|
HC SOM CRYPTOSPORIDIUM AG, F
|
Facility
OP
|
$40.00
|
|
|
Service Code
|
CPT 87328
|
| Hospital Charge Code |
900912939
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.00 |
| Max. Negotiated Rate |
$79.75 |
| Rate for Payer: Adventist Health Medi-Cal |
$13.82
|
| Rate for Payer: Aetna of CA HMO/PPO |
$68.17
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$20.73
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$15.20
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$13.82
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$65.38
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$79.75
|
| Rate for Payer: BCBS Transplant Transplant |
$24.00
|
| Rate for Payer: Blue Shield of California Commercial |
$24.72
|
| Rate for Payer: Blue Shield of California EPN |
$19.44
|
| Rate for Payer: Caremore Medicare Advantage |
$13.82
|
| Rate for Payer: Cash Price |
$18.00
|
| Rate for Payer: Cash Price |
$18.00
|
| Rate for Payer: Central Health Plan Commercial |
$32.00
|
| Rate for Payer: Cigna of CA HMO |
$25.60
|
| Rate for Payer: Cigna of CA PPO |
$29.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$18.66
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$13.82
|
| Rate for Payer: EPIC Health Plan Transplant |
$13.82
|
| Rate for Payer: Galaxy Health WC |
$34.00
|
| Rate for Payer: Global Benefits Group Commercial |
$24.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$36.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$30.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$22.66
|
| Rate for Payer: IEHP medi-cal |
$22.80
|
| Rate for Payer: IEHP Medicare Advantage |
$13.82
|
| Rate for Payer: Innovage PACE Commercial |
$20.73
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$26.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18.52
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18.52
|
| Rate for Payer: Multiplan Commercial |
$30.00
|
| Rate for Payer: Networks By Design Commercial |
$26.00
|
| Rate for Payer: Prime Health Services Commercial |
$34.00
|
| Rate for Payer: Prime Health Services Medicare |
$14.65
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$24.00
|
| Rate for Payer: Riverside University Health MISP |
$15.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$24.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$24.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$11.20
|
| Rate for Payer: United Healthcare All Other HMO |
$11.20
|
| Rate for Payer: United Healthcare HMO Rider |
$11.20
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.20
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20.73
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15.20
|
| Rate for Payer: Vantage Medical Group Senior |
$13.82
|
|
|
HC SOM CRYPTOSPORIDIUM AG, F
|
Facility
IP
|
$40.00
|
|
|
Service Code
|
CPT 87328
|
| Hospital Charge Code |
900912939
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.00 |
| Max. Negotiated Rate |
$36.00 |
| Rate for Payer: Cash Price |
$18.00
|
| Rate for Payer: Central Health Plan Commercial |
$32.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.00
|
| Rate for Payer: Galaxy Health WC |
$34.00
|
| Rate for Payer: Global Benefits Group Commercial |
$24.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$36.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$26.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.00
|
| Rate for Payer: Multiplan Commercial |
$30.00
|
| Rate for Payer: Networks By Design Commercial |
$26.00
|
| Rate for Payer: Prime Health Services Commercial |
$34.00
|
|
|
HC SOM CSF IGG INDEX ALB CSF
|
Facility
OP
|
$8.66
|
|
|
Service Code
|
CPT 82042
|
| Hospital Charge Code |
900914411
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$1.73 |
| Max. Negotiated Rate |
$45.88 |
| Rate for Payer: Adventist Health Medi-Cal |
$7.78
|
| Rate for Payer: Aetna of CA HMO/PPO |
$24.05
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$11.67
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$8.56
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$7.78
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$37.61
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$45.88
|
| Rate for Payer: BCBS Transplant Transplant |
$5.20
|
| Rate for Payer: Blue Shield of California Commercial |
$5.35
|
| Rate for Payer: Blue Shield of California EPN |
$4.21
|
| Rate for Payer: Caremore Medicare Advantage |
$7.78
|
| Rate for Payer: Cash Price |
$3.90
|
| Rate for Payer: Cash Price |
$3.90
|
| Rate for Payer: Central Health Plan Commercial |
$6.93
|
| Rate for Payer: Cigna of CA HMO |
$5.54
|
| Rate for Payer: Cigna of CA PPO |
$6.41
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.50
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$7.78
|
| Rate for Payer: EPIC Health Plan Transplant |
$7.78
|
| Rate for Payer: Galaxy Health WC |
$7.36
|
| Rate for Payer: Global Benefits Group Commercial |
$5.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$7.79
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$6.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$12.76
|
| Rate for Payer: IEHP medi-cal |
$12.84
|
| Rate for Payer: IEHP Medicare Advantage |
$7.78
|
| Rate for Payer: Innovage PACE Commercial |
$11.67
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.73
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.43
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10.43
|
| Rate for Payer: Multiplan Commercial |
$6.50
|
| Rate for Payer: Networks By Design Commercial |
$5.63
|
| Rate for Payer: Prime Health Services Commercial |
$7.36
|
| Rate for Payer: Prime Health Services Medicare |
$8.25
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$5.20
|
| Rate for Payer: Riverside University Health MISP |
$8.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.30
|
| Rate for Payer: United Healthcare All Other HMO |
$6.30
|
| Rate for Payer: United Healthcare HMO Rider |
$6.30
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.30
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11.67
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.56
|
| Rate for Payer: Vantage Medical Group Senior |
$7.78
|
|
|
HC SOM CSF IGG INDEX ALB CSF
|
Facility
IP
|
$8.66
|
|
|
Service Code
|
CPT 82042
|
| Hospital Charge Code |
900914411
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$1.73 |
| Max. Negotiated Rate |
$7.79 |
| Rate for Payer: Cash Price |
$3.90
|
| Rate for Payer: Central Health Plan Commercial |
$6.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.46
|
| Rate for Payer: Galaxy Health WC |
$7.36
|
| Rate for Payer: Global Benefits Group Commercial |
$5.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$7.79
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.73
|
| Rate for Payer: Multiplan Commercial |
$6.50
|
| Rate for Payer: Networks By Design Commercial |
$5.63
|
| Rate for Payer: Prime Health Services Commercial |
$7.36
|
|
|
HC SOM CSF IGG INDEX ALB S
|
Facility
OP
|
$5.51
|
|
|
Service Code
|
CPT 82040
|
| Hospital Charge Code |
900914410
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$1.10 |
| Max. Negotiated Rate |
$43.97 |
| Rate for Payer: Adventist Health Medi-Cal |
$4.95
|
| Rate for Payer: Aetna of CA HMO/PPO |
$36.32
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$7.42
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$5.44
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$4.95
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$36.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$43.97
|
| Rate for Payer: BCBS Transplant Transplant |
$3.31
|
| Rate for Payer: Blue Shield of California Commercial |
$3.41
|
| Rate for Payer: Blue Shield of California EPN |
$2.68
|
| Rate for Payer: Caremore Medicare Advantage |
$4.95
|
| Rate for Payer: Cash Price |
$2.48
|
| Rate for Payer: Cash Price |
$2.48
|
| Rate for Payer: Central Health Plan Commercial |
$4.41
|
| Rate for Payer: Cigna of CA HMO |
$3.53
|
| Rate for Payer: Cigna of CA PPO |
$4.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.68
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4.95
|
| Rate for Payer: EPIC Health Plan Transplant |
$4.95
|
| Rate for Payer: Galaxy Health WC |
$4.68
|
| Rate for Payer: Global Benefits Group Commercial |
$3.31
|
| Rate for Payer: Health Management Network EPO/PPO |
$4.96
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$4.13
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$8.12
|
| Rate for Payer: IEHP medi-cal |
$8.17
|
| Rate for Payer: IEHP Medicare Advantage |
$4.95
|
| Rate for Payer: Innovage PACE Commercial |
$7.42
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.10
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.63
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.63
|
| Rate for Payer: Multiplan Commercial |
$4.13
|
| Rate for Payer: Networks By Design Commercial |
$3.58
|
| Rate for Payer: Prime Health Services Commercial |
$4.68
|
| Rate for Payer: Prime Health Services Medicare |
$5.25
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$3.31
|
| Rate for Payer: Riverside University Health MISP |
$5.44
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3.31
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3.31
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.01
|
| Rate for Payer: United Healthcare All Other HMO |
$4.01
|
| Rate for Payer: United Healthcare HMO Rider |
$4.01
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.01
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.42
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.44
|
| Rate for Payer: Vantage Medical Group Senior |
$4.95
|
|
|
HC SOM CSF IGG INDEX ALB S
|
Facility
IP
|
$5.51
|
|
|
Service Code
|
CPT 82040
|
| Hospital Charge Code |
900914410
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$1.10 |
| Max. Negotiated Rate |
$4.96 |
| Rate for Payer: Cash Price |
$2.48
|
| Rate for Payer: Central Health Plan Commercial |
$4.41
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.20
|
| Rate for Payer: Galaxy Health WC |
$4.68
|
| Rate for Payer: Global Benefits Group Commercial |
$3.31
|
| Rate for Payer: Health Management Network EPO/PPO |
$4.96
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.10
|
| Rate for Payer: Multiplan Commercial |
$4.13
|
| Rate for Payer: Networks By Design Commercial |
$3.58
|
| Rate for Payer: Prime Health Services Commercial |
$4.68
|
|
|
HC SOM CSF IGG INDEX IGG, S
|
Facility
IP
|
$10.35
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
900914409
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.07 |
| Max. Negotiated Rate |
$9.32 |
| Rate for Payer: Cash Price |
$4.66
|
| Rate for Payer: Central Health Plan Commercial |
$8.28
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.14
|
| Rate for Payer: Galaxy Health WC |
$8.80
|
| Rate for Payer: Global Benefits Group Commercial |
$6.21
|
| Rate for Payer: Health Management Network EPO/PPO |
$9.32
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.07
|
| Rate for Payer: Multiplan Commercial |
$7.76
|
| Rate for Payer: Networks By Design Commercial |
$6.73
|
| Rate for Payer: Prime Health Services Commercial |
$8.80
|
|
|
HC SOM CSF IGG INDEX IGG, S
|
Facility
OP
|
$10.35
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
900914409
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.07 |
| 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 |
$6.21
|
| Rate for Payer: Blue Shield of California Commercial |
$6.40
|
| Rate for Payer: Blue Shield of California EPN |
$5.03
|
| Rate for Payer: Caremore Medicare Advantage |
$9.30
|
| Rate for Payer: Cash Price |
$4.66
|
| Rate for Payer: Cash Price |
$4.66
|
| Rate for Payer: Central Health Plan Commercial |
$8.28
|
| Rate for Payer: Cigna of CA HMO |
$6.62
|
| Rate for Payer: Cigna of CA PPO |
$7.66
|
| 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 |
$8.80
|
| Rate for Payer: Global Benefits Group Commercial |
$6.21
|
| Rate for Payer: Health Management Network EPO/PPO |
$9.32
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$7.76
|
| 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 |
$6.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.07
|
| 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 |
$7.76
|
| Rate for Payer: Networks By Design Commercial |
$6.73
|
| Rate for Payer: Prime Health Services Commercial |
$8.80
|
| Rate for Payer: Prime Health Services Medicare |
$9.86
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$6.21
|
| Rate for Payer: Riverside University Health MISP |
$10.23
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6.21
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6.21
|
| 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 C-TELOPEPTIDE
|
Facility
IP
|
$19.34
|
|
|
Service Code
|
CPT 82523
|
| Hospital Charge Code |
900912783
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.87 |
| Max. Negotiated Rate |
$17.41 |
| Rate for Payer: Cash Price |
$8.70
|
| Rate for Payer: Central Health Plan Commercial |
$15.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.74
|
| Rate for Payer: Galaxy Health WC |
$16.44
|
| Rate for Payer: Global Benefits Group Commercial |
$11.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$17.41
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.87
|
| Rate for Payer: Multiplan Commercial |
$14.50
|
| Rate for Payer: Networks By Design Commercial |
$12.57
|
| Rate for Payer: Prime Health Services Commercial |
$16.44
|
|
|
HC SOM C-TELOPEPTIDE
|
Facility
OP
|
$19.34
|
|
|
Service Code
|
CPT 82523
|
| Hospital Charge Code |
900912783
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.87 |
| Max. Negotiated Rate |
$244.52 |
| Rate for Payer: Adventist Health Medi-Cal |
$18.68
|
| Rate for Payer: Aetna of CA HMO/PPO |
$136.15
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$28.02
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$20.55
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$18.68
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$200.46
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$244.52
|
| Rate for Payer: BCBS Transplant Transplant |
$11.60
|
| Rate for Payer: Blue Shield of California Commercial |
$11.95
|
| Rate for Payer: Blue Shield of California EPN |
$9.40
|
| Rate for Payer: Caremore Medicare Advantage |
$18.68
|
| Rate for Payer: Cash Price |
$8.70
|
| Rate for Payer: Cash Price |
$8.70
|
| Rate for Payer: Central Health Plan Commercial |
$15.47
|
| Rate for Payer: Cigna of CA HMO |
$12.38
|
| Rate for Payer: Cigna of CA PPO |
$14.31
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$28.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$25.22
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$18.68
|
| Rate for Payer: EPIC Health Plan Transplant |
$18.68
|
| Rate for Payer: Galaxy Health WC |
$16.44
|
| Rate for Payer: Global Benefits Group Commercial |
$11.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$17.41
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$14.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$30.64
|
| Rate for Payer: IEHP medi-cal |
$30.82
|
| Rate for Payer: IEHP Medicare Advantage |
$18.68
|
| Rate for Payer: Innovage PACE Commercial |
$28.02
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.87
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$25.03
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$25.03
|
| Rate for Payer: Multiplan Commercial |
$14.50
|
| Rate for Payer: Networks By Design Commercial |
$12.57
|
| Rate for Payer: Prime Health Services Commercial |
$16.44
|
| Rate for Payer: Prime Health Services Medicare |
$19.80
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$11.60
|
| Rate for Payer: Riverside University Health MISP |
$20.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$11.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$11.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$15.13
|
| Rate for Payer: United Healthcare All Other HMO |
$15.13
|
| Rate for Payer: United Healthcare HMO Rider |
$15.13
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15.13
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$28.02
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$20.55
|
| Rate for Payer: Vantage Medical Group Senior |
$18.68
|
|
|
HC SOM C. TRACHOMATIS, IGG
|
Facility
IP
|
$7.00
|
|
|
Service Code
|
CPT 86631
|
| Hospital Charge Code |
900912801
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$1.40 |
| Max. Negotiated Rate |
$6.30 |
| Rate for Payer: Cash Price |
$3.15
|
| Rate for Payer: Central Health Plan Commercial |
$5.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.80
|
| Rate for Payer: Galaxy Health WC |
$5.95
|
| Rate for Payer: Global Benefits Group Commercial |
$4.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$6.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.40
|
| Rate for Payer: Multiplan Commercial |
$5.25
|
| Rate for Payer: Networks By Design Commercial |
$4.55
|
| Rate for Payer: Prime Health Services Commercial |
$5.95
|
|
|
HC SOM C. TRACHOMATIS, IGG
|
Facility
OP
|
$7.00
|
|
|
Service Code
|
CPT 86631
|
| Hospital Charge Code |
900912801
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$1.40 |
| Max. Negotiated Rate |
$114.52 |
| Rate for Payer: Adventist Health Medi-Cal |
$11.82
|
| Rate for Payer: Aetna of CA HMO/PPO |
$86.76
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$17.73
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$13.00
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$11.82
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$93.89
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$114.52
|
| Rate for Payer: BCBS Transplant Transplant |
$4.20
|
| Rate for Payer: Blue Shield of California Commercial |
$4.33
|
| Rate for Payer: Blue Shield of California EPN |
$3.40
|
| Rate for Payer: Caremore Medicare Advantage |
$11.82
|
| Rate for Payer: Cash Price |
$3.15
|
| Rate for Payer: Cash Price |
$3.15
|
| Rate for Payer: Central Health Plan Commercial |
$5.60
|
| Rate for Payer: Cigna of CA HMO |
$4.48
|
| Rate for Payer: Cigna of CA PPO |
$5.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$17.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.96
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$11.82
|
| Rate for Payer: EPIC Health Plan Transplant |
$11.82
|
| Rate for Payer: Galaxy Health WC |
$5.95
|
| Rate for Payer: Global Benefits Group Commercial |
$4.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$6.30
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$5.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$19.38
|
| Rate for Payer: IEHP medi-cal |
$19.50
|
| Rate for Payer: IEHP Medicare Advantage |
$11.82
|
| Rate for Payer: Innovage PACE Commercial |
$17.73
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$11.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$15.84
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$15.84
|
| Rate for Payer: Multiplan Commercial |
$5.25
|
| Rate for Payer: Networks By Design Commercial |
$4.55
|
| Rate for Payer: Prime Health Services Commercial |
$5.95
|
| Rate for Payer: Prime Health Services Medicare |
$12.53
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$4.20
|
| Rate for Payer: Riverside University Health MISP |
$13.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.58
|
| Rate for Payer: United Healthcare All Other HMO |
$9.58
|
| Rate for Payer: United Healthcare HMO Rider |
$9.58
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.58
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$17.73
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.00
|
| Rate for Payer: Vantage Medical Group Senior |
$11.82
|
|
|
HC SOM C. TRACHOMATIS IGM
|
Facility
IP
|
$7.00
|
|
|
Service Code
|
CPT 86632
|
| Hospital Charge Code |
900912799
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$1.40 |
| Max. Negotiated Rate |
$6.30 |
| Rate for Payer: Cash Price |
$3.15
|
| Rate for Payer: Central Health Plan Commercial |
$5.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.80
|
| Rate for Payer: Galaxy Health WC |
$5.95
|
| Rate for Payer: Global Benefits Group Commercial |
$4.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$6.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.40
|
| Rate for Payer: Multiplan Commercial |
$5.25
|
| Rate for Payer: Networks By Design Commercial |
$4.55
|
| Rate for Payer: Prime Health Services Commercial |
$5.95
|
|
|
HC SOM C. TRACHOMATIS IGM
|
Facility
OP
|
$7.00
|
|
|
Service Code
|
CPT 86632
|
| Hospital Charge Code |
900912799
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$1.40 |
| Max. Negotiated Rate |
$114.52 |
| Rate for Payer: Adventist Health Medi-Cal |
$12.68
|
| Rate for Payer: Aetna of CA HMO/PPO |
$93.14
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$19.02
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$13.95
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$12.68
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$93.89
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$114.52
|
| Rate for Payer: BCBS Transplant Transplant |
$4.20
|
| Rate for Payer: Blue Shield of California Commercial |
$4.33
|
| Rate for Payer: Blue Shield of California EPN |
$3.40
|
| Rate for Payer: Caremore Medicare Advantage |
$12.68
|
| Rate for Payer: Cash Price |
$3.15
|
| Rate for Payer: Cash Price |
$3.15
|
| Rate for Payer: Central Health Plan Commercial |
$5.60
|
| Rate for Payer: Cigna of CA HMO |
$4.48
|
| Rate for Payer: Cigna of CA PPO |
$5.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$17.12
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$12.68
|
| Rate for Payer: EPIC Health Plan Transplant |
$12.68
|
| Rate for Payer: Galaxy Health WC |
$5.95
|
| Rate for Payer: Global Benefits Group Commercial |
$4.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$6.30
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$5.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$20.80
|
| Rate for Payer: IEHP medi-cal |
$20.92
|
| Rate for Payer: IEHP Medicare Advantage |
$12.68
|
| Rate for Payer: Innovage PACE Commercial |
$19.02
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16.99
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16.99
|
| Rate for Payer: Multiplan Commercial |
$5.25
|
| Rate for Payer: Networks By Design Commercial |
$4.55
|
| Rate for Payer: Prime Health Services Commercial |
$5.95
|
| Rate for Payer: Prime Health Services Medicare |
$13.44
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$4.20
|
| Rate for Payer: Riverside University Health MISP |
$13.95
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.27
|
| Rate for Payer: United Healthcare All Other HMO |
$10.27
|
| Rate for Payer: United Healthcare HMO Rider |
$10.27
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.27
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.02
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.95
|
| Rate for Payer: Vantage Medical Group Senior |
$12.68
|
|
|
HC SOM CUCRU 82525
|
Facility
OP
|
$85.80
|
|
|
Service Code
|
CPT 82525
|
| Hospital Charge Code |
900914747
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.05 |
| Max. Negotiated Rate |
$110.40 |
| Rate for Payer: Adventist Health Medi-Cal |
$12.41
|
| Rate for Payer: Aetna of CA HMO/PPO |
$91.05
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$18.62
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$13.65
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$12.41
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$90.51
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$110.40
|
| Rate for Payer: BCBS Transplant Transplant |
$51.48
|
| Rate for Payer: Blue Shield of California Commercial |
$53.02
|
| Rate for Payer: Blue Shield of California EPN |
$41.70
|
| Rate for Payer: Caremore Medicare Advantage |
$12.41
|
| Rate for Payer: Cash Price |
$38.61
|
| Rate for Payer: Cash Price |
$38.61
|
| Rate for Payer: Central Health Plan Commercial |
$68.64
|
| Rate for Payer: Cigna of CA HMO |
$54.91
|
| Rate for Payer: Cigna of CA PPO |
$63.49
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$18.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.75
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$12.41
|
| Rate for Payer: EPIC Health Plan Transplant |
$12.41
|
| Rate for Payer: Galaxy Health WC |
$72.93
|
| Rate for Payer: Global Benefits Group Commercial |
$51.48
|
| Rate for Payer: Health Management Network EPO/PPO |
$77.22
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$64.35
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$20.35
|
| Rate for Payer: IEHP medi-cal |
$20.48
|
| Rate for Payer: IEHP Medicare Advantage |
$12.41
|
| Rate for Payer: Innovage PACE Commercial |
$18.62
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$57.23
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$17.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16.63
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16.63
|
| Rate for Payer: Multiplan Commercial |
$64.35
|
| Rate for Payer: Networks By Design Commercial |
$55.77
|
| Rate for Payer: Prime Health Services Commercial |
$72.93
|
| Rate for Payer: Prime Health Services Medicare |
$13.15
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$51.48
|
| Rate for Payer: Riverside University Health MISP |
$13.65
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$51.48
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$51.48
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.05
|
| Rate for Payer: United Healthcare All Other HMO |
$10.05
|
| Rate for Payer: United Healthcare HMO Rider |
$10.05
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$18.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.65
|
| Rate for Payer: Vantage Medical Group Senior |
$12.41
|
|
|
HC SOM CUCRU 82525
|
Facility
IP
|
$85.80
|
|
|
Service Code
|
CPT 82525
|
| Hospital Charge Code |
900914747
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$17.16 |
| Max. Negotiated Rate |
$77.22 |
| Rate for Payer: Cash Price |
$38.61
|
| Rate for Payer: Central Health Plan Commercial |
$68.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$34.32
|
| Rate for Payer: Galaxy Health WC |
$72.93
|
| Rate for Payer: Global Benefits Group Commercial |
$51.48
|
| Rate for Payer: Health Management Network EPO/PPO |
$77.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$57.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$17.16
|
| Rate for Payer: Multiplan Commercial |
$64.35
|
| Rate for Payer: Networks By Design Commercial |
$55.77
|
| Rate for Payer: Prime Health Services Commercial |
$72.93
|
|
|
HC SOM CULTURE 05
|
Facility
IP
|
$175.00
|
|
|
Service Code
|
CPT 88239
|
| Hospital Charge Code |
900915288
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$35.00 |
| Max. Negotiated Rate |
$157.50 |
| Rate for Payer: Cash Price |
$78.75
|
| Rate for Payer: Central Health Plan Commercial |
$140.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$70.00
|
| Rate for Payer: Galaxy Health WC |
$148.75
|
| Rate for Payer: Global Benefits Group Commercial |
$105.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$157.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$116.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$35.00
|
| Rate for Payer: Multiplan Commercial |
$131.25
|
| Rate for Payer: Networks By Design Commercial |
$113.75
|
| Rate for Payer: Prime Health Services Commercial |
$148.75
|
|
|
HC SOM CULTURE 05
|
Facility
OP
|
$175.00
|
|
|
Service Code
|
CPT 88239
|
| Hospital Charge Code |
900915288
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$35.00 |
| 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 |
$105.00
|
| Rate for Payer: Blue Shield of California Commercial |
$108.15
|
| Rate for Payer: Blue Shield of California EPN |
$85.05
|
| Rate for Payer: Caremore Medicare Advantage |
$147.52
|
| Rate for Payer: Cash Price |
$78.75
|
| Rate for Payer: Cash Price |
$78.75
|
| Rate for Payer: Central Health Plan Commercial |
$140.00
|
| Rate for Payer: Cigna of CA HMO |
$112.00
|
| Rate for Payer: Cigna of CA PPO |
$129.50
|
| 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 |
$148.75
|
| Rate for Payer: Global Benefits Group Commercial |
$105.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$157.50
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$131.25
|
| 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 |
$116.72
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$147.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$35.00
|
| 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 |
$131.25
|
| Rate for Payer: Networks By Design Commercial |
$113.75
|
| Rate for Payer: Prime Health Services Commercial |
$148.75
|
| Rate for Payer: Prime Health Services Medicare |
$156.37
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$105.00
|
| Rate for Payer: Riverside University Health MISP |
$162.27
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$105.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$105.00
|
| 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 CYANIDE
|
Facility
OP
|
$89.00
|
|
|
Service Code
|
CPT 82600
|
| Hospital Charge Code |
900911136
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.71 |
| Max. Negotiated Rate |
$172.17 |
| Rate for Payer: Adventist Health Medi-Cal |
$19.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$142.41
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$29.10
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$21.34
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$19.40
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$141.15
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$172.17
|
| Rate for Payer: BCBS Transplant Transplant |
$53.40
|
| Rate for Payer: Blue Shield of California Commercial |
$55.00
|
| Rate for Payer: Blue Shield of California EPN |
$43.25
|
| Rate for Payer: Caremore Medicare Advantage |
$19.40
|
| Rate for Payer: Cash Price |
$40.05
|
| Rate for Payer: Cash Price |
$40.05
|
| Rate for Payer: Central Health Plan Commercial |
$71.20
|
| Rate for Payer: Cigna of CA HMO |
$56.96
|
| Rate for Payer: Cigna of CA PPO |
$65.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$29.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.19
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$19.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$19.40
|
| Rate for Payer: Galaxy Health WC |
$75.65
|
| Rate for Payer: Global Benefits Group Commercial |
$53.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$80.10
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$66.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$31.82
|
| Rate for Payer: IEHP medi-cal |
$32.01
|
| Rate for Payer: IEHP Medicare Advantage |
$19.40
|
| Rate for Payer: Innovage PACE Commercial |
$29.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$59.36
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$19.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$17.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$26.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$26.00
|
| Rate for Payer: Multiplan Commercial |
$66.75
|
| Rate for Payer: Networks By Design Commercial |
$57.85
|
| Rate for Payer: Prime Health Services Commercial |
$75.65
|
| Rate for Payer: Prime Health Services Medicare |
$20.56
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$53.40
|
| Rate for Payer: Riverside University Health MISP |
$21.34
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$53.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$53.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$15.71
|
| Rate for Payer: United Healthcare All Other HMO |
$15.71
|
| Rate for Payer: United Healthcare HMO Rider |
$15.71
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15.71
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$29.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$21.34
|
| Rate for Payer: Vantage Medical Group Senior |
$19.40
|
|
|
HC SOM CYANIDE
|
Facility
IP
|
$89.00
|
|
|
Service Code
|
CPT 82600
|
| Hospital Charge Code |
900911136
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$17.80 |
| Max. Negotiated Rate |
$80.10 |
| Rate for Payer: Cash Price |
$40.05
|
| Rate for Payer: Central Health Plan Commercial |
$71.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$35.60
|
| Rate for Payer: Galaxy Health WC |
$75.65
|
| Rate for Payer: Global Benefits Group Commercial |
$53.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$80.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$59.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$17.80
|
| Rate for Payer: Multiplan Commercial |
$66.75
|
| Rate for Payer: Networks By Design Commercial |
$57.85
|
| Rate for Payer: Prime Health Services Commercial |
$75.65
|
|
|
HC SOM CYSTATIN C WITH EGFR, S
|
Facility
IP
|
$37.23
|
|
|
Service Code
|
CPT 82610
|
| Hospital Charge Code |
900915362
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.45 |
| Max. Negotiated Rate |
$33.51 |
| Rate for Payer: Cash Price |
$16.75
|
| Rate for Payer: Central Health Plan Commercial |
$29.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.89
|
| Rate for Payer: Galaxy Health WC |
$31.65
|
| Rate for Payer: Global Benefits Group Commercial |
$22.34
|
| Rate for Payer: Health Management Network EPO/PPO |
$33.51
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$24.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.45
|
| Rate for Payer: Multiplan Commercial |
$27.92
|
| Rate for Payer: Networks By Design Commercial |
$24.20
|
| Rate for Payer: Prime Health Services Commercial |
$31.65
|
|
|
HC SOM CYSTATIN C WITH EGFR, S
|
Facility
OP
|
$37.23
|
|
|
Service Code
|
CPT 82610
|
| Hospital Charge Code |
900915362
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.45 |
| Max. Negotiated Rate |
$120.67 |
| Rate for Payer: Adventist Health Medi-Cal |
$18.52
|
| Rate for Payer: Aetna of CA HMO/PPO |
$99.77
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$27.78
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$20.37
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$18.52
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$98.93
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$120.67
|
| Rate for Payer: BCBS Transplant Transplant |
$22.34
|
| Rate for Payer: Blue Shield of California Commercial |
$23.01
|
| Rate for Payer: Blue Shield of California EPN |
$18.09
|
| Rate for Payer: Caremore Medicare Advantage |
$18.52
|
| Rate for Payer: Cash Price |
$16.75
|
| Rate for Payer: Cash Price |
$16.75
|
| Rate for Payer: Central Health Plan Commercial |
$29.78
|
| Rate for Payer: Cigna of CA HMO |
$23.83
|
| Rate for Payer: Cigna of CA PPO |
$27.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$27.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$25.00
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$18.52
|
| Rate for Payer: EPIC Health Plan Transplant |
$18.52
|
| Rate for Payer: Galaxy Health WC |
$31.65
|
| Rate for Payer: Global Benefits Group Commercial |
$22.34
|
| Rate for Payer: Health Management Network EPO/PPO |
$33.51
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$27.92
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$30.37
|
| Rate for Payer: IEHP medi-cal |
$30.56
|
| Rate for Payer: IEHP Medicare Advantage |
$18.52
|
| Rate for Payer: Innovage PACE Commercial |
$27.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$24.83
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.45
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$24.82
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$24.82
|
| Rate for Payer: Multiplan Commercial |
$27.92
|
| Rate for Payer: Networks By Design Commercial |
$24.20
|
| Rate for Payer: Prime Health Services Commercial |
$31.65
|
| Rate for Payer: Prime Health Services Medicare |
$19.63
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$22.34
|
| Rate for Payer: Riverside University Health MISP |
$20.37
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$22.34
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$22.34
|
| Rate for Payer: United Healthcare All Other Commercial |
$15.00
|
| Rate for Payer: United Healthcare All Other HMO |
$15.00
|
| Rate for Payer: United Healthcare HMO Rider |
$15.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$27.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$20.37
|
| Rate for Payer: Vantage Medical Group Senior |
$18.52
|
|
|
HC SOM CYSTICERCOSIS AB BLOOD
|
Facility
OP
|
$30.00
|
|
|
Service Code
|
CPT 86682
|
| Hospital Charge Code |
900911763
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.00 |
| Max. Negotiated Rate |
$116.49 |
| Rate for Payer: Adventist Health Medi-Cal |
$13.01
|
| Rate for Payer: Aetna of CA HMO/PPO |
$95.47
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$19.52
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$14.31
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$13.01
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$95.51
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$116.49
|
| Rate for Payer: BCBS Transplant Transplant |
$18.00
|
| Rate for Payer: Blue Shield of California Commercial |
$18.54
|
| Rate for Payer: Blue Shield of California EPN |
$14.58
|
| Rate for Payer: Caremore Medicare Advantage |
$13.01
|
| Rate for Payer: Cash Price |
$13.50
|
| Rate for Payer: Cash Price |
$13.50
|
| Rate for Payer: Central Health Plan Commercial |
$24.00
|
| Rate for Payer: Cigna of CA HMO |
$19.20
|
| Rate for Payer: Cigna of CA PPO |
$22.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$17.56
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$13.01
|
| Rate for Payer: EPIC Health Plan Transplant |
$13.01
|
| Rate for Payer: Galaxy Health WC |
$25.50
|
| Rate for Payer: Global Benefits Group Commercial |
$18.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$27.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$22.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$21.34
|
| Rate for Payer: IEHP medi-cal |
$21.47
|
| Rate for Payer: IEHP Medicare Advantage |
$13.01
|
| Rate for Payer: Innovage PACE Commercial |
$19.52
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20.01
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17.43
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17.43
|
| Rate for Payer: Multiplan Commercial |
$22.50
|
| Rate for Payer: Networks By Design Commercial |
$19.50
|
| Rate for Payer: Prime Health Services Commercial |
$25.50
|
| Rate for Payer: Prime Health Services Medicare |
$13.79
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$18.00
|
| Rate for Payer: Riverside University Health MISP |
$14.31
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$18.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$18.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.54
|
| Rate for Payer: United Healthcare All Other HMO |
$10.54
|
| Rate for Payer: United Healthcare HMO Rider |
$10.54
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.54
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.31
|
| Rate for Payer: Vantage Medical Group Senior |
$13.01
|
|
|
HC SOM CYSTICERCOSIS AB BLOOD
|
Facility
IP
|
$30.00
|
|
|
Service Code
|
CPT 86682
|
| Hospital Charge Code |
900911763
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.00 |
| Max. Negotiated Rate |
$27.00 |
| Rate for Payer: Cash Price |
$13.50
|
| Rate for Payer: Central Health Plan Commercial |
$24.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.00
|
| Rate for Payer: Galaxy Health WC |
$25.50
|
| Rate for Payer: Global Benefits Group Commercial |
$18.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$27.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.00
|
| Rate for Payer: Multiplan Commercial |
$22.50
|
| Rate for Payer: Networks By Design Commercial |
$19.50
|
| Rate for Payer: Prime Health Services Commercial |
$25.50
|
|
|
HC SOM CYSTIC FIBROSIS DNA
|
Facility
OP
|
$168.38
|
|
|
Service Code
|
CPT 81220
|
| Hospital Charge Code |
900911481
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$33.68 |
| Max. Negotiated Rate |
$3,761.71 |
| Rate for Payer: Adventist Health Medi-Cal |
$556.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,005.76
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$834.90
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$612.26
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$556.60
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,083.98
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,761.71
|
| Rate for Payer: BCBS Transplant Transplant |
$101.03
|
| Rate for Payer: Blue Shield of California Commercial |
$104.06
|
| Rate for Payer: Blue Shield of California EPN |
$81.83
|
| Rate for Payer: Caremore Medicare Advantage |
$556.60
|
| Rate for Payer: Cash Price |
$75.77
|
| Rate for Payer: Cash Price |
$75.77
|
| Rate for Payer: Central Health Plan Commercial |
$134.70
|
| Rate for Payer: Cigna of CA HMO |
$107.76
|
| Rate for Payer: Cigna of CA PPO |
$124.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$834.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$751.41
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$556.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$556.60
|
| Rate for Payer: Galaxy Health WC |
$143.12
|
| Rate for Payer: Global Benefits Group Commercial |
$101.03
|
| Rate for Payer: Health Management Network EPO/PPO |
$151.54
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$126.28
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$912.82
|
| Rate for Payer: IEHP medi-cal |
$918.39
|
| Rate for Payer: IEHP Medicare Advantage |
$556.60
|
| Rate for Payer: Innovage PACE Commercial |
$834.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$112.31
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$556.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$33.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$745.84
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$745.84
|
| Rate for Payer: Multiplan Commercial |
$126.28
|
| Rate for Payer: Networks By Design Commercial |
$109.45
|
| Rate for Payer: Prime Health Services Commercial |
$143.12
|
| Rate for Payer: Prime Health Services Medicare |
$590.00
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$101.03
|
| Rate for Payer: Riverside University Health MISP |
$612.26
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$101.03
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$101.03
|
| Rate for Payer: United Healthcare All Other Commercial |
$450.85
|
| Rate for Payer: United Healthcare All Other HMO |
$450.85
|
| Rate for Payer: United Healthcare HMO Rider |
$450.85
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$450.85
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$834.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$612.26
|
| Rate for Payer: Vantage Medical Group Senior |
$556.60
|
|
