|
HC SOM HISTOPLAS BLASTOMYC PCR1
|
Facility
IP
|
$148.12
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
900914670
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$29.62 |
| Max. Negotiated Rate |
$133.31 |
| Rate for Payer: Cash Price |
$66.65
|
| Rate for Payer: Central Health Plan Commercial |
$118.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$59.25
|
| Rate for Payer: Galaxy Health WC |
$125.90
|
| Rate for Payer: Global Benefits Group Commercial |
$88.87
|
| Rate for Payer: Health Management Network EPO/PPO |
$133.31
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$98.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$29.62
|
| Rate for Payer: Multiplan Commercial |
$111.09
|
| Rate for Payer: Networks By Design Commercial |
$96.28
|
| Rate for Payer: Prime Health Services Commercial |
$125.90
|
|
|
HC SOM HISTOPLAS BLASTOMYC PCR2
|
Facility
IP
|
$148.13
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
900914671
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$29.63 |
| Max. Negotiated Rate |
$133.32 |
| Rate for Payer: Cash Price |
$66.66
|
| Rate for Payer: Central Health Plan Commercial |
$118.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$59.25
|
| Rate for Payer: Galaxy Health WC |
$125.91
|
| Rate for Payer: Global Benefits Group Commercial |
$88.88
|
| Rate for Payer: Health Management Network EPO/PPO |
$133.32
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$98.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$29.63
|
| Rate for Payer: Multiplan Commercial |
$111.10
|
| Rate for Payer: Networks By Design Commercial |
$96.28
|
| Rate for Payer: Prime Health Services Commercial |
$125.91
|
|
|
HC SOM HISTOPLAS BLASTOMYC PCR2
|
Facility
OP
|
$148.13
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
900914671
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$28.42 |
| Max. Negotiated Rate |
$301.33 |
| Rate for Payer: Adventist Health Medi-Cal |
$35.09
|
| Rate for Payer: Aetna of CA HMO/PPO |
$257.58
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$52.64
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$38.60
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$35.09
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$247.04
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$301.33
|
| Rate for Payer: BCBS Transplant Transplant |
$88.88
|
| Rate for Payer: Blue Shield of California Commercial |
$91.54
|
| Rate for Payer: Blue Shield of California EPN |
$71.99
|
| Rate for Payer: Caremore Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$66.66
|
| Rate for Payer: Cash Price |
$66.66
|
| Rate for Payer: Central Health Plan Commercial |
$118.50
|
| Rate for Payer: Cigna of CA HMO |
$94.80
|
| Rate for Payer: Cigna of CA PPO |
$109.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$52.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$47.37
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$35.09
|
| Rate for Payer: EPIC Health Plan Transplant |
$35.09
|
| Rate for Payer: Galaxy Health WC |
$125.91
|
| Rate for Payer: Global Benefits Group Commercial |
$88.88
|
| Rate for Payer: Health Management Network EPO/PPO |
$133.32
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$111.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$57.55
|
| Rate for Payer: IEHP medi-cal |
$57.90
|
| Rate for Payer: IEHP Medicare Advantage |
$35.09
|
| Rate for Payer: Innovage PACE Commercial |
$52.64
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$98.80
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$35.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$29.63
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$47.02
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$47.02
|
| Rate for Payer: Multiplan Commercial |
$111.10
|
| Rate for Payer: Networks By Design Commercial |
$96.28
|
| Rate for Payer: Prime Health Services Commercial |
$125.91
|
| Rate for Payer: Prime Health Services Medicare |
$37.20
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$88.88
|
| Rate for Payer: Riverside University Health MISP |
$38.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$88.88
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$88.88
|
| Rate for Payer: United Healthcare All Other Commercial |
$28.42
|
| Rate for Payer: United Healthcare All Other HMO |
$28.42
|
| Rate for Payer: United Healthcare HMO Rider |
$28.42
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$28.42
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$52.64
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$38.60
|
| Rate for Payer: Vantage Medical Group Senior |
$35.09
|
|
|
HC SOM HISTOPLASMA AB IMMUNODIFFUSION
|
Facility
IP
|
$8.52
|
|
|
Service Code
|
CPT 86698
|
| Hospital Charge Code |
900912643
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$1.70 |
| Max. Negotiated Rate |
$7.67 |
| Rate for Payer: Cash Price |
$3.83
|
| Rate for Payer: Central Health Plan Commercial |
$6.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.41
|
| Rate for Payer: Galaxy Health WC |
$7.24
|
| Rate for Payer: Global Benefits Group Commercial |
$5.11
|
| Rate for Payer: Health Management Network EPO/PPO |
$7.67
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.70
|
| Rate for Payer: Multiplan Commercial |
$6.39
|
| Rate for Payer: Networks By Design Commercial |
$5.54
|
| Rate for Payer: Prime Health Services Commercial |
$7.24
|
|
|
HC SOM HISTOPLASMA AB IMMUNODIFFUSION
|
Facility
OP
|
$8.52
|
|
|
Service Code
|
CPT 86698
|
| Hospital Charge Code |
900912643
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$1.70 |
| Max. Negotiated Rate |
$112.01 |
| Rate for Payer: Adventist Health Medi-Cal |
$13.79
|
| Rate for Payer: Aetna of CA HMO/PPO |
$91.73
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$20.68
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$15.17
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$13.79
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$91.83
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$112.01
|
| Rate for Payer: BCBS Transplant Transplant |
$5.11
|
| Rate for Payer: Blue Shield of California Commercial |
$5.27
|
| Rate for Payer: Blue Shield of California EPN |
$4.14
|
| Rate for Payer: Caremore Medicare Advantage |
$13.79
|
| Rate for Payer: Cash Price |
$3.83
|
| Rate for Payer: Cash Price |
$3.83
|
| Rate for Payer: Central Health Plan Commercial |
$6.82
|
| Rate for Payer: Cigna of CA HMO |
$5.45
|
| Rate for Payer: Cigna of CA PPO |
$6.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$18.62
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$13.79
|
| Rate for Payer: EPIC Health Plan Transplant |
$13.79
|
| Rate for Payer: Galaxy Health WC |
$7.24
|
| Rate for Payer: Global Benefits Group Commercial |
$5.11
|
| Rate for Payer: Health Management Network EPO/PPO |
$7.67
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$6.39
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$22.62
|
| Rate for Payer: IEHP medi-cal |
$22.75
|
| Rate for Payer: IEHP Medicare Advantage |
$13.79
|
| Rate for Payer: Innovage PACE Commercial |
$20.68
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.70
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18.48
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18.48
|
| Rate for Payer: Multiplan Commercial |
$6.39
|
| Rate for Payer: Networks By Design Commercial |
$5.54
|
| Rate for Payer: Prime Health Services Commercial |
$7.24
|
| Rate for Payer: Prime Health Services Medicare |
$14.62
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$5.11
|
| Rate for Payer: Riverside University Health MISP |
$15.17
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5.11
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5.11
|
| Rate for Payer: United Healthcare All Other Commercial |
$11.17
|
| Rate for Payer: United Healthcare All Other HMO |
$11.17
|
| Rate for Payer: United Healthcare HMO Rider |
$11.17
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.17
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15.17
|
| Rate for Payer: Vantage Medical Group Senior |
$13.79
|
|
|
HC SOM HIV-1 ANTIBODY
|
Facility
IP
|
$29.76
|
|
|
Service Code
|
CPT 86701
|
| Hospital Charge Code |
900915308
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.95 |
| Max. Negotiated Rate |
$26.78 |
| Rate for Payer: Cash Price |
$13.39
|
| Rate for Payer: Central Health Plan Commercial |
$23.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.90
|
| Rate for Payer: Galaxy Health WC |
$25.30
|
| Rate for Payer: Global Benefits Group Commercial |
$17.86
|
| Rate for Payer: Health Management Network EPO/PPO |
$26.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$19.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.95
|
| Rate for Payer: Multiplan Commercial |
$22.32
|
| Rate for Payer: Networks By Design Commercial |
$19.34
|
| Rate for Payer: Prime Health Services Commercial |
$25.30
|
|
|
HC SOM HIV-1 ANTIBODY
|
Facility
OP
|
$29.76
|
|
|
Service Code
|
CPT 86701
|
| Hospital Charge Code |
900915308
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.95 |
| Max. Negotiated Rate |
$78.80 |
| Rate for Payer: Adventist Health Medi-Cal |
$8.89
|
| Rate for Payer: Aetna of CA HMO/PPO |
$65.22
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$13.34
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$9.78
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$8.89
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$64.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$78.80
|
| Rate for Payer: BCBS Transplant Transplant |
$17.86
|
| Rate for Payer: Blue Shield of California Commercial |
$18.39
|
| Rate for Payer: Blue Shield of California EPN |
$14.46
|
| Rate for Payer: Caremore Medicare Advantage |
$8.89
|
| Rate for Payer: Cash Price |
$13.39
|
| Rate for Payer: Cash Price |
$13.39
|
| Rate for Payer: Central Health Plan Commercial |
$23.81
|
| Rate for Payer: Cigna of CA HMO |
$19.05
|
| Rate for Payer: Cigna of CA PPO |
$22.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13.34
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.00
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$8.89
|
| Rate for Payer: EPIC Health Plan Transplant |
$8.89
|
| Rate for Payer: Galaxy Health WC |
$25.30
|
| Rate for Payer: Global Benefits Group Commercial |
$17.86
|
| Rate for Payer: Health Management Network EPO/PPO |
$26.78
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$22.32
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$14.58
|
| Rate for Payer: IEHP medi-cal |
$14.67
|
| Rate for Payer: IEHP Medicare Advantage |
$8.89
|
| Rate for Payer: Innovage PACE Commercial |
$13.34
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$19.85
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.95
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11.91
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11.91
|
| Rate for Payer: Multiplan Commercial |
$22.32
|
| Rate for Payer: Networks By Design Commercial |
$19.34
|
| Rate for Payer: Prime Health Services Commercial |
$25.30
|
| Rate for Payer: Prime Health Services Medicare |
$9.42
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$17.86
|
| Rate for Payer: Riverside University Health MISP |
$9.78
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$17.86
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$17.86
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.20
|
| Rate for Payer: United Healthcare All Other HMO |
$7.20
|
| Rate for Payer: United Healthcare HMO Rider |
$7.20
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.20
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13.34
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.78
|
| Rate for Payer: Vantage Medical Group Senior |
$8.89
|
|
|
HC SOM HIV-1 PROVIRAL DNA
|
Facility
IP
|
$50.27
|
|
|
Service Code
|
CPT 87535
|
| Hospital Charge Code |
900914170
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$10.05 |
| Max. Negotiated Rate |
$45.24 |
| Rate for Payer: Cash Price |
$22.62
|
| Rate for Payer: Central Health Plan Commercial |
$40.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$20.11
|
| Rate for Payer: Galaxy Health WC |
$42.73
|
| Rate for Payer: Global Benefits Group Commercial |
$30.16
|
| Rate for Payer: Health Management Network EPO/PPO |
$45.24
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$33.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.05
|
| Rate for Payer: Multiplan Commercial |
$37.70
|
| Rate for Payer: Networks By Design Commercial |
$32.68
|
| Rate for Payer: Prime Health Services Commercial |
$42.73
|
|
|
HC SOM HIV-1 PROVIRAL DNA
|
Facility
OP
|
$50.27
|
|
|
Service Code
|
CPT 87535
|
| Hospital Charge Code |
900914170
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$10.05 |
| Max. Negotiated Rate |
$301.33 |
| Rate for Payer: Adventist Health Medi-Cal |
$35.09
|
| Rate for Payer: Aetna of CA HMO/PPO |
$257.58
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$52.64
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$38.60
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$35.09
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$247.04
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$301.33
|
| Rate for Payer: BCBS Transplant Transplant |
$30.16
|
| Rate for Payer: Blue Shield of California Commercial |
$31.07
|
| Rate for Payer: Blue Shield of California EPN |
$24.43
|
| Rate for Payer: Caremore Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$22.62
|
| Rate for Payer: Cash Price |
$22.62
|
| Rate for Payer: Central Health Plan Commercial |
$40.22
|
| Rate for Payer: Cigna of CA HMO |
$32.17
|
| Rate for Payer: Cigna of CA PPO |
$37.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$52.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$47.37
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$35.09
|
| Rate for Payer: EPIC Health Plan Transplant |
$35.09
|
| Rate for Payer: Galaxy Health WC |
$42.73
|
| Rate for Payer: Global Benefits Group Commercial |
$30.16
|
| Rate for Payer: Health Management Network EPO/PPO |
$45.24
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$37.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$57.55
|
| Rate for Payer: IEHP medi-cal |
$57.90
|
| Rate for Payer: IEHP Medicare Advantage |
$35.09
|
| Rate for Payer: Innovage PACE Commercial |
$52.64
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$33.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$35.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.05
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$47.02
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$47.02
|
| Rate for Payer: Multiplan Commercial |
$37.70
|
| Rate for Payer: Networks By Design Commercial |
$32.68
|
| Rate for Payer: Prime Health Services Commercial |
$42.73
|
| Rate for Payer: Prime Health Services Medicare |
$37.20
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$30.16
|
| Rate for Payer: Riverside University Health MISP |
$38.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$30.16
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$30.16
|
| Rate for Payer: United Healthcare All Other Commercial |
$28.42
|
| Rate for Payer: United Healthcare All Other HMO |
$28.42
|
| Rate for Payer: United Healthcare HMO Rider |
$28.42
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$28.42
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$52.64
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$38.60
|
| Rate for Payer: Vantage Medical Group Senior |
$35.09
|
|
|
HC SOM HIV2 86702
|
Facility
OP
|
$19.37
|
|
|
Service Code
|
CPT 86702
|
| Hospital Charge Code |
900914737
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.87 |
| Max. Negotiated Rate |
$121.87 |
| Rate for Payer: Adventist Health Medi-Cal |
$13.52
|
| Rate for Payer: Aetna of CA HMO/PPO |
$99.28
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$20.28
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$14.87
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$13.52
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$99.91
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$121.87
|
| Rate for Payer: BCBS Transplant Transplant |
$11.62
|
| Rate for Payer: Blue Shield of California Commercial |
$11.97
|
| Rate for Payer: Blue Shield of California EPN |
$9.41
|
| Rate for Payer: Caremore Medicare Advantage |
$13.52
|
| Rate for Payer: Cash Price |
$8.72
|
| Rate for Payer: Cash Price |
$8.72
|
| Rate for Payer: Central Health Plan Commercial |
$15.50
|
| Rate for Payer: Cigna of CA HMO |
$12.40
|
| Rate for Payer: Cigna of CA PPO |
$14.33
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20.28
|
| Rate for Payer: EPIC Health Plan Commercial |
$18.25
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$13.52
|
| Rate for Payer: EPIC Health Plan Transplant |
$13.52
|
| Rate for Payer: Galaxy Health WC |
$16.46
|
| Rate for Payer: Global Benefits Group Commercial |
$11.62
|
| Rate for Payer: Health Management Network EPO/PPO |
$17.43
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$14.53
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$22.17
|
| Rate for Payer: IEHP medi-cal |
$22.31
|
| Rate for Payer: IEHP Medicare Advantage |
$13.52
|
| Rate for Payer: Innovage PACE Commercial |
$20.28
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12.92
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.87
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18.12
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18.12
|
| Rate for Payer: Multiplan Commercial |
$14.53
|
| Rate for Payer: Networks By Design Commercial |
$12.59
|
| Rate for Payer: Prime Health Services Commercial |
$16.46
|
| Rate for Payer: Prime Health Services Medicare |
$14.33
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$11.62
|
| Rate for Payer: Riverside University Health MISP |
$14.87
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$11.62
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$11.62
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.95
|
| Rate for Payer: United Healthcare All Other HMO |
$10.95
|
| Rate for Payer: United Healthcare HMO Rider |
$10.95
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.95
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20.28
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.87
|
| Rate for Payer: Vantage Medical Group Senior |
$13.52
|
|
|
HC SOM HIV2 86702
|
Facility
IP
|
$19.37
|
|
|
Service Code
|
CPT 86702
|
| Hospital Charge Code |
900914737
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.87 |
| Max. Negotiated Rate |
$17.43 |
| Rate for Payer: Cash Price |
$8.72
|
| Rate for Payer: Central Health Plan Commercial |
$15.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.75
|
| Rate for Payer: Galaxy Health WC |
$16.46
|
| Rate for Payer: Global Benefits Group Commercial |
$11.62
|
| Rate for Payer: Health Management Network EPO/PPO |
$17.43
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.87
|
| Rate for Payer: Multiplan Commercial |
$14.53
|
| Rate for Payer: Networks By Design Commercial |
$12.59
|
| Rate for Payer: Prime Health Services Commercial |
$16.46
|
|
|
HC SOM HIV-2 ANTIBODY
|
Facility
OP
|
$45.24
|
|
|
Service Code
|
CPT 86702
|
| Hospital Charge Code |
900915309
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.05 |
| Max. Negotiated Rate |
$121.87 |
| Rate for Payer: Adventist Health Medi-Cal |
$13.52
|
| Rate for Payer: Aetna of CA HMO/PPO |
$99.28
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$20.28
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$14.87
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$13.52
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$99.91
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$121.87
|
| Rate for Payer: BCBS Transplant Transplant |
$27.14
|
| Rate for Payer: Blue Shield of California Commercial |
$27.96
|
| Rate for Payer: Blue Shield of California EPN |
$21.99
|
| Rate for Payer: Caremore Medicare Advantage |
$13.52
|
| Rate for Payer: Cash Price |
$20.36
|
| Rate for Payer: Cash Price |
$20.36
|
| Rate for Payer: Central Health Plan Commercial |
$36.19
|
| Rate for Payer: Cigna of CA HMO |
$28.95
|
| Rate for Payer: Cigna of CA PPO |
$33.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20.28
|
| Rate for Payer: EPIC Health Plan Commercial |
$18.25
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$13.52
|
| Rate for Payer: EPIC Health Plan Transplant |
$13.52
|
| Rate for Payer: Galaxy Health WC |
$38.45
|
| Rate for Payer: Global Benefits Group Commercial |
$27.14
|
| Rate for Payer: Health Management Network EPO/PPO |
$40.72
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$33.93
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$22.17
|
| Rate for Payer: IEHP medi-cal |
$22.31
|
| Rate for Payer: IEHP Medicare Advantage |
$13.52
|
| Rate for Payer: Innovage PACE Commercial |
$20.28
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$30.18
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.05
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18.12
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18.12
|
| Rate for Payer: Multiplan Commercial |
$33.93
|
| Rate for Payer: Networks By Design Commercial |
$29.41
|
| Rate for Payer: Prime Health Services Commercial |
$38.45
|
| Rate for Payer: Prime Health Services Medicare |
$14.33
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$27.14
|
| Rate for Payer: Riverside University Health MISP |
$14.87
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$27.14
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$27.14
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.95
|
| Rate for Payer: United Healthcare All Other HMO |
$10.95
|
| Rate for Payer: United Healthcare HMO Rider |
$10.95
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.95
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20.28
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.87
|
| Rate for Payer: Vantage Medical Group Senior |
$13.52
|
|
|
HC SOM HIV-2 ANTIBODY
|
Facility
IP
|
$45.24
|
|
|
Service Code
|
CPT 86702
|
| Hospital Charge Code |
900915309
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.05 |
| Max. Negotiated Rate |
$40.72 |
| Rate for Payer: Cash Price |
$20.36
|
| Rate for Payer: Central Health Plan Commercial |
$36.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$18.10
|
| Rate for Payer: Galaxy Health WC |
$38.45
|
| Rate for Payer: Global Benefits Group Commercial |
$27.14
|
| Rate for Payer: Health Management Network EPO/PPO |
$40.72
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$30.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.05
|
| Rate for Payer: Multiplan Commercial |
$33.93
|
| Rate for Payer: Networks By Design Commercial |
$29.41
|
| Rate for Payer: Prime Health Services Commercial |
$38.45
|
|
|
HC SOM HIV 2 CONFIRM
|
Facility
IP
|
$57.80
|
|
|
Service Code
|
CPT 86702
|
| Hospital Charge Code |
900911352
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.56 |
| Max. Negotiated Rate |
$52.02 |
| Rate for Payer: Cash Price |
$26.01
|
| Rate for Payer: Central Health Plan Commercial |
$46.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$23.12
|
| Rate for Payer: Galaxy Health WC |
$49.13
|
| Rate for Payer: Global Benefits Group Commercial |
$34.68
|
| Rate for Payer: Health Management Network EPO/PPO |
$52.02
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$38.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.56
|
| Rate for Payer: Multiplan Commercial |
$43.35
|
| Rate for Payer: Networks By Design Commercial |
$37.57
|
| Rate for Payer: Prime Health Services Commercial |
$49.13
|
|
|
HC SOM HIV 2 CONFIRM
|
Facility
OP
|
$65.00
|
|
|
Service Code
|
CPT 86702
|
| Hospital Charge Code |
900911352
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.95 |
| Max. Negotiated Rate |
$121.87 |
| Rate for Payer: Adventist Health Medi-Cal |
$13.52
|
| Rate for Payer: Aetna of CA HMO/PPO |
$99.28
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$20.28
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$14.87
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$13.52
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$99.91
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$121.87
|
| Rate for Payer: BCBS Transplant Transplant |
$39.00
|
| Rate for Payer: Blue Shield of California Commercial |
$40.17
|
| Rate for Payer: Blue Shield of California EPN |
$31.59
|
| Rate for Payer: Caremore Medicare Advantage |
$13.52
|
| Rate for Payer: Cash Price |
$29.25
|
| Rate for Payer: Cash Price |
$29.25
|
| Rate for Payer: Central Health Plan Commercial |
$52.00
|
| Rate for Payer: Cigna of CA HMO |
$41.60
|
| Rate for Payer: Cigna of CA PPO |
$48.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20.28
|
| Rate for Payer: EPIC Health Plan Commercial |
$18.25
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$13.52
|
| Rate for Payer: EPIC Health Plan Transplant |
$13.52
|
| Rate for Payer: Galaxy Health WC |
$55.25
|
| Rate for Payer: Global Benefits Group Commercial |
$39.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$58.50
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$48.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$22.17
|
| Rate for Payer: IEHP medi-cal |
$22.31
|
| Rate for Payer: IEHP Medicare Advantage |
$13.52
|
| Rate for Payer: Innovage PACE Commercial |
$20.28
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$43.36
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18.12
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18.12
|
| Rate for Payer: Multiplan Commercial |
$48.75
|
| Rate for Payer: Networks By Design Commercial |
$42.25
|
| Rate for Payer: Prime Health Services Commercial |
$55.25
|
| Rate for Payer: Prime Health Services Medicare |
$14.33
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$39.00
|
| Rate for Payer: Riverside University Health MISP |
$14.87
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$39.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$39.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.95
|
| Rate for Payer: United Healthcare All Other HMO |
$10.95
|
| Rate for Payer: United Healthcare HMO Rider |
$10.95
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.95
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20.28
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.87
|
| Rate for Payer: Vantage Medical Group Senior |
$13.52
|
|
|
HC SOM HIV DNA (PCR)
|
Facility
IP
|
$85.00
|
|
|
Service Code
|
CPT 87536
|
| Hospital Charge Code |
900911055
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$17.00 |
| Max. Negotiated Rate |
$76.50 |
| Rate for Payer: Cash Price |
$38.25
|
| Rate for Payer: Central Health Plan Commercial |
$68.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$34.00
|
| Rate for Payer: Galaxy Health WC |
$72.25
|
| Rate for Payer: Global Benefits Group Commercial |
$51.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$76.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$56.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$17.00
|
| Rate for Payer: Multiplan Commercial |
$63.75
|
| Rate for Payer: Networks By Design Commercial |
$55.25
|
| Rate for Payer: Prime Health Services Commercial |
$72.25
|
|
|
HC SOM HIV DNA (PCR)
|
Facility
OP
|
$85.00
|
|
|
Service Code
|
CPT 87536
|
| Hospital Charge Code |
900911055
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$17.00 |
| Max. Negotiated Rate |
$624.55 |
| Rate for Payer: Adventist Health Medi-Cal |
$85.10
|
| Rate for Payer: Aetna of CA HMO/PPO |
$624.55
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$127.65
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$93.61
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$85.10
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$188.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$229.58
|
| Rate for Payer: BCBS Transplant Transplant |
$51.00
|
| Rate for Payer: Blue Shield of California Commercial |
$52.53
|
| Rate for Payer: Blue Shield of California EPN |
$41.31
|
| Rate for Payer: Caremore Medicare Advantage |
$85.10
|
| Rate for Payer: Cash Price |
$38.25
|
| Rate for Payer: Cash Price |
$38.25
|
| Rate for Payer: Central Health Plan Commercial |
$68.00
|
| Rate for Payer: Cigna of CA HMO |
$54.40
|
| Rate for Payer: Cigna of CA PPO |
$62.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$127.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$114.88
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$85.10
|
| Rate for Payer: EPIC Health Plan Transplant |
$85.10
|
| Rate for Payer: Galaxy Health WC |
$72.25
|
| Rate for Payer: Global Benefits Group Commercial |
$51.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$76.50
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$63.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$139.56
|
| Rate for Payer: IEHP medi-cal |
$140.42
|
| Rate for Payer: IEHP Medicare Advantage |
$85.10
|
| Rate for Payer: Innovage PACE Commercial |
$127.65
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$56.70
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$85.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$17.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$114.03
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$114.03
|
| Rate for Payer: Multiplan Commercial |
$63.75
|
| Rate for Payer: Networks By Design Commercial |
$55.25
|
| Rate for Payer: Prime Health Services Commercial |
$72.25
|
| Rate for Payer: Prime Health Services Medicare |
$90.21
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$51.00
|
| Rate for Payer: Riverside University Health MISP |
$93.61
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$51.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$51.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$68.93
|
| Rate for Payer: United Healthcare All Other HMO |
$68.93
|
| Rate for Payer: United Healthcare HMO Rider |
$68.93
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$68.93
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$127.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$93.61
|
| Rate for Payer: Vantage Medical Group Senior |
$85.10
|
|
|
HC SOM HIVE 86703
|
Facility
IP
|
$114.45
|
|
|
Service Code
|
CPT 86703
|
| Hospital Charge Code |
900914736
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$22.89 |
| Max. Negotiated Rate |
$103.00 |
| Rate for Payer: Cash Price |
$51.50
|
| Rate for Payer: Central Health Plan Commercial |
$91.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$45.78
|
| Rate for Payer: Galaxy Health WC |
$97.28
|
| Rate for Payer: Global Benefits Group Commercial |
$68.67
|
| Rate for Payer: Health Management Network EPO/PPO |
$103.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$76.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.89
|
| Rate for Payer: Multiplan Commercial |
$85.84
|
| Rate for Payer: Networks By Design Commercial |
$74.39
|
| Rate for Payer: Prime Health Services Commercial |
$97.28
|
|
|
HC SOM HIVE 86703
|
Facility
OP
|
$114.45
|
|
|
Service Code
|
CPT 86703
|
| Hospital Charge Code |
900914736
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.11 |
| Max. Negotiated Rate |
$125.39 |
| Rate for Payer: Adventist Health Medi-Cal |
$13.71
|
| Rate for Payer: Aetna of CA HMO/PPO |
$100.69
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$20.56
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$15.08
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$13.71
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$102.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$125.39
|
| Rate for Payer: BCBS Transplant Transplant |
$68.67
|
| Rate for Payer: Blue Shield of California Commercial |
$70.73
|
| Rate for Payer: Blue Shield of California EPN |
$55.62
|
| Rate for Payer: Caremore Medicare Advantage |
$13.71
|
| Rate for Payer: Cash Price |
$51.50
|
| Rate for Payer: Cash Price |
$51.50
|
| Rate for Payer: Central Health Plan Commercial |
$91.56
|
| Rate for Payer: Cigna of CA HMO |
$73.25
|
| Rate for Payer: Cigna of CA PPO |
$84.69
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$18.51
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$13.71
|
| Rate for Payer: EPIC Health Plan Transplant |
$13.71
|
| Rate for Payer: Galaxy Health WC |
$97.28
|
| Rate for Payer: Global Benefits Group Commercial |
$68.67
|
| Rate for Payer: Health Management Network EPO/PPO |
$103.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$85.84
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$22.48
|
| Rate for Payer: IEHP medi-cal |
$22.62
|
| Rate for Payer: IEHP Medicare Advantage |
$13.71
|
| Rate for Payer: Innovage PACE Commercial |
$20.56
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$76.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.89
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18.37
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18.37
|
| Rate for Payer: Multiplan Commercial |
$85.84
|
| Rate for Payer: Networks By Design Commercial |
$74.39
|
| Rate for Payer: Prime Health Services Commercial |
$97.28
|
| Rate for Payer: Prime Health Services Medicare |
$14.53
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$68.67
|
| Rate for Payer: Riverside University Health MISP |
$15.08
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$68.67
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$68.67
|
| Rate for Payer: United Healthcare All Other Commercial |
$11.11
|
| Rate for Payer: United Healthcare All Other HMO |
$11.11
|
| Rate for Payer: United Healthcare HMO Rider |
$11.11
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.11
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20.56
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15.08
|
| Rate for Payer: Vantage Medical Group Senior |
$13.71
|
|
|
HC SOM HMUCR ARSENIC/CREAT, RAND, U
|
Facility
IP
|
$23.66
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
900915364
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.73 |
| Max. Negotiated Rate |
$21.29 |
| Rate for Payer: Cash Price |
$10.65
|
| Rate for Payer: Central Health Plan Commercial |
$18.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.46
|
| Rate for Payer: Galaxy Health WC |
$20.11
|
| Rate for Payer: Global Benefits Group Commercial |
$14.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$21.29
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.73
|
| Rate for Payer: Multiplan Commercial |
$17.74
|
| Rate for Payer: Networks By Design Commercial |
$15.38
|
| Rate for Payer: Prime Health Services Commercial |
$20.11
|
|
|
HC SOM HMUCR ARSENIC/CREAT, RAND, U
|
Facility
OP
|
$23.66
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
900915364
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.73 |
| Max. Negotiated Rate |
$168.35 |
| Rate for Payer: Adventist Health Medi-Cal |
$18.97
|
| Rate for Payer: Aetna of CA HMO/PPO |
$139.28
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$28.46
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$20.87
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$18.97
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$138.02
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$168.35
|
| Rate for Payer: BCBS Transplant Transplant |
$14.20
|
| Rate for Payer: Blue Shield of California Commercial |
$14.62
|
| Rate for Payer: Blue Shield of California EPN |
$11.50
|
| Rate for Payer: Caremore Medicare Advantage |
$18.97
|
| Rate for Payer: Cash Price |
$10.65
|
| Rate for Payer: Cash Price |
$10.65
|
| Rate for Payer: Central Health Plan Commercial |
$18.93
|
| Rate for Payer: Cigna of CA HMO |
$15.14
|
| Rate for Payer: Cigna of CA PPO |
$17.51
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$28.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$25.61
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$18.97
|
| Rate for Payer: EPIC Health Plan Transplant |
$18.97
|
| Rate for Payer: Galaxy Health WC |
$20.11
|
| Rate for Payer: Global Benefits Group Commercial |
$14.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$21.29
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$17.74
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$31.11
|
| Rate for Payer: IEHP medi-cal |
$31.30
|
| Rate for Payer: IEHP Medicare Advantage |
$18.97
|
| Rate for Payer: Innovage PACE Commercial |
$28.46
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.73
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$25.42
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$25.42
|
| Rate for Payer: Multiplan Commercial |
$17.74
|
| Rate for Payer: Networks By Design Commercial |
$15.38
|
| Rate for Payer: Prime Health Services Commercial |
$20.11
|
| Rate for Payer: Prime Health Services Medicare |
$20.11
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$14.20
|
| Rate for Payer: Riverside University Health MISP |
$20.87
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$14.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$14.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$15.36
|
| Rate for Payer: United Healthcare All Other HMO |
$15.36
|
| Rate for Payer: United Healthcare HMO Rider |
$15.36
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15.36
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$28.46
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$20.87
|
| Rate for Payer: Vantage Medical Group Senior |
$18.97
|
|
|
HC SOM HMUCR CADMIUM/CREAT, RAND, U
|
Facility
OP
|
$29.49
|
|
|
Service Code
|
CPT 82300
|
| Hospital Charge Code |
900915365
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.90 |
| Max. Negotiated Rate |
$205.27 |
| Rate for Payer: Adventist Health Medi-Cal |
$23.64
|
| Rate for Payer: Aetna of CA HMO/PPO |
$169.84
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$35.46
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$26.00
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$23.64
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$168.28
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$205.27
|
| Rate for Payer: BCBS Transplant Transplant |
$17.69
|
| Rate for Payer: Blue Shield of California Commercial |
$18.22
|
| Rate for Payer: Blue Shield of California EPN |
$14.33
|
| Rate for Payer: Caremore Medicare Advantage |
$23.64
|
| Rate for Payer: Cash Price |
$13.27
|
| Rate for Payer: Cash Price |
$13.27
|
| Rate for Payer: Central Health Plan Commercial |
$23.59
|
| Rate for Payer: Cigna of CA HMO |
$18.87
|
| Rate for Payer: Cigna of CA PPO |
$21.82
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$35.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$31.91
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$23.64
|
| Rate for Payer: EPIC Health Plan Transplant |
$23.64
|
| Rate for Payer: Galaxy Health WC |
$25.07
|
| Rate for Payer: Global Benefits Group Commercial |
$17.69
|
| Rate for Payer: Health Management Network EPO/PPO |
$26.54
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$22.12
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$38.77
|
| Rate for Payer: IEHP medi-cal |
$39.01
|
| Rate for Payer: IEHP Medicare Advantage |
$23.64
|
| Rate for Payer: Innovage PACE Commercial |
$35.46
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$19.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$23.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.90
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$31.68
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$31.68
|
| Rate for Payer: Multiplan Commercial |
$22.12
|
| Rate for Payer: Networks By Design Commercial |
$19.17
|
| Rate for Payer: Prime Health Services Commercial |
$25.07
|
| Rate for Payer: Prime Health Services Medicare |
$25.06
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$17.69
|
| Rate for Payer: Riverside University Health MISP |
$26.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$17.69
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$17.69
|
| Rate for Payer: United Healthcare All Other Commercial |
$19.15
|
| Rate for Payer: United Healthcare All Other HMO |
$19.15
|
| Rate for Payer: United Healthcare HMO Rider |
$19.15
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$19.15
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$35.46
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$26.00
|
| Rate for Payer: Vantage Medical Group Senior |
$23.64
|
|
|
HC SOM HMUCR CADMIUM/CREAT, RAND, U
|
Facility
IP
|
$29.49
|
|
|
Service Code
|
CPT 82300
|
| Hospital Charge Code |
900915365
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.90 |
| Max. Negotiated Rate |
$26.54 |
| Rate for Payer: Cash Price |
$13.27
|
| Rate for Payer: Central Health Plan Commercial |
$23.59
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.80
|
| Rate for Payer: Galaxy Health WC |
$25.07
|
| Rate for Payer: Global Benefits Group Commercial |
$17.69
|
| Rate for Payer: Health Management Network EPO/PPO |
$26.54
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$19.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.90
|
| Rate for Payer: Multiplan Commercial |
$22.12
|
| Rate for Payer: Networks By Design Commercial |
$19.17
|
| Rate for Payer: Prime Health Services Commercial |
$25.07
|
|
|
HC SOM HMUCR CREATININE, RAND, U
|
Facility
IP
|
$6.46
|
|
|
Service Code
|
CPT 82570
|
| Hospital Charge Code |
900915368
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$1.29 |
| Max. Negotiated Rate |
$5.81 |
| Rate for Payer: Cash Price |
$2.91
|
| Rate for Payer: Central Health Plan Commercial |
$5.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.58
|
| Rate for Payer: Galaxy Health WC |
$5.49
|
| Rate for Payer: Global Benefits Group Commercial |
$3.88
|
| Rate for Payer: Health Management Network EPO/PPO |
$5.81
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.29
|
| Rate for Payer: Multiplan Commercial |
$4.84
|
| Rate for Payer: Networks By Design Commercial |
$4.20
|
| Rate for Payer: Prime Health Services Commercial |
$5.49
|
|
|
HC SOM HMUCR CREATININE, RAND, U
|
Facility
OP
|
$6.46
|
|
|
Service Code
|
CPT 82570
|
| Hospital Charge Code |
900915368
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$1.29 |
| Max. Negotiated Rate |
$45.88 |
| Rate for Payer: Adventist Health Medi-Cal |
$5.18
|
| Rate for Payer: Aetna of CA HMO/PPO |
$37.98
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$7.77
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$5.70
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$5.18
|
| 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 |
$3.88
|
| Rate for Payer: Blue Shield of California Commercial |
$3.99
|
| Rate for Payer: Blue Shield of California EPN |
$3.14
|
| Rate for Payer: Caremore Medicare Advantage |
$5.18
|
| Rate for Payer: Cash Price |
$2.91
|
| Rate for Payer: Cash Price |
$2.91
|
| Rate for Payer: Central Health Plan Commercial |
$5.17
|
| Rate for Payer: Cigna of CA HMO |
$4.13
|
| Rate for Payer: Cigna of CA PPO |
$4.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.99
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$5.18
|
| Rate for Payer: EPIC Health Plan Transplant |
$5.18
|
| Rate for Payer: Galaxy Health WC |
$5.49
|
| Rate for Payer: Global Benefits Group Commercial |
$3.88
|
| Rate for Payer: Health Management Network EPO/PPO |
$5.81
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$4.84
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$8.50
|
| Rate for Payer: IEHP medi-cal |
$8.55
|
| Rate for Payer: IEHP Medicare Advantage |
$5.18
|
| Rate for Payer: Innovage PACE Commercial |
$7.77
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4.31
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.29
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.94
|
| Rate for Payer: Multiplan Commercial |
$4.84
|
| Rate for Payer: Networks By Design Commercial |
$4.20
|
| Rate for Payer: Prime Health Services Commercial |
$5.49
|
| Rate for Payer: Prime Health Services Medicare |
$5.49
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$3.88
|
| Rate for Payer: Riverside University Health MISP |
$5.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3.88
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3.88
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.19
|
| Rate for Payer: United Healthcare All Other HMO |
$4.19
|
| Rate for Payer: United Healthcare HMO Rider |
$4.19
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.19
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.77
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.70
|
| Rate for Payer: Vantage Medical Group Senior |
$5.18
|
|
