|
|
|
HC SOM CHROMOSOMES CHORIONIC VILLUS
|
Facility
IP
|
$400.00
|
|
|
Service Code
|
CPT 88291
|
| Hospital Charge Code |
900912549
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$80.00 |
| Max. Negotiated Rate |
$360.00 |
| Rate for Payer: Cash Price |
$180.00
|
| Rate for Payer: Central Health Plan Commercial |
$320.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$160.00
|
| Rate for Payer: Galaxy Health WC |
$340.00
|
| Rate for Payer: Global Benefits Group Commercial |
$240.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$360.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$266.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$80.00
|
| Rate for Payer: Multiplan Commercial |
$300.00
|
| Rate for Payer: Networks By Design Commercial |
$260.00
|
| Rate for Payer: Prime Health Services Commercial |
$340.00
|
|
|
HC SOM CHROMOSOMES CHORIONIC VILLUS
|
Facility
OP
|
$400.00
|
|
|
Service Code
|
CPT 88291
|
| Hospital Charge Code |
900912549
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$27.19 |
| Max. Negotiated Rate |
$2,718.90 |
| Rate for Payer: Aetna of CA HMO/PPO |
$155.72
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$340.00
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$220.00
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$220.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$135.91
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$165.78
|
| Rate for Payer: BCBS Transplant Transplant |
$240.00
|
| Rate for Payer: Blue Shield of California Commercial |
$247.20
|
| Rate for Payer: Blue Shield of California EPN |
$194.40
|
| Rate for Payer: Cash Price |
$180.00
|
| Rate for Payer: Cash Price |
$180.00
|
| Rate for Payer: Central Health Plan Commercial |
$320.00
|
| Rate for Payer: Cigna of CA HMO |
$256.00
|
| Rate for Payer: Cigna of CA PPO |
$296.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$340.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$160.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$160.00
|
| Rate for Payer: Galaxy Health WC |
$340.00
|
| Rate for Payer: Global Benefits Group Commercial |
$240.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$360.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$300.00
|
| Rate for Payer: IEHP medi-cal |
$140.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$266.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$80.00
|
| Rate for Payer: Multiplan Commercial |
$300.00
|
| Rate for Payer: Networks By Design Commercial |
$260.00
|
| Rate for Payer: Prime Health Services Commercial |
$340.00
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$240.00
|
| Rate for Payer: Riverside University Health MISP |
$160.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$240.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$240.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$27.19
|
| Rate for Payer: United Healthcare All Other HMO |
$27.19
|
| Rate for Payer: United Healthcare HMO Rider |
$27.19
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,718.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$340.00
|
| Rate for Payer: Vantage Medical Group Senior |
$340.00
|
|
|
HC SOM CHROMOSOMES LYMPHOID
|
Facility
IP
|
$36.56
|
|
|
Service Code
|
CPT 88291
|
| Hospital Charge Code |
900912548
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$7.31 |
| Max. Negotiated Rate |
$32.90 |
| Rate for Payer: Cash Price |
$16.45
|
| Rate for Payer: Central Health Plan Commercial |
$29.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.62
|
| Rate for Payer: Galaxy Health WC |
$31.08
|
| Rate for Payer: Global Benefits Group Commercial |
$21.94
|
| Rate for Payer: Health Management Network EPO/PPO |
$32.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$24.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.31
|
| Rate for Payer: Multiplan Commercial |
$27.42
|
| Rate for Payer: Networks By Design Commercial |
$23.76
|
| Rate for Payer: Prime Health Services Commercial |
$31.08
|
|
|
HC SOM CHROMOSOMES LYMPHOID
|
Facility
OP
|
$36.56
|
|
|
Service Code
|
CPT 88291
|
| Hospital Charge Code |
900912548
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$7.31 |
| Max. Negotiated Rate |
$2,718.90 |
| Rate for Payer: Aetna of CA HMO/PPO |
$155.72
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$31.08
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$20.11
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$20.11
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$135.91
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$165.78
|
| Rate for Payer: BCBS Transplant Transplant |
$21.94
|
| Rate for Payer: Blue Shield of California Commercial |
$22.59
|
| Rate for Payer: Blue Shield of California EPN |
$17.77
|
| Rate for Payer: Cash Price |
$16.45
|
| Rate for Payer: Cash Price |
$16.45
|
| Rate for Payer: Central Health Plan Commercial |
$29.25
|
| Rate for Payer: Cigna of CA HMO |
$23.40
|
| Rate for Payer: Cigna of CA PPO |
$27.05
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$31.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.62
|
| Rate for Payer: EPIC Health Plan Transplant |
$14.62
|
| Rate for Payer: Galaxy Health WC |
$31.08
|
| Rate for Payer: Global Benefits Group Commercial |
$21.94
|
| Rate for Payer: Health Management Network EPO/PPO |
$32.90
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$27.42
|
| Rate for Payer: IEHP medi-cal |
$12.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$24.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.31
|
| Rate for Payer: Multiplan Commercial |
$27.42
|
| Rate for Payer: Networks By Design Commercial |
$23.76
|
| Rate for Payer: Prime Health Services Commercial |
$31.08
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$21.94
|
| Rate for Payer: Riverside University Health MISP |
$14.62
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$21.94
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$21.94
|
| Rate for Payer: United Healthcare All Other Commercial |
$27.19
|
| Rate for Payer: United Healthcare All Other HMO |
$27.19
|
| Rate for Payer: United Healthcare HMO Rider |
$27.19
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,718.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$31.08
|
| Rate for Payer: Vantage Medical Group Senior |
$31.08
|
|
|
HC SOM CHROMOSOMES SKIN BIOPSY
|
Facility
OP
|
$276.95
|
|
|
Service Code
|
CPT 88291
|
| Hospital Charge Code |
900912547
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$27.19 |
| Max. Negotiated Rate |
$2,718.90 |
| Rate for Payer: Aetna of CA HMO/PPO |
$155.72
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$235.41
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$152.32
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$152.32
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$135.91
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$165.78
|
| Rate for Payer: BCBS Transplant Transplant |
$166.17
|
| Rate for Payer: Blue Shield of California Commercial |
$171.16
|
| Rate for Payer: Blue Shield of California EPN |
$134.60
|
| Rate for Payer: Cash Price |
$124.63
|
| Rate for Payer: Cash Price |
$124.63
|
| Rate for Payer: Central Health Plan Commercial |
$221.56
|
| Rate for Payer: Cigna of CA HMO |
$177.25
|
| Rate for Payer: Cigna of CA PPO |
$204.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$235.41
|
| Rate for Payer: EPIC Health Plan Commercial |
$110.78
|
| Rate for Payer: EPIC Health Plan Transplant |
$110.78
|
| Rate for Payer: Galaxy Health WC |
$235.41
|
| Rate for Payer: Global Benefits Group Commercial |
$166.17
|
| Rate for Payer: Health Management Network EPO/PPO |
$249.26
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$207.71
|
| Rate for Payer: IEHP medi-cal |
$96.93
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$184.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$55.39
|
| Rate for Payer: Multiplan Commercial |
$207.71
|
| Rate for Payer: Networks By Design Commercial |
$180.02
|
| Rate for Payer: Prime Health Services Commercial |
$235.41
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$166.17
|
| Rate for Payer: Riverside University Health MISP |
$110.78
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$166.17
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$166.17
|
| Rate for Payer: United Healthcare All Other Commercial |
$27.19
|
| Rate for Payer: United Healthcare All Other HMO |
$27.19
|
| Rate for Payer: United Healthcare HMO Rider |
$27.19
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,718.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$235.41
|
| Rate for Payer: Vantage Medical Group Senior |
$235.41
|
|
|
HC SOM CHROMOSOMES SKIN BIOPSY
|
Facility
IP
|
$276.95
|
|
|
Service Code
|
CPT 88291
|
| Hospital Charge Code |
900912547
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$55.39 |
| Max. Negotiated Rate |
$249.26 |
| Rate for Payer: Cash Price |
$124.63
|
| Rate for Payer: Central Health Plan Commercial |
$221.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$110.78
|
| Rate for Payer: Galaxy Health WC |
$235.41
|
| Rate for Payer: Global Benefits Group Commercial |
$166.17
|
| Rate for Payer: Health Management Network EPO/PPO |
$249.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$184.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$55.39
|
| Rate for Payer: Multiplan Commercial |
$207.71
|
| Rate for Payer: Networks By Design Commercial |
$180.02
|
| Rate for Payer: Prime Health Services Commercial |
$235.41
|
|
