|
HC SOM IMMUNOGLOBULIN IGD
|
Facility
IP
|
$26.40
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
900910574
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.28 |
| Max. Negotiated Rate |
$23.76 |
| Rate for Payer: Cash Price |
$11.88
|
| Rate for Payer: Central Health Plan Commercial |
$21.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.56
|
| Rate for Payer: Galaxy Health WC |
$22.44
|
| Rate for Payer: Global Benefits Group Commercial |
$15.84
|
| Rate for Payer: Health Management Network EPO/PPO |
$23.76
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.28
|
| Rate for Payer: Multiplan Commercial |
$19.80
|
| Rate for Payer: Networks By Design Commercial |
$17.16
|
| Rate for Payer: Prime Health Services Commercial |
$22.44
|
|
|
HC SOM IMMUNOGLOBULIN IGD
|
Facility
OP
|
$26.40
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
900910574
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.28 |
| 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 |
$15.84
|
| Rate for Payer: Blue Shield of California Commercial |
$16.32
|
| Rate for Payer: Blue Shield of California EPN |
$12.83
|
| Rate for Payer: Caremore Medicare Advantage |
$9.30
|
| Rate for Payer: Cash Price |
$11.88
|
| Rate for Payer: Cash Price |
$11.88
|
| Rate for Payer: Central Health Plan Commercial |
$21.12
|
| Rate for Payer: Cigna of CA HMO |
$16.90
|
| Rate for Payer: Cigna of CA PPO |
$19.54
|
| 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 |
$22.44
|
| Rate for Payer: Global Benefits Group Commercial |
$15.84
|
| Rate for Payer: Health Management Network EPO/PPO |
$23.76
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$19.80
|
| 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 |
$17.61
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.28
|
| 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 |
$19.80
|
| Rate for Payer: Networks By Design Commercial |
$17.16
|
| Rate for Payer: Prime Health Services Commercial |
$22.44
|
| Rate for Payer: Prime Health Services Medicare |
$9.86
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$15.84
|
| Rate for Payer: Riverside University Health MISP |
$10.23
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15.84
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$15.84
|
| 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 IMMUNOGLOBULINS,IGC SUBCLASS 1
|
Facility
IP
|
$6.00
|
|
|
Service Code
|
CPT 82787
|
| Hospital Charge Code |
900911271
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$1.20 |
| Max. Negotiated Rate |
$5.40 |
| Rate for Payer: Cash Price |
$2.70
|
| Rate for Payer: Central Health Plan Commercial |
$4.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.40
|
| Rate for Payer: Galaxy Health WC |
$5.10
|
| Rate for Payer: Global Benefits Group Commercial |
$3.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$5.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.20
|
| Rate for Payer: Multiplan Commercial |
$4.50
|
| Rate for Payer: Networks By Design Commercial |
$3.90
|
| Rate for Payer: Prime Health Services Commercial |
$5.10
|
|
|
HC SOM IMMUNOGLOBULINS,IGC SUBCLASS 1
|
Facility
OP
|
$6.00
|
|
|
Service Code
|
CPT 82787
|
| Hospital Charge Code |
900911271
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$1.20 |
| Max. Negotiated Rate |
$295.59 |
| Rate for Payer: Adventist Health Medi-Cal |
$8.02
|
| Rate for Payer: Aetna of CA HMO/PPO |
$58.90
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$12.03
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$8.82
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$8.02
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$242.34
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$295.59
|
| Rate for Payer: BCBS Transplant Transplant |
$3.60
|
| Rate for Payer: Blue Shield of California Commercial |
$3.71
|
| Rate for Payer: Blue Shield of California EPN |
$2.92
|
| Rate for Payer: Caremore Medicare Advantage |
$8.02
|
| Rate for Payer: Cash Price |
$2.70
|
| Rate for Payer: Cash Price |
$2.70
|
| Rate for Payer: Central Health Plan Commercial |
$4.80
|
| Rate for Payer: Cigna of CA HMO |
$3.84
|
| Rate for Payer: Cigna of CA PPO |
$4.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.83
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$8.02
|
| Rate for Payer: EPIC Health Plan Transplant |
$8.02
|
| Rate for Payer: Galaxy Health WC |
$5.10
|
| Rate for Payer: Global Benefits Group Commercial |
$3.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$5.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$4.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$13.15
|
| Rate for Payer: IEHP medi-cal |
$13.23
|
| Rate for Payer: IEHP Medicare Advantage |
$8.02
|
| Rate for Payer: Innovage PACE Commercial |
$12.03
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.75
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10.75
|
| Rate for Payer: Multiplan Commercial |
$4.50
|
| Rate for Payer: Networks By Design Commercial |
$3.90
|
| Rate for Payer: Prime Health Services Commercial |
$5.10
|
| Rate for Payer: Prime Health Services Medicare |
$8.50
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$3.60
|
| Rate for Payer: Riverside University Health MISP |
$8.82
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.50
|
| Rate for Payer: United Healthcare All Other HMO |
$6.50
|
| Rate for Payer: United Healthcare HMO Rider |
$6.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.03
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.82
|
| Rate for Payer: Vantage Medical Group Senior |
$8.02
|
|
|
HC SOM IMMUNOGLOBULINS,IGG SUBCLASS 2
|
Facility
OP
|
$6.00
|
|
|
Service Code
|
CPT 82787
|
| Hospital Charge Code |
900911272
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$1.20 |
| Max. Negotiated Rate |
$295.59 |
| Rate for Payer: Adventist Health Medi-Cal |
$8.02
|
| Rate for Payer: Aetna of CA HMO/PPO |
$58.90
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$12.03
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$8.82
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$8.02
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$242.34
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$295.59
|
| Rate for Payer: BCBS Transplant Transplant |
$3.60
|
| Rate for Payer: Blue Shield of California Commercial |
$3.71
|
| Rate for Payer: Blue Shield of California EPN |
$2.92
|
| Rate for Payer: Caremore Medicare Advantage |
$8.02
|
| Rate for Payer: Cash Price |
$2.70
|
| Rate for Payer: Cash Price |
$2.70
|
| Rate for Payer: Central Health Plan Commercial |
$4.80
|
| Rate for Payer: Cigna of CA HMO |
$3.84
|
| Rate for Payer: Cigna of CA PPO |
$4.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.83
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$8.02
|
| Rate for Payer: EPIC Health Plan Transplant |
$8.02
|
| Rate for Payer: Galaxy Health WC |
$5.10
|
| Rate for Payer: Global Benefits Group Commercial |
$3.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$5.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$4.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$13.15
|
| Rate for Payer: IEHP medi-cal |
$13.23
|
| Rate for Payer: IEHP Medicare Advantage |
$8.02
|
| Rate for Payer: Innovage PACE Commercial |
$12.03
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.75
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10.75
|
| Rate for Payer: Multiplan Commercial |
$4.50
|
| Rate for Payer: Networks By Design Commercial |
$3.90
|
| Rate for Payer: Prime Health Services Commercial |
$5.10
|
| Rate for Payer: Prime Health Services Medicare |
$8.50
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$3.60
|
| Rate for Payer: Riverside University Health MISP |
$8.82
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.50
|
| Rate for Payer: United Healthcare All Other HMO |
$6.50
|
| Rate for Payer: United Healthcare HMO Rider |
$6.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.03
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.82
|
| Rate for Payer: Vantage Medical Group Senior |
$8.02
|
|
|
HC SOM IMMUNOGLOBULINS,IGG SUBCLASS 2
|
Facility
IP
|
$6.00
|
|
|
Service Code
|
CPT 82787
|
| Hospital Charge Code |
900911272
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$1.20 |
| Max. Negotiated Rate |
$5.40 |
| Rate for Payer: Cash Price |
$2.70
|
| Rate for Payer: Central Health Plan Commercial |
$4.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.40
|
| Rate for Payer: Galaxy Health WC |
$5.10
|
| Rate for Payer: Global Benefits Group Commercial |
$3.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$5.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.20
|
| Rate for Payer: Multiplan Commercial |
$4.50
|
| Rate for Payer: Networks By Design Commercial |
$3.90
|
| Rate for Payer: Prime Health Services Commercial |
$5.10
|
|
|
HC SOM IMMUNOGLOBULINS IGG SUBCLASS 3
|
Facility
OP
|
$7.24
|
|
|
Service Code
|
CPT 82787
|
| Hospital Charge Code |
900911273
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$1.45 |
| Max. Negotiated Rate |
$295.59 |
| Rate for Payer: Adventist Health Medi-Cal |
$8.02
|
| Rate for Payer: Aetna of CA HMO/PPO |
$58.90
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$12.03
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$8.82
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$8.02
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$242.34
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$295.59
|
| Rate for Payer: BCBS Transplant Transplant |
$4.34
|
| Rate for Payer: Blue Shield of California Commercial |
$4.47
|
| Rate for Payer: Blue Shield of California EPN |
$3.52
|
| Rate for Payer: Caremore Medicare Advantage |
$8.02
|
| Rate for Payer: Cash Price |
$3.26
|
| Rate for Payer: Cash Price |
$3.26
|
| Rate for Payer: Central Health Plan Commercial |
$5.79
|
| Rate for Payer: Cigna of CA HMO |
$4.63
|
| Rate for Payer: Cigna of CA PPO |
$5.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.83
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$8.02
|
| Rate for Payer: EPIC Health Plan Transplant |
$8.02
|
| Rate for Payer: Galaxy Health WC |
$6.15
|
| Rate for Payer: Global Benefits Group Commercial |
$4.34
|
| Rate for Payer: Health Management Network EPO/PPO |
$6.52
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$5.43
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$13.15
|
| Rate for Payer: IEHP medi-cal |
$13.23
|
| Rate for Payer: IEHP Medicare Advantage |
$8.02
|
| Rate for Payer: Innovage PACE Commercial |
$12.03
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4.83
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.45
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.75
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10.75
|
| Rate for Payer: Multiplan Commercial |
$5.43
|
| Rate for Payer: Networks By Design Commercial |
$4.71
|
| Rate for Payer: Prime Health Services Commercial |
$6.15
|
| Rate for Payer: Prime Health Services Medicare |
$8.50
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$4.34
|
| Rate for Payer: Riverside University Health MISP |
$8.82
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4.34
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4.34
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.50
|
| Rate for Payer: United Healthcare All Other HMO |
$6.50
|
| Rate for Payer: United Healthcare HMO Rider |
$6.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.03
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.82
|
| Rate for Payer: Vantage Medical Group Senior |
$8.02
|
|
|
HC SOM IMMUNOGLOBULINS IGG SUBCLASS 3
|
Facility
IP
|
$7.24
|
|
|
Service Code
|
CPT 82787
|
| Hospital Charge Code |
900911273
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$1.45 |
| Max. Negotiated Rate |
$6.52 |
| Rate for Payer: Cash Price |
$3.26
|
| Rate for Payer: Central Health Plan Commercial |
$5.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.90
|
| Rate for Payer: Galaxy Health WC |
$6.15
|
| Rate for Payer: Global Benefits Group Commercial |
$4.34
|
| Rate for Payer: Health Management Network EPO/PPO |
$6.52
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.45
|
| Rate for Payer: Multiplan Commercial |
$5.43
|
| Rate for Payer: Networks By Design Commercial |
$4.71
|
| Rate for Payer: Prime Health Services Commercial |
$6.15
|
|
|
HC SOM IMMUNOGLOBULINS IGG SUBCLASS 4
|
Facility
IP
|
$7.25
|
|
|
Service Code
|
CPT 82787
|
| Hospital Charge Code |
900910440
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$1.45 |
| Max. Negotiated Rate |
$6.52 |
| Rate for Payer: Cash Price |
$3.26
|
| Rate for Payer: Central Health Plan Commercial |
$5.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.90
|
| Rate for Payer: Galaxy Health WC |
$6.16
|
| Rate for Payer: Global Benefits Group Commercial |
$4.35
|
| Rate for Payer: Health Management Network EPO/PPO |
$6.52
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.45
|
| Rate for Payer: Multiplan Commercial |
$5.44
|
| Rate for Payer: Networks By Design Commercial |
$4.71
|
| Rate for Payer: Prime Health Services Commercial |
$6.16
|
|
|
HC SOM IMMUNOGLOBULINS IGG SUBCLASS 4
|
Facility
OP
|
$7.25
|
|
|
Service Code
|
CPT 82787
|
| Hospital Charge Code |
900910440
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$1.45 |
| Max. Negotiated Rate |
$295.59 |
| Rate for Payer: Adventist Health Medi-Cal |
$8.02
|
| Rate for Payer: Aetna of CA HMO/PPO |
$58.90
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$12.03
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$8.82
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$8.02
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$242.34
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$295.59
|
| Rate for Payer: BCBS Transplant Transplant |
$4.35
|
| Rate for Payer: Blue Shield of California Commercial |
$4.48
|
| Rate for Payer: Blue Shield of California EPN |
$3.52
|
| Rate for Payer: Caremore Medicare Advantage |
$8.02
|
| Rate for Payer: Cash Price |
$3.26
|
| Rate for Payer: Cash Price |
$3.26
|
| Rate for Payer: Central Health Plan Commercial |
$5.80
|
| Rate for Payer: Cigna of CA HMO |
$4.64
|
| Rate for Payer: Cigna of CA PPO |
$5.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.83
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$8.02
|
| Rate for Payer: EPIC Health Plan Transplant |
$8.02
|
| Rate for Payer: Galaxy Health WC |
$6.16
|
| Rate for Payer: Global Benefits Group Commercial |
$4.35
|
| Rate for Payer: Health Management Network EPO/PPO |
$6.52
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$5.44
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$13.15
|
| Rate for Payer: IEHP medi-cal |
$13.23
|
| Rate for Payer: IEHP Medicare Advantage |
$8.02
|
| Rate for Payer: Innovage PACE Commercial |
$12.03
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4.84
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.45
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.75
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10.75
|
| Rate for Payer: Multiplan Commercial |
$5.44
|
| Rate for Payer: Networks By Design Commercial |
$4.71
|
| Rate for Payer: Prime Health Services Commercial |
$6.16
|
| Rate for Payer: Prime Health Services Medicare |
$8.50
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$4.35
|
| Rate for Payer: Riverside University Health MISP |
$8.82
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4.35
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4.35
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.50
|
| Rate for Payer: United Healthcare All Other HMO |
$6.50
|
| Rate for Payer: United Healthcare HMO Rider |
$6.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.03
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.82
|
| Rate for Payer: Vantage Medical Group Senior |
$8.02
|
|
|
HC SOM INFLIXIMAB AB
|
Facility
OP
|
$100.00
|
|
|
Service Code
|
CPT 82397
|
| Hospital Charge Code |
900915313
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.44 |
| Max. Negotiated Rate |
$125.39 |
| Rate for Payer: Adventist Health Medi-Cal |
$14.12
|
| Rate for Payer: Aetna of CA HMO/PPO |
$103.69
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$21.18
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$15.53
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$14.12
|
| 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 |
$60.00
|
| Rate for Payer: Blue Shield of California Commercial |
$61.80
|
| Rate for Payer: Blue Shield of California EPN |
$48.60
|
| Rate for Payer: Caremore Medicare Advantage |
$14.12
|
| Rate for Payer: Cash Price |
$45.00
|
| Rate for Payer: Cash Price |
$45.00
|
| Rate for Payer: Central Health Plan Commercial |
$80.00
|
| Rate for Payer: Cigna of CA HMO |
$64.00
|
| Rate for Payer: Cigna of CA PPO |
$74.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.06
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$14.12
|
| Rate for Payer: EPIC Health Plan Transplant |
$14.12
|
| Rate for Payer: Galaxy Health WC |
$85.00
|
| Rate for Payer: Global Benefits Group Commercial |
$60.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$90.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$75.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$23.16
|
| Rate for Payer: IEHP medi-cal |
$23.30
|
| Rate for Payer: IEHP Medicare Advantage |
$14.12
|
| Rate for Payer: Innovage PACE Commercial |
$21.18
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$66.70
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18.92
|
| Rate for Payer: Multiplan Commercial |
$75.00
|
| Rate for Payer: Networks By Design Commercial |
$65.00
|
| Rate for Payer: Prime Health Services Commercial |
$85.00
|
| Rate for Payer: Prime Health Services Medicare |
$14.97
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$60.00
|
| Rate for Payer: Riverside University Health MISP |
$15.53
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$60.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$60.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$11.44
|
| Rate for Payer: United Healthcare All Other HMO |
$11.44
|
| Rate for Payer: United Healthcare HMO Rider |
$11.44
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.44
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15.53
|
| Rate for Payer: Vantage Medical Group Senior |
$14.12
|
|
|
HC SOM INFLIXIMAB AB
|
Facility
IP
|
$100.00
|
|
|
Service Code
|
CPT 82397
|
| Hospital Charge Code |
900915313
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$20.00 |
| Max. Negotiated Rate |
$90.00 |
| Rate for Payer: Cash Price |
$45.00
|
| Rate for Payer: Central Health Plan Commercial |
$80.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$40.00
|
| Rate for Payer: Galaxy Health WC |
$85.00
|
| Rate for Payer: Global Benefits Group Commercial |
$60.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$90.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$66.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.00
|
| Rate for Payer: Multiplan Commercial |
$75.00
|
| Rate for Payer: Networks By Design Commercial |
$65.00
|
| Rate for Payer: Prime Health Services Commercial |
$85.00
|
|
|
HC SOM INFLIXIMAB, QUANT
|
Facility
OP
|
$155.31
|
|
|
Service Code
|
CPT 80230
|
| Hospital Charge Code |
900915310
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$31.06 |
| Max. Negotiated Rate |
$201.13 |
| Rate for Payer: Adventist Health Medi-Cal |
$38.57
|
| Rate for Payer: Aetna of CA HMO/PPO |
$201.13
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$57.86
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$42.43
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$38.57
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$99.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$121.27
|
| Rate for Payer: BCBS Transplant Transplant |
$93.19
|
| Rate for Payer: Blue Shield of California Commercial |
$95.98
|
| Rate for Payer: Blue Shield of California EPN |
$75.48
|
| Rate for Payer: Caremore Medicare Advantage |
$38.57
|
| Rate for Payer: Cash Price |
$69.89
|
| Rate for Payer: Cash Price |
$69.89
|
| Rate for Payer: Central Health Plan Commercial |
$124.25
|
| Rate for Payer: Cigna of CA HMO |
$99.40
|
| Rate for Payer: Cigna of CA PPO |
$114.93
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$57.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$52.07
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$38.57
|
| Rate for Payer: EPIC Health Plan Transplant |
$38.57
|
| Rate for Payer: Galaxy Health WC |
$132.01
|
| Rate for Payer: Global Benefits Group Commercial |
$93.19
|
| Rate for Payer: Health Management Network EPO/PPO |
$139.78
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$116.48
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$63.25
|
| Rate for Payer: IEHP medi-cal |
$63.64
|
| Rate for Payer: IEHP Medicare Advantage |
$38.57
|
| Rate for Payer: Innovage PACE Commercial |
$57.86
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$103.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$38.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$31.06
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$51.68
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$51.68
|
| Rate for Payer: Multiplan Commercial |
$116.48
|
| Rate for Payer: Networks By Design Commercial |
$100.95
|
| Rate for Payer: Prime Health Services Commercial |
$132.01
|
| Rate for Payer: Prime Health Services Medicare |
$40.88
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$93.19
|
| Rate for Payer: Riverside University Health MISP |
$42.43
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$93.19
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$93.19
|
| Rate for Payer: United Healthcare All Other Commercial |
$31.24
|
| Rate for Payer: United Healthcare All Other HMO |
$31.24
|
| Rate for Payer: United Healthcare HMO Rider |
$31.24
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$31.24
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$57.86
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$42.43
|
| Rate for Payer: Vantage Medical Group Senior |
$38.57
|
|
|
HC SOM INFLIXIMAB, QUANT
|
Facility
IP
|
$155.31
|
|
|
Service Code
|
CPT 80230
|
| Hospital Charge Code |
900915310
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$31.06 |
| Max. Negotiated Rate |
$139.78 |
| Rate for Payer: Cash Price |
$69.89
|
| Rate for Payer: Central Health Plan Commercial |
$124.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$62.12
|
| Rate for Payer: Galaxy Health WC |
$132.01
|
| Rate for Payer: Global Benefits Group Commercial |
$93.19
|
| Rate for Payer: Health Management Network EPO/PPO |
$139.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$103.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$31.06
|
| Rate for Payer: Multiplan Commercial |
$116.48
|
| Rate for Payer: Networks By Design Commercial |
$100.95
|
| Rate for Payer: Prime Health Services Commercial |
$132.01
|
|
|
HC SOM INFLUENZA A AB TITER (CF)
|
Facility
IP
|
$14.75
|
|
|
Service Code
|
CPT 86710
|
| Hospital Charge Code |
900911771
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.95 |
| Max. Negotiated Rate |
$13.28 |
| Rate for Payer: Cash Price |
$6.64
|
| Rate for Payer: Central Health Plan Commercial |
$11.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.90
|
| Rate for Payer: Galaxy Health WC |
$12.54
|
| Rate for Payer: Global Benefits Group Commercial |
$8.85
|
| Rate for Payer: Health Management Network EPO/PPO |
$13.28
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.95
|
| Rate for Payer: Multiplan Commercial |
$11.06
|
| Rate for Payer: Networks By Design Commercial |
$9.59
|
| Rate for Payer: Prime Health Services Commercial |
$12.54
|
|
|
HC SOM INFLUENZA A AB TITER (CF)
|
Facility
OP
|
$14.75
|
|
|
Service Code
|
CPT 86710
|
| Hospital Charge Code |
900911771
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.95 |
| Max. Negotiated Rate |
$122.59 |
| Rate for Payer: Adventist Health Medi-Cal |
$13.55
|
| Rate for Payer: Aetna of CA HMO/PPO |
$99.52
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$20.32
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$14.90
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$13.55
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$100.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$122.59
|
| Rate for Payer: BCBS Transplant Transplant |
$8.85
|
| Rate for Payer: Blue Shield of California Commercial |
$9.12
|
| Rate for Payer: Blue Shield of California EPN |
$7.17
|
| Rate for Payer: Caremore Medicare Advantage |
$13.55
|
| Rate for Payer: Cash Price |
$6.64
|
| Rate for Payer: Cash Price |
$6.64
|
| Rate for Payer: Central Health Plan Commercial |
$11.80
|
| Rate for Payer: Cigna of CA HMO |
$9.44
|
| Rate for Payer: Cigna of CA PPO |
$10.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20.32
|
| Rate for Payer: EPIC Health Plan Commercial |
$18.29
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$13.55
|
| Rate for Payer: EPIC Health Plan Transplant |
$13.55
|
| Rate for Payer: Galaxy Health WC |
$12.54
|
| Rate for Payer: Global Benefits Group Commercial |
$8.85
|
| Rate for Payer: Health Management Network EPO/PPO |
$13.28
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$11.06
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$22.22
|
| Rate for Payer: IEHP medi-cal |
$22.36
|
| Rate for Payer: IEHP Medicare Advantage |
$13.55
|
| Rate for Payer: Innovage PACE Commercial |
$20.32
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9.84
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.95
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18.16
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18.16
|
| Rate for Payer: Multiplan Commercial |
$11.06
|
| Rate for Payer: Networks By Design Commercial |
$9.59
|
| Rate for Payer: Prime Health Services Commercial |
$12.54
|
| Rate for Payer: Prime Health Services Medicare |
$14.36
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$8.85
|
| Rate for Payer: Riverside University Health MISP |
$14.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8.85
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$8.85
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.98
|
| Rate for Payer: United Healthcare All Other HMO |
$10.98
|
| Rate for Payer: United Healthcare HMO Rider |
$10.98
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.98
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.90
|
| Rate for Payer: Vantage Medical Group Senior |
$13.55
|
|
|
HC SOM INFLUENZA B AB TITER (CF)
|
Facility
OP
|
$7.50
|
|
|
Service Code
|
CPT 86710
|
| Hospital Charge Code |
900911772
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$1.50 |
| Max. Negotiated Rate |
$122.59 |
| Rate for Payer: Adventist Health Medi-Cal |
$13.55
|
| Rate for Payer: Aetna of CA HMO/PPO |
$99.52
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$20.32
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$14.90
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$13.55
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$100.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$122.59
|
| Rate for Payer: BCBS Transplant Transplant |
$4.50
|
| Rate for Payer: Blue Shield of California Commercial |
$4.64
|
| Rate for Payer: Blue Shield of California EPN |
$3.64
|
| Rate for Payer: Caremore Medicare Advantage |
$13.55
|
| Rate for Payer: Cash Price |
$3.38
|
| Rate for Payer: Cash Price |
$3.38
|
| Rate for Payer: Central Health Plan Commercial |
$6.00
|
| Rate for Payer: Cigna of CA HMO |
$4.80
|
| Rate for Payer: Cigna of CA PPO |
$5.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20.32
|
| Rate for Payer: EPIC Health Plan Commercial |
$18.29
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$13.55
|
| Rate for Payer: EPIC Health Plan Transplant |
$13.55
|
| Rate for Payer: Galaxy Health WC |
$6.38
|
| Rate for Payer: Global Benefits Group Commercial |
$4.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$6.75
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$5.62
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$22.22
|
| Rate for Payer: IEHP medi-cal |
$22.36
|
| Rate for Payer: IEHP Medicare Advantage |
$13.55
|
| Rate for Payer: Innovage PACE Commercial |
$20.32
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18.16
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18.16
|
| Rate for Payer: Multiplan Commercial |
$5.62
|
| Rate for Payer: Networks By Design Commercial |
$4.88
|
| Rate for Payer: Prime Health Services Commercial |
$6.38
|
| Rate for Payer: Prime Health Services Medicare |
$14.36
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$4.50
|
| Rate for Payer: Riverside University Health MISP |
$14.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4.50
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.98
|
| Rate for Payer: United Healthcare All Other HMO |
$10.98
|
| Rate for Payer: United Healthcare HMO Rider |
$10.98
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.98
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.90
|
| Rate for Payer: Vantage Medical Group Senior |
$13.55
|
|
|
HC SOM INFLUENZA B AB TITER (CF)
|
Facility
IP
|
$7.50
|
|
|
Service Code
|
CPT 86710
|
| Hospital Charge Code |
900911772
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$1.50 |
| Max. Negotiated Rate |
$6.75 |
| Rate for Payer: Cash Price |
$3.38
|
| Rate for Payer: Central Health Plan Commercial |
$6.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.00
|
| Rate for Payer: Galaxy Health WC |
$6.38
|
| Rate for Payer: Global Benefits Group Commercial |
$4.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$6.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.50
|
| Rate for Payer: Multiplan Commercial |
$5.62
|
| Rate for Payer: Networks By Design Commercial |
$4.88
|
| Rate for Payer: Prime Health Services Commercial |
$6.38
|
|
|
HC SOM INHIBIN B
|
Facility
OP
|
$50.00
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
900913934
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.00 |
| Max. Negotiated Rate |
$114.88 |
| Rate for Payer: Adventist Health Medi-Cal |
$17.27
|
| Rate for Payer: Aetna of CA HMO/PPO |
$95.04
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$25.90
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$19.00
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$17.27
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$94.18
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$114.88
|
| Rate for Payer: BCBS Transplant Transplant |
$30.00
|
| Rate for Payer: Blue Shield of California Commercial |
$30.90
|
| Rate for Payer: Blue Shield of California EPN |
$24.30
|
| Rate for Payer: Caremore Medicare Advantage |
$17.27
|
| Rate for Payer: Cash Price |
$22.50
|
| Rate for Payer: Cash Price |
$22.50
|
| Rate for Payer: Central Health Plan Commercial |
$40.00
|
| Rate for Payer: Cigna of CA HMO |
$32.00
|
| Rate for Payer: Cigna of CA PPO |
$37.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$25.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$23.31
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$17.27
|
| Rate for Payer: EPIC Health Plan Transplant |
$17.27
|
| Rate for Payer: Galaxy Health WC |
$42.50
|
| Rate for Payer: Global Benefits Group Commercial |
$30.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$45.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$37.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$28.32
|
| Rate for Payer: IEHP medi-cal |
$28.50
|
| Rate for Payer: IEHP Medicare Advantage |
$17.27
|
| Rate for Payer: Innovage PACE Commercial |
$25.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$33.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$17.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$23.14
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$23.14
|
| Rate for Payer: Multiplan Commercial |
$37.50
|
| Rate for Payer: Networks By Design Commercial |
$32.50
|
| Rate for Payer: Prime Health Services Commercial |
$42.50
|
| Rate for Payer: Prime Health Services Medicare |
$18.31
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$30.00
|
| Rate for Payer: Riverside University Health MISP |
$19.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$30.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$30.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$13.99
|
| Rate for Payer: United Healthcare All Other HMO |
$13.99
|
| Rate for Payer: United Healthcare HMO Rider |
$13.99
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$13.99
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$25.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.00
|
| Rate for Payer: Vantage Medical Group Senior |
$17.27
|
|
|
HC SOM INHIBIN B
|
Facility
IP
|
$50.00
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
900913934
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.00 |
| Max. Negotiated Rate |
$45.00 |
| Rate for Payer: Cash Price |
$22.50
|
| Rate for Payer: Central Health Plan Commercial |
$40.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$20.00
|
| Rate for Payer: Galaxy Health WC |
$42.50
|
| Rate for Payer: Global Benefits Group Commercial |
$30.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$45.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$33.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.00
|
| Rate for Payer: Multiplan Commercial |
$37.50
|
| Rate for Payer: Networks By Design Commercial |
$32.50
|
| Rate for Payer: Prime Health Services Commercial |
$42.50
|
|
|
HC SOM INSULIN ANTIBODIES QUANTITATIV
|
Facility
OP
|
$32.21
|
|
|
Service Code
|
CPT 86337
|
| Hospital Charge Code |
900911061
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.44 |
| Max. Negotiated Rate |
$161.30 |
| Rate for Payer: Adventist Health Medi-Cal |
$21.41
|
| Rate for Payer: Aetna of CA HMO/PPO |
$157.14
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$32.12
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$23.55
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$21.41
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$132.24
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$161.30
|
| Rate for Payer: BCBS Transplant Transplant |
$19.33
|
| Rate for Payer: Blue Shield of California Commercial |
$19.91
|
| Rate for Payer: Blue Shield of California EPN |
$15.65
|
| Rate for Payer: Caremore Medicare Advantage |
$21.41
|
| Rate for Payer: Cash Price |
$14.49
|
| Rate for Payer: Cash Price |
$14.49
|
| Rate for Payer: Central Health Plan Commercial |
$25.77
|
| Rate for Payer: Cigna of CA HMO |
$20.61
|
| Rate for Payer: Cigna of CA PPO |
$23.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$32.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$28.90
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$21.41
|
| Rate for Payer: EPIC Health Plan Transplant |
$21.41
|
| Rate for Payer: Galaxy Health WC |
$27.38
|
| Rate for Payer: Global Benefits Group Commercial |
$19.33
|
| Rate for Payer: Health Management Network EPO/PPO |
$28.99
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$24.16
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$35.11
|
| Rate for Payer: IEHP medi-cal |
$35.33
|
| Rate for Payer: IEHP Medicare Advantage |
$21.41
|
| Rate for Payer: Innovage PACE Commercial |
$32.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$21.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$28.69
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$28.69
|
| Rate for Payer: Multiplan Commercial |
$24.16
|
| Rate for Payer: Networks By Design Commercial |
$20.94
|
| Rate for Payer: Prime Health Services Commercial |
$27.38
|
| Rate for Payer: Prime Health Services Medicare |
$22.69
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$19.33
|
| Rate for Payer: Riverside University Health MISP |
$23.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$19.33
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$19.33
|
| Rate for Payer: United Healthcare All Other Commercial |
$17.34
|
| Rate for Payer: United Healthcare All Other HMO |
$17.34
|
| Rate for Payer: United Healthcare HMO Rider |
$17.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$17.34
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$32.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$23.55
|
| Rate for Payer: Vantage Medical Group Senior |
$21.41
|
|
|
HC SOM INSULIN ANTIBODIES QUANTITATIV
|
Facility
IP
|
$32.21
|
|
|
Service Code
|
CPT 86337
|
| Hospital Charge Code |
900911061
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.44 |
| Max. Negotiated Rate |
$28.99 |
| Rate for Payer: Cash Price |
$14.49
|
| Rate for Payer: Central Health Plan Commercial |
$25.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.88
|
| Rate for Payer: Galaxy Health WC |
$27.38
|
| Rate for Payer: Global Benefits Group Commercial |
$19.33
|
| Rate for Payer: Health Management Network EPO/PPO |
$28.99
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$21.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.44
|
| Rate for Payer: Multiplan Commercial |
$24.16
|
| Rate for Payer: Networks By Design Commercial |
$20.94
|
| Rate for Payer: Prime Health Services Commercial |
$27.38
|
|
|
HC SOM INSULIN-LIKE GROWTH FACTOR I
|
Facility
OP
|
$20.20
|
|
|
Service Code
|
CPT 84305
|
| Hospital Charge Code |
900911132
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.04 |
| Max. Negotiated Rate |
$156.03 |
| Rate for Payer: Adventist Health Medi-Cal |
$21.26
|
| Rate for Payer: Aetna of CA HMO/PPO |
$156.03
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$31.89
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$23.39
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$21.26
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$123.72
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$150.90
|
| Rate for Payer: BCBS Transplant Transplant |
$12.12
|
| Rate for Payer: Blue Shield of California Commercial |
$12.48
|
| Rate for Payer: Blue Shield of California EPN |
$9.82
|
| Rate for Payer: Caremore Medicare Advantage |
$21.26
|
| Rate for Payer: Cash Price |
$9.09
|
| Rate for Payer: Cash Price |
$9.09
|
| Rate for Payer: Central Health Plan Commercial |
$16.16
|
| Rate for Payer: Cigna of CA HMO |
$12.93
|
| Rate for Payer: Cigna of CA PPO |
$14.95
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$31.89
|
| Rate for Payer: EPIC Health Plan Commercial |
$28.70
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$21.26
|
| Rate for Payer: EPIC Health Plan Transplant |
$21.26
|
| Rate for Payer: Galaxy Health WC |
$17.17
|
| Rate for Payer: Global Benefits Group Commercial |
$12.12
|
| Rate for Payer: Health Management Network EPO/PPO |
$18.18
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$15.15
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$34.87
|
| Rate for Payer: IEHP medi-cal |
$35.08
|
| Rate for Payer: IEHP Medicare Advantage |
$21.26
|
| Rate for Payer: Innovage PACE Commercial |
$31.89
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$13.47
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.04
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$28.49
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$28.49
|
| Rate for Payer: Multiplan Commercial |
$15.15
|
| Rate for Payer: Networks By Design Commercial |
$13.13
|
| Rate for Payer: Prime Health Services Commercial |
$17.17
|
| Rate for Payer: Prime Health Services Medicare |
$22.54
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$12.12
|
| Rate for Payer: Riverside University Health MISP |
$23.39
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$12.12
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$12.12
|
| Rate for Payer: United Healthcare All Other Commercial |
$17.22
|
| Rate for Payer: United Healthcare All Other HMO |
$17.22
|
| Rate for Payer: United Healthcare HMO Rider |
$17.22
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$17.22
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$31.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$23.39
|
| Rate for Payer: Vantage Medical Group Senior |
$21.26
|
|
|
HC SOM INSULIN-LIKE GROWTH FACTOR I
|
Facility
IP
|
$20.20
|
|
|
Service Code
|
CPT 84305
|
| Hospital Charge Code |
900911132
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.04 |
| Max. Negotiated Rate |
$18.18 |
| Rate for Payer: Cash Price |
$9.09
|
| Rate for Payer: Central Health Plan Commercial |
$16.16
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.08
|
| Rate for Payer: Galaxy Health WC |
$17.17
|
| Rate for Payer: Global Benefits Group Commercial |
$12.12
|
| Rate for Payer: Health Management Network EPO/PPO |
$18.18
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$13.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.04
|
| Rate for Payer: Multiplan Commercial |
$15.15
|
| Rate for Payer: Networks By Design Commercial |
$13.13
|
| Rate for Payer: Prime Health Services Commercial |
$17.17
|
|
|
HC SOM INTERPHASES 100-300
|
Facility
OP
|
$30.00
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
900915276
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$6.00 |
| Max. Negotiated Rate |
$4,146.30 |
| Rate for Payer: Adventist Health Medi-Cal |
$51.19
|
| Rate for Payer: Aetna of CA HMO/PPO |
$294.70
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$76.78
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$56.31
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$51.19
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,904.23
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,322.69
|
| 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 |
$51.19
|
| 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 |
$76.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$69.11
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$51.19
|
| Rate for Payer: EPIC Health Plan Transplant |
$51.19
|
| 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 |
$83.95
|
| Rate for Payer: IEHP medi-cal |
$84.46
|
| Rate for Payer: IEHP Medicare Advantage |
$51.19
|
| Rate for Payer: Innovage PACE Commercial |
$76.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20.01
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$51.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$68.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$68.59
|
| 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 |
$54.26
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$18.00
|
| Rate for Payer: Riverside University Health MISP |
$56.31
|
| 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 |
$41.46
|
| Rate for Payer: United Healthcare All Other HMO |
$41.46
|
| Rate for Payer: United Healthcare HMO Rider |
$41.46
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,146.30
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$76.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$56.31
|
| Rate for Payer: Vantage Medical Group Senior |
$51.19
|
|
