|
HC SOM META GT 25 CHROM ANAL
|
Facility
IP
|
$108.46
|
|
|
Service Code
|
CPT 88264
|
| Hospital Charge Code |
900915296
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$21.69 |
| Max. Negotiated Rate |
$97.61 |
| Rate for Payer: Cash Price |
$48.81
|
| Rate for Payer: Central Health Plan Commercial |
$86.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$43.38
|
| Rate for Payer: Galaxy Health WC |
$92.19
|
| Rate for Payer: Global Benefits Group Commercial |
$65.08
|
| Rate for Payer: Health Management Network EPO/PPO |
$97.61
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$72.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$21.69
|
| Rate for Payer: Multiplan Commercial |
$81.34
|
| Rate for Payer: Networks By Design Commercial |
$70.50
|
| Rate for Payer: Prime Health Services Commercial |
$92.19
|
|
|
HC SOM META GT 25 CHROM ANAL
|
Facility
OP
|
$108.46
|
|
|
Service Code
|
CPT 88264
|
| Hospital Charge Code |
900915296
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$21.69 |
| Max. Negotiated Rate |
$11,713.50 |
| Rate for Payer: Adventist Health Medi-Cal |
$144.61
|
| Rate for Payer: Aetna of CA HMO/PPO |
$914.77
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$216.92
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$159.07
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$144.61
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$902.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,101.07
|
| Rate for Payer: BCBS Transplant Transplant |
$65.08
|
| Rate for Payer: Blue Shield of California Commercial |
$67.03
|
| Rate for Payer: Blue Shield of California EPN |
$52.71
|
| Rate for Payer: Caremore Medicare Advantage |
$144.61
|
| Rate for Payer: Cash Price |
$48.81
|
| Rate for Payer: Cash Price |
$48.81
|
| Rate for Payer: Central Health Plan Commercial |
$86.77
|
| Rate for Payer: Cigna of CA HMO |
$69.41
|
| Rate for Payer: Cigna of CA PPO |
$80.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$216.92
|
| Rate for Payer: EPIC Health Plan Commercial |
$195.22
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$144.61
|
| Rate for Payer: EPIC Health Plan Transplant |
$144.61
|
| Rate for Payer: Galaxy Health WC |
$92.19
|
| Rate for Payer: Global Benefits Group Commercial |
$65.08
|
| Rate for Payer: Health Management Network EPO/PPO |
$97.61
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$81.34
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$237.16
|
| Rate for Payer: IEHP medi-cal |
$238.61
|
| Rate for Payer: IEHP Medicare Advantage |
$144.61
|
| Rate for Payer: Innovage PACE Commercial |
$216.92
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$72.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$144.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$21.69
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$193.78
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$193.78
|
| Rate for Payer: Multiplan Commercial |
$81.34
|
| Rate for Payer: Networks By Design Commercial |
$70.50
|
| Rate for Payer: Prime Health Services Commercial |
$92.19
|
| Rate for Payer: Prime Health Services Medicare |
$153.29
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$65.08
|
| Rate for Payer: Riverside University Health MISP |
$159.07
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$65.08
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$65.08
|
| Rate for Payer: United Healthcare All Other Commercial |
$117.14
|
| Rate for Payer: United Healthcare All Other HMO |
$117.14
|
| Rate for Payer: United Healthcare HMO Rider |
$117.14
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,713.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$216.92
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$159.07
|
| Rate for Payer: Vantage Medical Group Senior |
$144.61
|
|
|
HC SOM META GT 26 CHROM ADDIT
|
Facility
OP
|
$14.15
|
|
|
Service Code
|
CPT 88285
|
| Hospital Charge Code |
900915306
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$2.83 |
| Max. Negotiated Rate |
$2,179.80 |
| Rate for Payer: Adventist Health Medi-Cal |
$26.91
|
| Rate for Payer: Aetna of CA HMO/PPO |
$139.46
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$40.36
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$29.60
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$26.91
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$117.40
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$143.20
|
| Rate for Payer: BCBS Transplant Transplant |
$8.49
|
| Rate for Payer: Blue Shield of California Commercial |
$8.74
|
| Rate for Payer: Blue Shield of California EPN |
$6.88
|
| Rate for Payer: Caremore Medicare Advantage |
$26.91
|
| Rate for Payer: Cash Price |
$6.37
|
| Rate for Payer: Cash Price |
$6.37
|
| Rate for Payer: Central Health Plan Commercial |
$11.32
|
| Rate for Payer: Cigna of CA HMO |
$9.06
|
| Rate for Payer: Cigna of CA PPO |
$10.47
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$40.36
|
| Rate for Payer: EPIC Health Plan Commercial |
$36.33
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$26.91
|
| Rate for Payer: EPIC Health Plan Transplant |
$26.91
|
| Rate for Payer: Galaxy Health WC |
$12.03
|
| Rate for Payer: Global Benefits Group Commercial |
$8.49
|
| Rate for Payer: Health Management Network EPO/PPO |
$12.74
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$10.61
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$44.13
|
| Rate for Payer: IEHP medi-cal |
$44.40
|
| Rate for Payer: IEHP Medicare Advantage |
$26.91
|
| Rate for Payer: Innovage PACE Commercial |
$40.36
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$26.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.83
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$36.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$36.06
|
| Rate for Payer: Multiplan Commercial |
$10.61
|
| Rate for Payer: Networks By Design Commercial |
$9.20
|
| Rate for Payer: Prime Health Services Commercial |
$12.03
|
| Rate for Payer: Prime Health Services Medicare |
$28.52
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$8.49
|
| Rate for Payer: Riverside University Health MISP |
$29.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8.49
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$8.49
|
| Rate for Payer: United Healthcare All Other Commercial |
$21.80
|
| Rate for Payer: United Healthcare All Other HMO |
$21.80
|
| Rate for Payer: United Healthcare HMO Rider |
$21.80
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,179.80
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$40.36
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$29.60
|
| Rate for Payer: Vantage Medical Group Senior |
$26.91
|
|
|
HC SOM META GT 26 CHROM ADDIT
|
Facility
IP
|
$14.15
|
|
|
Service Code
|
CPT 88285
|
| Hospital Charge Code |
900915306
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$2.83 |
| Max. Negotiated Rate |
$12.74 |
| Rate for Payer: Cash Price |
$6.37
|
| Rate for Payer: Central Health Plan Commercial |
$11.32
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.66
|
| Rate for Payer: Galaxy Health WC |
$12.03
|
| Rate for Payer: Global Benefits Group Commercial |
$8.49
|
| Rate for Payer: Health Management Network EPO/PPO |
$12.74
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.83
|
| Rate for Payer: Multiplan Commercial |
$10.61
|
| Rate for Payer: Networks By Design Commercial |
$9.20
|
| Rate for Payer: Prime Health Services Commercial |
$12.03
|
|
|
HC SOM META GT 26 CHROM ANAL
|
Facility
IP
|
$110.85
|
|
|
Service Code
|
CPT 88245
|
| Hospital Charge Code |
900915292
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$22.17 |
| Max. Negotiated Rate |
$99.76 |
| Rate for Payer: Cash Price |
$49.88
|
| Rate for Payer: Central Health Plan Commercial |
$88.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$44.34
|
| Rate for Payer: Galaxy Health WC |
$94.22
|
| Rate for Payer: Global Benefits Group Commercial |
$66.51
|
| Rate for Payer: Health Management Network EPO/PPO |
$99.76
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$73.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.17
|
| Rate for Payer: Multiplan Commercial |
$83.14
|
| Rate for Payer: Networks By Design Commercial |
$72.05
|
| Rate for Payer: Prime Health Services Commercial |
$94.22
|
|
|
HC SOM META GT 26 CHROM ANAL
|
Facility
OP
|
$110.85
|
|
|
Service Code
|
CPT 88245
|
| Hospital Charge Code |
900915292
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$22.17 |
| Max. Negotiated Rate |
$14,026.50 |
| Rate for Payer: Adventist Health Medi-Cal |
$173.17
|
| Rate for Payer: Aetna of CA HMO/PPO |
$953.12
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$259.76
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$190.49
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$173.17
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,047.86
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,278.14
|
| Rate for Payer: BCBS Transplant Transplant |
$66.51
|
| Rate for Payer: Blue Shield of California Commercial |
$68.51
|
| Rate for Payer: Blue Shield of California EPN |
$53.87
|
| Rate for Payer: Caremore Medicare Advantage |
$173.17
|
| Rate for Payer: Cash Price |
$49.88
|
| Rate for Payer: Cash Price |
$49.88
|
| Rate for Payer: Central Health Plan Commercial |
$88.68
|
| Rate for Payer: Cigna of CA HMO |
$70.94
|
| Rate for Payer: Cigna of CA PPO |
$82.03
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$259.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$233.78
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$173.17
|
| Rate for Payer: EPIC Health Plan Transplant |
$173.17
|
| Rate for Payer: Galaxy Health WC |
$94.22
|
| Rate for Payer: Global Benefits Group Commercial |
$66.51
|
| Rate for Payer: Health Management Network EPO/PPO |
$99.76
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$83.14
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$284.00
|
| Rate for Payer: IEHP medi-cal |
$285.73
|
| Rate for Payer: IEHP Medicare Advantage |
$173.17
|
| Rate for Payer: Innovage PACE Commercial |
$259.76
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$73.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$173.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.17
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$232.05
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$232.05
|
| Rate for Payer: Multiplan Commercial |
$83.14
|
| Rate for Payer: Networks By Design Commercial |
$72.05
|
| Rate for Payer: Prime Health Services Commercial |
$94.22
|
| Rate for Payer: Prime Health Services Medicare |
$183.56
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$66.51
|
| Rate for Payer: Riverside University Health MISP |
$190.49
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$66.51
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$66.51
|
| Rate for Payer: United Healthcare All Other Commercial |
$140.26
|
| Rate for Payer: United Healthcare All Other HMO |
$140.26
|
| Rate for Payer: United Healthcare HMO Rider |
$140.26
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14,026.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$259.76
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$190.49
|
| Rate for Payer: Vantage Medical Group Senior |
$173.17
|
|
|
HC SOM META LT 15
|
Facility
IP
|
$125.00
|
|
|
Service Code
|
CPT 88267
|
| Hospital Charge Code |
900915299
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$25.00 |
| Max. Negotiated Rate |
$112.50 |
| Rate for Payer: Cash Price |
$56.25
|
| Rate for Payer: Central Health Plan Commercial |
$100.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$50.00
|
| Rate for Payer: Galaxy Health WC |
$106.25
|
| Rate for Payer: Global Benefits Group Commercial |
$75.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$112.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$83.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.00
|
| Rate for Payer: Multiplan Commercial |
$93.75
|
| Rate for Payer: Networks By Design Commercial |
$81.25
|
| Rate for Payer: Prime Health Services Commercial |
$106.25
|
|
|
HC SOM META LT 15
|
Facility
OP
|
$125.00
|
|
|
Service Code
|
CPT 88267
|
| Hospital Charge Code |
900915299
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$25.00 |
| Max. Negotiated Rate |
$15,273.90 |
| Rate for Payer: Adventist Health Medi-Cal |
$188.57
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,319.36
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$282.86
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$207.43
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$188.57
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,307.78
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,595.18
|
| Rate for Payer: BCBS Transplant Transplant |
$75.00
|
| Rate for Payer: Blue Shield of California Commercial |
$77.25
|
| Rate for Payer: Blue Shield of California EPN |
$60.75
|
| Rate for Payer: Caremore Medicare Advantage |
$188.57
|
| Rate for Payer: Cash Price |
$56.25
|
| Rate for Payer: Cash Price |
$56.25
|
| Rate for Payer: Central Health Plan Commercial |
$100.00
|
| Rate for Payer: Cigna of CA HMO |
$80.00
|
| Rate for Payer: Cigna of CA PPO |
$92.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$282.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$254.57
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$188.57
|
| Rate for Payer: EPIC Health Plan Transplant |
$188.57
|
| Rate for Payer: Galaxy Health WC |
$106.25
|
| Rate for Payer: Global Benefits Group Commercial |
$75.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$112.50
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$93.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$309.25
|
| Rate for Payer: IEHP medi-cal |
$311.14
|
| Rate for Payer: IEHP Medicare Advantage |
$188.57
|
| Rate for Payer: Innovage PACE Commercial |
$282.86
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$83.38
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$188.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$252.68
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$252.68
|
| Rate for Payer: Multiplan Commercial |
$93.75
|
| Rate for Payer: Networks By Design Commercial |
$81.25
|
| Rate for Payer: Prime Health Services Commercial |
$106.25
|
| Rate for Payer: Prime Health Services Medicare |
$199.88
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$75.00
|
| Rate for Payer: Riverside University Health MISP |
$207.43
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$75.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$75.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$152.74
|
| Rate for Payer: United Healthcare All Other HMO |
$152.74
|
| Rate for Payer: United Healthcare HMO Rider |
$152.74
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15,273.90
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$282.86
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$207.43
|
| Rate for Payer: Vantage Medical Group Senior |
$188.57
|
|
|
HC SOM METANEPHRINES,FRACT,FREE,P
|
Facility
IP
|
$24.26
|
|
|
Service Code
|
CPT 83835
|
| Hospital Charge Code |
900912922
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.85 |
| Max. Negotiated Rate |
$21.83 |
| Rate for Payer: Cash Price |
$10.92
|
| Rate for Payer: Central Health Plan Commercial |
$19.41
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.70
|
| Rate for Payer: Galaxy Health WC |
$20.62
|
| Rate for Payer: Global Benefits Group Commercial |
$14.56
|
| Rate for Payer: Health Management Network EPO/PPO |
$21.83
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.85
|
| Rate for Payer: Multiplan Commercial |
$18.20
|
| Rate for Payer: Networks By Design Commercial |
$15.77
|
| Rate for Payer: Prime Health Services Commercial |
$20.62
|
|
|
HC SOM METANEPHRINES,FRACT,FREE,P
|
Facility
OP
|
$24.26
|
|
|
Service Code
|
CPT 83835
|
| Hospital Charge Code |
900912922
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.85 |
| Max. Negotiated Rate |
$150.37 |
| Rate for Payer: Adventist Health Medi-Cal |
$16.94
|
| Rate for Payer: Aetna of CA HMO/PPO |
$124.31
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$25.41
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$18.63
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$16.94
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$123.28
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$150.37
|
| Rate for Payer: BCBS Transplant Transplant |
$14.56
|
| Rate for Payer: Blue Shield of California Commercial |
$14.99
|
| Rate for Payer: Blue Shield of California EPN |
$11.79
|
| Rate for Payer: Caremore Medicare Advantage |
$16.94
|
| Rate for Payer: Cash Price |
$10.92
|
| Rate for Payer: Cash Price |
$10.92
|
| Rate for Payer: Central Health Plan Commercial |
$19.41
|
| Rate for Payer: Cigna of CA HMO |
$15.53
|
| Rate for Payer: Cigna of CA PPO |
$17.95
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$25.41
|
| Rate for Payer: EPIC Health Plan Commercial |
$22.87
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$16.94
|
| Rate for Payer: EPIC Health Plan Transplant |
$16.94
|
| Rate for Payer: Galaxy Health WC |
$20.62
|
| Rate for Payer: Global Benefits Group Commercial |
$14.56
|
| Rate for Payer: Health Management Network EPO/PPO |
$21.83
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$18.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$27.78
|
| Rate for Payer: IEHP medi-cal |
$27.95
|
| Rate for Payer: IEHP Medicare Advantage |
$16.94
|
| Rate for Payer: Innovage PACE Commercial |
$25.41
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16.18
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.85
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$22.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$22.70
|
| Rate for Payer: Multiplan Commercial |
$18.20
|
| Rate for Payer: Networks By Design Commercial |
$15.77
|
| Rate for Payer: Prime Health Services Commercial |
$20.62
|
| Rate for Payer: Prime Health Services Medicare |
$17.96
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$14.56
|
| Rate for Payer: Riverside University Health MISP |
$18.63
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$14.56
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$14.56
|
| Rate for Payer: United Healthcare All Other Commercial |
$13.72
|
| Rate for Payer: United Healthcare All Other HMO |
$13.72
|
| Rate for Payer: United Healthcare HMO Rider |
$13.72
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$13.72
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$25.41
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$18.63
|
| Rate for Payer: Vantage Medical Group Senior |
$16.94
|
|
|
HC SOM METHADONE CONFIRMATION, U
|
Facility
IP
|
$114.08
|
|
|
Service Code
|
CPT 80358
|
| Hospital Charge Code |
900912918
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$22.82 |
| Max. Negotiated Rate |
$102.67 |
| Rate for Payer: Cash Price |
$51.34
|
| Rate for Payer: Central Health Plan Commercial |
$91.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$45.63
|
| Rate for Payer: Galaxy Health WC |
$96.97
|
| Rate for Payer: Global Benefits Group Commercial |
$68.45
|
| Rate for Payer: Health Management Network EPO/PPO |
$102.67
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$76.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.82
|
| Rate for Payer: Multiplan Commercial |
$85.56
|
| Rate for Payer: Networks By Design Commercial |
$74.15
|
| Rate for Payer: Prime Health Services Commercial |
$96.97
|
|
|
HC SOM METHADONE CONFIRMATION, U
|
Facility
OP
|
$114.08
|
|
|
Service Code
|
CPT 80358
|
| Hospital Charge Code |
900912918
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$0.06 |
| Max. Negotiated Rate |
$139.01 |
| Rate for Payer: Aetna of CA HMO/PPO |
$0.06
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$96.97
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$62.74
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$62.74
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$113.97
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$139.01
|
| Rate for Payer: BCBS Transplant Transplant |
$68.45
|
| Rate for Payer: Blue Shield of California Commercial |
$70.50
|
| Rate for Payer: Blue Shield of California EPN |
$55.44
|
| Rate for Payer: Cash Price |
$51.34
|
| Rate for Payer: Cash Price |
$51.34
|
| Rate for Payer: Central Health Plan Commercial |
$91.26
|
| Rate for Payer: Cigna of CA HMO |
$73.01
|
| Rate for Payer: Cigna of CA PPO |
$84.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$96.97
|
| Rate for Payer: EPIC Health Plan Commercial |
$45.63
|
| Rate for Payer: EPIC Health Plan Transplant |
$45.63
|
| Rate for Payer: Galaxy Health WC |
$96.97
|
| Rate for Payer: Global Benefits Group Commercial |
$68.45
|
| Rate for Payer: Health Management Network EPO/PPO |
$102.67
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$85.56
|
| Rate for Payer: IEHP medi-cal |
$39.93
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$76.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.82
|
| Rate for Payer: Multiplan Commercial |
$85.56
|
| Rate for Payer: Networks By Design Commercial |
$74.15
|
| Rate for Payer: Prime Health Services Commercial |
$96.97
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$68.45
|
| Rate for Payer: Riverside University Health MISP |
$45.63
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$68.45
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$68.45
|
| Rate for Payer: United Healthcare All Other Commercial |
$57.04
|
| Rate for Payer: United Healthcare All Other HMO |
$57.04
|
| Rate for Payer: United Healthcare HMO Rider |
$57.04
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$57.04
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$96.97
|
| Rate for Payer: Vantage Medical Group Senior |
$96.97
|
|
|
HC SOM METHANPHETAMINE QUANT
|
Facility
OP
|
$16.18
|
|
|
Service Code
|
CPT 80359
|
| Hospital Charge Code |
900912822
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$0.06 |
| Max. Negotiated Rate |
$132.32 |
| Rate for Payer: Aetna of CA HMO/PPO |
$0.06
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$13.75
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$8.90
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$8.90
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$108.48
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$132.32
|
| Rate for Payer: BCBS Transplant Transplant |
$9.71
|
| Rate for Payer: Blue Shield of California Commercial |
$10.00
|
| Rate for Payer: Blue Shield of California EPN |
$7.86
|
| Rate for Payer: Cash Price |
$7.28
|
| Rate for Payer: Cash Price |
$7.28
|
| Rate for Payer: Central Health Plan Commercial |
$12.94
|
| Rate for Payer: Cigna of CA HMO |
$10.36
|
| Rate for Payer: Cigna of CA PPO |
$11.97
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.47
|
| Rate for Payer: EPIC Health Plan Transplant |
$6.47
|
| Rate for Payer: Galaxy Health WC |
$13.75
|
| Rate for Payer: Global Benefits Group Commercial |
$9.71
|
| Rate for Payer: Health Management Network EPO/PPO |
$14.56
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$12.14
|
| Rate for Payer: IEHP medi-cal |
$5.66
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.24
|
| Rate for Payer: Multiplan Commercial |
$12.14
|
| Rate for Payer: Networks By Design Commercial |
$10.52
|
| Rate for Payer: Prime Health Services Commercial |
$13.75
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$9.71
|
| Rate for Payer: Riverside University Health MISP |
$6.47
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.71
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.71
|
| Rate for Payer: United Healthcare All Other Commercial |
$8.09
|
| Rate for Payer: United Healthcare All Other HMO |
$8.09
|
| Rate for Payer: United Healthcare HMO Rider |
$8.09
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8.09
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.75
|
| Rate for Payer: Vantage Medical Group Senior |
$13.75
|
|
|
HC SOM METHANPHETAMINE QUANT
|
Facility
IP
|
$16.18
|
|
|
Service Code
|
CPT 80359
|
| Hospital Charge Code |
900912822
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.24 |
| Max. Negotiated Rate |
$14.56 |
| Rate for Payer: Cash Price |
$7.28
|
| Rate for Payer: Central Health Plan Commercial |
$12.94
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.47
|
| Rate for Payer: Galaxy Health WC |
$13.75
|
| Rate for Payer: Global Benefits Group Commercial |
$9.71
|
| Rate for Payer: Health Management Network EPO/PPO |
$14.56
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.24
|
| Rate for Payer: Multiplan Commercial |
$12.14
|
| Rate for Payer: Networks By Design Commercial |
$10.52
|
| Rate for Payer: Prime Health Services Commercial |
$13.75
|
|
|
HC SOM METHEMOGLOBIN
|
Facility
IP
|
$117.05
|
|
|
Service Code
|
CPT 83050
|
| Hospital Charge Code |
900915429
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$23.41 |
| Max. Negotiated Rate |
$105.34 |
| Rate for Payer: Cash Price |
$52.67
|
| Rate for Payer: Central Health Plan Commercial |
$93.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$46.82
|
| Rate for Payer: Galaxy Health WC |
$99.49
|
| Rate for Payer: Global Benefits Group Commercial |
$70.23
|
| Rate for Payer: Health Management Network EPO/PPO |
$105.34
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$78.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23.41
|
| Rate for Payer: Multiplan Commercial |
$87.79
|
| Rate for Payer: Networks By Design Commercial |
$76.08
|
| Rate for Payer: Prime Health Services Commercial |
$99.49
|
|
|
HC SOM METHEMOGLOBIN
|
Facility
OP
|
$117.05
|
|
|
Service Code
|
CPT 83050
|
| Hospital Charge Code |
900915429
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.64 |
| Max. Negotiated Rate |
$105.34 |
| Rate for Payer: Adventist Health Medi-Cal |
$8.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$53.75
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$12.30
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$9.02
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$8.20
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$53.29
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$65.00
|
| Rate for Payer: BCBS Transplant Transplant |
$70.23
|
| Rate for Payer: Blue Shield of California Commercial |
$72.34
|
| Rate for Payer: Blue Shield of California EPN |
$56.89
|
| Rate for Payer: Caremore Medicare Advantage |
$8.20
|
| Rate for Payer: Cash Price |
$52.67
|
| Rate for Payer: Cash Price |
$52.67
|
| Rate for Payer: Central Health Plan Commercial |
$93.64
|
| Rate for Payer: Cigna of CA HMO |
$74.91
|
| Rate for Payer: Cigna of CA PPO |
$86.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.07
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$8.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$8.20
|
| Rate for Payer: Galaxy Health WC |
$99.49
|
| Rate for Payer: Global Benefits Group Commercial |
$70.23
|
| Rate for Payer: Health Management Network EPO/PPO |
$105.34
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$87.79
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$13.45
|
| Rate for Payer: IEHP medi-cal |
$13.53
|
| Rate for Payer: IEHP Medicare Advantage |
$8.20
|
| Rate for Payer: Innovage PACE Commercial |
$12.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$78.07
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23.41
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.99
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10.99
|
| Rate for Payer: Multiplan Commercial |
$87.79
|
| Rate for Payer: Networks By Design Commercial |
$76.08
|
| Rate for Payer: Prime Health Services Commercial |
$99.49
|
| Rate for Payer: Prime Health Services Medicare |
$8.69
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$70.23
|
| Rate for Payer: Riverside University Health MISP |
$9.02
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$70.23
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$70.23
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.64
|
| Rate for Payer: United Healthcare All Other HMO |
$6.64
|
| Rate for Payer: United Healthcare HMO Rider |
$6.64
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.02
|
| Rate for Payer: Vantage Medical Group Senior |
$8.20
|
|
|
HC SOM METHYLMALONIC ACID
|
Facility
OP
|
$22.00
|
|
|
Service Code
|
CPT 83921
|
| Hospital Charge Code |
900911265
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.40 |
| Max. Negotiated Rate |
$146.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$21.21
|
| Rate for Payer: Aetna of CA HMO/PPO |
$120.81
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$31.82
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$23.33
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$21.21
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$119.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$146.00
|
| Rate for Payer: BCBS Transplant Transplant |
$13.20
|
| Rate for Payer: Blue Shield of California Commercial |
$13.60
|
| Rate for Payer: Blue Shield of California EPN |
$10.69
|
| Rate for Payer: Caremore Medicare Advantage |
$21.21
|
| Rate for Payer: Cash Price |
$9.90
|
| Rate for Payer: Cash Price |
$9.90
|
| Rate for Payer: Central Health Plan Commercial |
$17.60
|
| Rate for Payer: Cigna of CA HMO |
$14.08
|
| Rate for Payer: Cigna of CA PPO |
$16.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$31.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$28.63
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$21.21
|
| Rate for Payer: EPIC Health Plan Transplant |
$21.21
|
| Rate for Payer: Galaxy Health WC |
$18.70
|
| Rate for Payer: Global Benefits Group Commercial |
$13.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$19.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$16.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$34.78
|
| Rate for Payer: IEHP medi-cal |
$35.00
|
| Rate for Payer: IEHP Medicare Advantage |
$21.21
|
| Rate for Payer: Innovage PACE Commercial |
$31.82
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$14.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$28.42
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$28.42
|
| Rate for Payer: Multiplan Commercial |
$16.50
|
| Rate for Payer: Networks By Design Commercial |
$14.30
|
| Rate for Payer: Prime Health Services Commercial |
$18.70
|
| Rate for Payer: Prime Health Services Medicare |
$22.48
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$13.20
|
| Rate for Payer: Riverside University Health MISP |
$23.33
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$13.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$13.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$17.18
|
| Rate for Payer: United Healthcare All Other HMO |
$17.18
|
| Rate for Payer: United Healthcare HMO Rider |
$17.18
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$17.18
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$31.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$23.33
|
| Rate for Payer: Vantage Medical Group Senior |
$21.21
|
|
|
HC SOM METHYLMALONIC ACID
|
Facility
IP
|
$22.00
|
|
|
Service Code
|
CPT 83921
|
| Hospital Charge Code |
900911265
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.40 |
| Max. Negotiated Rate |
$19.80 |
| Rate for Payer: Cash Price |
$9.90
|
| Rate for Payer: Central Health Plan Commercial |
$17.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.80
|
| Rate for Payer: Galaxy Health WC |
$18.70
|
| Rate for Payer: Global Benefits Group Commercial |
$13.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$19.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$14.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.40
|
| Rate for Payer: Multiplan Commercial |
$16.50
|
| Rate for Payer: Networks By Design Commercial |
$14.30
|
| Rate for Payer: Prime Health Services Commercial |
$18.70
|
|
|
HC SOM METHYLMALONIC ACID URINE
|
Facility
OP
|
$22.00
|
|
|
Service Code
|
CPT 83921
|
| Hospital Charge Code |
900910587
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.40 |
| Max. Negotiated Rate |
$146.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$21.21
|
| Rate for Payer: Aetna of CA HMO/PPO |
$120.81
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$31.82
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$23.33
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$21.21
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$119.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$146.00
|
| Rate for Payer: BCBS Transplant Transplant |
$13.20
|
| Rate for Payer: Blue Shield of California Commercial |
$13.60
|
| Rate for Payer: Blue Shield of California EPN |
$10.69
|
| Rate for Payer: Caremore Medicare Advantage |
$21.21
|
| Rate for Payer: Cash Price |
$9.90
|
| Rate for Payer: Cash Price |
$9.90
|
| Rate for Payer: Central Health Plan Commercial |
$17.60
|
| Rate for Payer: Cigna of CA HMO |
$14.08
|
| Rate for Payer: Cigna of CA PPO |
$16.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$31.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$28.63
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$21.21
|
| Rate for Payer: EPIC Health Plan Transplant |
$21.21
|
| Rate for Payer: Galaxy Health WC |
$18.70
|
| Rate for Payer: Global Benefits Group Commercial |
$13.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$19.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$16.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$34.78
|
| Rate for Payer: IEHP medi-cal |
$35.00
|
| Rate for Payer: IEHP Medicare Advantage |
$21.21
|
| Rate for Payer: Innovage PACE Commercial |
$31.82
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$14.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$28.42
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$28.42
|
| Rate for Payer: Multiplan Commercial |
$16.50
|
| Rate for Payer: Networks By Design Commercial |
$14.30
|
| Rate for Payer: Prime Health Services Commercial |
$18.70
|
| Rate for Payer: Prime Health Services Medicare |
$22.48
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$13.20
|
| Rate for Payer: Riverside University Health MISP |
$23.33
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$13.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$13.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$17.18
|
| Rate for Payer: United Healthcare All Other HMO |
$17.18
|
| Rate for Payer: United Healthcare HMO Rider |
$17.18
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$17.18
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$31.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$23.33
|
| Rate for Payer: Vantage Medical Group Senior |
$21.21
|
|
|
HC SOM METHYLMALONIC ACID URINE
|
Facility
IP
|
$22.00
|
|
|
Service Code
|
CPT 83921
|
| Hospital Charge Code |
900910587
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.40 |
| Max. Negotiated Rate |
$19.80 |
| Rate for Payer: Cash Price |
$9.90
|
| Rate for Payer: Central Health Plan Commercial |
$17.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.80
|
| Rate for Payer: Galaxy Health WC |
$18.70
|
| Rate for Payer: Global Benefits Group Commercial |
$13.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$19.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$14.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.40
|
| Rate for Payer: Multiplan Commercial |
$16.50
|
| Rate for Payer: Networks By Design Commercial |
$14.30
|
| Rate for Payer: Prime Health Services Commercial |
$18.70
|
|
|
HC SOM MEXILETINE PLASMA
|
Facility
OP
|
$266.46
|
|
|
Service Code
|
CPT 80299
|
| Hospital Charge Code |
900911280
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.10 |
| Max. Negotiated Rate |
$239.81 |
| Rate for Payer: Adventist Health Medi-Cal |
$18.64
|
| Rate for Payer: Aetna of CA HMO/PPO |
$97.19
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$27.96
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$20.50
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$18.64
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$105.94
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$129.22
|
| Rate for Payer: BCBS Transplant Transplant |
$159.88
|
| Rate for Payer: Blue Shield of California Commercial |
$164.67
|
| Rate for Payer: Blue Shield of California EPN |
$129.50
|
| Rate for Payer: Caremore Medicare Advantage |
$18.64
|
| Rate for Payer: Cash Price |
$119.91
|
| Rate for Payer: Cash Price |
$119.91
|
| Rate for Payer: Central Health Plan Commercial |
$213.17
|
| Rate for Payer: Cigna of CA HMO |
$170.53
|
| Rate for Payer: Cigna of CA PPO |
$197.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$27.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$25.16
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$18.64
|
| Rate for Payer: EPIC Health Plan Transplant |
$18.64
|
| Rate for Payer: Galaxy Health WC |
$226.49
|
| Rate for Payer: Global Benefits Group Commercial |
$159.88
|
| Rate for Payer: Health Management Network EPO/PPO |
$239.81
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$199.84
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$30.57
|
| Rate for Payer: IEHP medi-cal |
$30.76
|
| Rate for Payer: IEHP Medicare Advantage |
$18.64
|
| Rate for Payer: Innovage PACE Commercial |
$27.96
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$177.73
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$53.29
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$24.98
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$24.98
|
| Rate for Payer: Multiplan Commercial |
$199.84
|
| Rate for Payer: Networks By Design Commercial |
$173.20
|
| Rate for Payer: Prime Health Services Commercial |
$226.49
|
| Rate for Payer: Prime Health Services Medicare |
$19.76
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$159.88
|
| Rate for Payer: Riverside University Health MISP |
$20.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$159.88
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$159.88
|
| Rate for Payer: United Healthcare All Other Commercial |
$15.10
|
| Rate for Payer: United Healthcare All Other HMO |
$15.10
|
| Rate for Payer: United Healthcare HMO Rider |
$15.10
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15.10
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$27.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$20.50
|
| Rate for Payer: Vantage Medical Group Senior |
$18.64
|
|
|
HC SOM MEXILETINE PLASMA
|
Facility
IP
|
$266.46
|
|
|
Service Code
|
CPT 80299
|
| Hospital Charge Code |
900911280
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$53.29 |
| Max. Negotiated Rate |
$239.81 |
| Rate for Payer: Cash Price |
$119.91
|
| Rate for Payer: Central Health Plan Commercial |
$213.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$106.58
|
| Rate for Payer: Galaxy Health WC |
$226.49
|
| Rate for Payer: Global Benefits Group Commercial |
$159.88
|
| Rate for Payer: Health Management Network EPO/PPO |
$239.81
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$177.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$53.29
|
| Rate for Payer: Multiplan Commercial |
$199.84
|
| Rate for Payer: Networks By Design Commercial |
$173.20
|
| Rate for Payer: Prime Health Services Commercial |
$226.49
|
|
|
HC SOM MGLE ACH RECEPTOR BINDING AB
|
Facility
OP
|
$269.00
|
|
|
Service Code
|
CPT 83519
|
| Hospital Charge Code |
900911445
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$14.90 |
| Max. Negotiated Rate |
$242.10 |
| Rate for Payer: Adventist Health Medi-Cal |
$18.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$99.15
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$27.60
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$20.24
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$18.40
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$98.30
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$119.90
|
| Rate for Payer: BCBS Transplant Transplant |
$161.40
|
| Rate for Payer: Blue Shield of California Commercial |
$166.24
|
| Rate for Payer: Blue Shield of California EPN |
$130.73
|
| Rate for Payer: Caremore Medicare Advantage |
$18.40
|
| Rate for Payer: Cash Price |
$121.05
|
| Rate for Payer: Cash Price |
$121.05
|
| Rate for Payer: Central Health Plan Commercial |
$215.20
|
| Rate for Payer: Cigna of CA HMO |
$172.16
|
| Rate for Payer: Cigna of CA PPO |
$199.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$27.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$24.84
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$18.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$18.40
|
| Rate for Payer: Galaxy Health WC |
$228.65
|
| Rate for Payer: Global Benefits Group Commercial |
$161.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$242.10
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$201.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$30.18
|
| Rate for Payer: IEHP medi-cal |
$30.36
|
| Rate for Payer: IEHP Medicare Advantage |
$18.40
|
| Rate for Payer: Innovage PACE Commercial |
$27.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$179.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$53.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$24.66
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$24.66
|
| Rate for Payer: Multiplan Commercial |
$201.75
|
| Rate for Payer: Networks By Design Commercial |
$174.85
|
| Rate for Payer: Prime Health Services Commercial |
$228.65
|
| Rate for Payer: Prime Health Services Medicare |
$19.50
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$161.40
|
| Rate for Payer: Riverside University Health MISP |
$20.24
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$161.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$161.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.90
|
| Rate for Payer: United Healthcare All Other HMO |
$14.90
|
| Rate for Payer: United Healthcare HMO Rider |
$14.90
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.90
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$27.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$20.24
|
| Rate for Payer: Vantage Medical Group Senior |
$18.40
|
|
|
HC SOM MGLE ACH RECEPTOR BINDING AB
|
Facility
IP
|
$269.00
|
|
|
Service Code
|
CPT 83519
|
| Hospital Charge Code |
900911445
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$53.80 |
| Max. Negotiated Rate |
$242.10 |
| Rate for Payer: Cash Price |
$121.05
|
| Rate for Payer: Central Health Plan Commercial |
$215.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$107.60
|
| Rate for Payer: Galaxy Health WC |
$228.65
|
| Rate for Payer: Global Benefits Group Commercial |
$161.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$242.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$179.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$53.80
|
| Rate for Payer: Multiplan Commercial |
$201.75
|
| Rate for Payer: Networks By Design Commercial |
$174.85
|
| Rate for Payer: Prime Health Services Commercial |
$228.65
|
|
|
HC SOM MGLE P/Q TYPE CA CHANNEL AB
|
Facility
OP
|
$176.17
|
|
|
Service Code
|
CPT 86596
|
| Hospital Charge Code |
900915420
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.05 |
| Max. Negotiated Rate |
$158.55 |
| Rate for Payer: Adventist Health Medi-Cal |
$12.05
|
| Rate for Payer: Aetna of CA HMO/PPO |
$95.96
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$18.08
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$13.26
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$12.05
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$37.66
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$45.94
|
| Rate for Payer: BCBS Transplant Transplant |
$105.70
|
| Rate for Payer: Blue Shield of California Commercial |
$108.87
|
| Rate for Payer: Blue Shield of California EPN |
$85.62
|
| Rate for Payer: Caremore Medicare Advantage |
$12.05
|
| Rate for Payer: Cash Price |
$79.28
|
| Rate for Payer: Cash Price |
$79.28
|
| Rate for Payer: Central Health Plan Commercial |
$140.94
|
| Rate for Payer: Cigna of CA HMO |
$112.75
|
| Rate for Payer: Cigna of CA PPO |
$130.37
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$18.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.27
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$12.05
|
| Rate for Payer: EPIC Health Plan Transplant |
$12.05
|
| Rate for Payer: Galaxy Health WC |
$149.74
|
| Rate for Payer: Global Benefits Group Commercial |
$105.70
|
| Rate for Payer: Health Management Network EPO/PPO |
$158.55
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$132.13
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$19.76
|
| Rate for Payer: IEHP medi-cal |
$19.88
|
| Rate for Payer: IEHP Medicare Advantage |
$12.05
|
| Rate for Payer: Innovage PACE Commercial |
$18.08
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$117.51
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$35.23
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16.15
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16.15
|
| Rate for Payer: Multiplan Commercial |
$132.13
|
| Rate for Payer: Networks By Design Commercial |
$114.51
|
| Rate for Payer: Prime Health Services Commercial |
$149.74
|
| Rate for Payer: Prime Health Services Medicare |
$12.77
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$105.70
|
| Rate for Payer: Riverside University Health MISP |
$13.26
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$105.70
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$105.70
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.90
|
| Rate for Payer: United Healthcare All Other HMO |
$14.90
|
| Rate for Payer: United Healthcare HMO Rider |
$14.90
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.90
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$18.08
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.26
|
| Rate for Payer: Vantage Medical Group Senior |
$12.05
|
|
