|
HC SOM MURAMIDASE SERUM
|
Facility
IP
|
$20.00
|
|
|
Service Code
|
CPT 85549
|
| Hospital Charge Code |
900911063
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$4.00 |
| Max. Negotiated Rate |
$18.00 |
| Rate for Payer: Cash Price |
$9.00
|
| Rate for Payer: Central Health Plan Commercial |
$16.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.00
|
| Rate for Payer: Galaxy Health WC |
$17.00
|
| Rate for Payer: Global Benefits Group Commercial |
$12.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$18.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$13.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.00
|
| Rate for Payer: Multiplan Commercial |
$15.00
|
| Rate for Payer: Networks By Design Commercial |
$13.00
|
| Rate for Payer: Prime Health Services Commercial |
$17.00
|
|
|
HC SOM MUSK AUTOANTIBODY
|
Facility
OP
|
$550.00
|
|
|
Service Code
|
CPT 83519
|
| Hospital Charge Code |
900915423
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$14.90 |
| Max. Negotiated Rate |
$495.00 |
| 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 |
$330.00
|
| Rate for Payer: Blue Shield of California Commercial |
$339.90
|
| Rate for Payer: Blue Shield of California EPN |
$267.30
|
| Rate for Payer: Caremore Medicare Advantage |
$18.40
|
| Rate for Payer: Cash Price |
$247.50
|
| Rate for Payer: Cash Price |
$247.50
|
| Rate for Payer: Central Health Plan Commercial |
$440.00
|
| Rate for Payer: Cigna of CA HMO |
$352.00
|
| Rate for Payer: Cigna of CA PPO |
$407.00
|
| 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 |
$467.50
|
| Rate for Payer: Global Benefits Group Commercial |
$330.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$495.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$412.50
|
| 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 |
$366.85
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$110.00
|
| 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 |
$412.50
|
| Rate for Payer: Networks By Design Commercial |
$357.50
|
| Rate for Payer: Prime Health Services Commercial |
$467.50
|
| Rate for Payer: Prime Health Services Medicare |
$19.50
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$330.00
|
| Rate for Payer: Riverside University Health MISP |
$20.24
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$330.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$330.00
|
| 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 MUSK AUTOANTIBODY
|
Facility
IP
|
$550.00
|
|
|
Service Code
|
CPT 83519
|
| Hospital Charge Code |
900915423
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$110.00 |
| Max. Negotiated Rate |
$495.00 |
| Rate for Payer: Cash Price |
$247.50
|
| Rate for Payer: Central Health Plan Commercial |
$440.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$220.00
|
| Rate for Payer: Galaxy Health WC |
$467.50
|
| Rate for Payer: Global Benefits Group Commercial |
$330.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$495.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$366.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$110.00
|
| Rate for Payer: Multiplan Commercial |
$412.50
|
| Rate for Payer: Networks By Design Commercial |
$357.50
|
| Rate for Payer: Prime Health Services Commercial |
$467.50
|
|
|
HC SOM MYCOPHENOLIC ACID
|
Facility
OP
|
$22.00
|
|
|
Service Code
|
CPT 80180
|
| Hospital Charge Code |
900910761
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.40 |
| Max. Negotiated Rate |
$128.48 |
| Rate for Payer: Adventist Health Medi-Cal |
$18.05
|
| Rate for Payer: Aetna of CA HMO/PPO |
$128.48
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$27.08
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$19.86
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$18.05
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$79.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$96.36
|
| 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 |
$18.05
|
| 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 |
$27.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$24.37
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$18.05
|
| Rate for Payer: EPIC Health Plan Transplant |
$18.05
|
| 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 |
$29.60
|
| Rate for Payer: IEHP medi-cal |
$29.78
|
| Rate for Payer: IEHP Medicare Advantage |
$18.05
|
| Rate for Payer: Innovage PACE Commercial |
$27.08
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$14.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$24.19
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$24.19
|
| 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 |
$19.13
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$13.20
|
| Rate for Payer: Riverside University Health MISP |
$19.86
|
| 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 |
$14.62
|
| Rate for Payer: United Healthcare All Other HMO |
$14.62
|
| Rate for Payer: United Healthcare HMO Rider |
$14.62
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.62
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$27.08
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.86
|
| Rate for Payer: Vantage Medical Group Senior |
$18.05
|
|
|
HC SOM MYCOPHENOLIC ACID
|
Facility
IP
|
$22.00
|
|
|
Service Code
|
CPT 80180
|
| Hospital Charge Code |
900910761
|
|
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 MYCOPLASMA PNEUMONIAE AB IGG
|
Facility
IP
|
$10.40
|
|
|
Service Code
|
CPT 86738
|
| Hospital Charge Code |
900911589
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.08 |
| Max. Negotiated Rate |
$9.36 |
| Rate for Payer: Cash Price |
$4.68
|
| Rate for Payer: Central Health Plan Commercial |
$8.32
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.16
|
| Rate for Payer: Galaxy Health WC |
$8.84
|
| Rate for Payer: Global Benefits Group Commercial |
$6.24
|
| Rate for Payer: Health Management Network EPO/PPO |
$9.36
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.08
|
| Rate for Payer: Multiplan Commercial |
$7.80
|
| Rate for Payer: Networks By Design Commercial |
$6.76
|
| Rate for Payer: Prime Health Services Commercial |
$8.84
|
|
|
HC SOM MYCOPLASMA PNEUMONIAE AB IGG
|
Facility
OP
|
$10.40
|
|
|
Service Code
|
CPT 86738
|
| Hospital Charge Code |
900911589
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.08 |
| Max. Negotiated Rate |
$117.03 |
| Rate for Payer: Adventist Health Medi-Cal |
$13.24
|
| Rate for Payer: Aetna of CA HMO/PPO |
$97.19
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$19.86
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$14.56
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$13.24
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$95.95
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$117.03
|
| Rate for Payer: BCBS Transplant Transplant |
$6.24
|
| Rate for Payer: Blue Shield of California Commercial |
$6.43
|
| Rate for Payer: Blue Shield of California EPN |
$5.05
|
| Rate for Payer: Caremore Medicare Advantage |
$13.24
|
| Rate for Payer: Cash Price |
$4.68
|
| Rate for Payer: Cash Price |
$4.68
|
| Rate for Payer: Central Health Plan Commercial |
$8.32
|
| Rate for Payer: Cigna of CA HMO |
$6.66
|
| Rate for Payer: Cigna of CA PPO |
$7.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$17.87
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$13.24
|
| Rate for Payer: EPIC Health Plan Transplant |
$13.24
|
| Rate for Payer: Galaxy Health WC |
$8.84
|
| Rate for Payer: Global Benefits Group Commercial |
$6.24
|
| Rate for Payer: Health Management Network EPO/PPO |
$9.36
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$7.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$21.71
|
| Rate for Payer: IEHP medi-cal |
$21.85
|
| Rate for Payer: IEHP Medicare Advantage |
$13.24
|
| Rate for Payer: Innovage PACE Commercial |
$19.86
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.08
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17.74
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17.74
|
| Rate for Payer: Multiplan Commercial |
$7.80
|
| Rate for Payer: Networks By Design Commercial |
$6.76
|
| Rate for Payer: Prime Health Services Commercial |
$8.84
|
| Rate for Payer: Prime Health Services Medicare |
$14.03
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$6.24
|
| Rate for Payer: Riverside University Health MISP |
$14.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6.24
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6.24
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.73
|
| Rate for Payer: United Healthcare All Other HMO |
$10.73
|
| Rate for Payer: United Healthcare HMO Rider |
$10.73
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.73
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.86
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.56
|
| Rate for Payer: Vantage Medical Group Senior |
$13.24
|
|
|
HC SOM MYCOPLASMA PNEUMONIAE AB IGM
|
Facility
OP
|
$10.41
|
|
|
Service Code
|
CPT 86738
|
| Hospital Charge Code |
900912639
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.08 |
| Max. Negotiated Rate |
$117.03 |
| Rate for Payer: Adventist Health Medi-Cal |
$13.24
|
| Rate for Payer: Aetna of CA HMO/PPO |
$97.19
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$19.86
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$14.56
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$13.24
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$95.95
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$117.03
|
| Rate for Payer: BCBS Transplant Transplant |
$6.25
|
| Rate for Payer: Blue Shield of California Commercial |
$6.43
|
| Rate for Payer: Blue Shield of California EPN |
$5.06
|
| Rate for Payer: Caremore Medicare Advantage |
$13.24
|
| Rate for Payer: Cash Price |
$4.68
|
| Rate for Payer: Cash Price |
$4.68
|
| Rate for Payer: Central Health Plan Commercial |
$8.33
|
| Rate for Payer: Cigna of CA HMO |
$6.66
|
| Rate for Payer: Cigna of CA PPO |
$7.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$17.87
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$13.24
|
| Rate for Payer: EPIC Health Plan Transplant |
$13.24
|
| Rate for Payer: Galaxy Health WC |
$8.85
|
| Rate for Payer: Global Benefits Group Commercial |
$6.25
|
| Rate for Payer: Health Management Network EPO/PPO |
$9.37
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$7.81
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$21.71
|
| Rate for Payer: IEHP medi-cal |
$21.85
|
| Rate for Payer: IEHP Medicare Advantage |
$13.24
|
| Rate for Payer: Innovage PACE Commercial |
$19.86
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.08
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17.74
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17.74
|
| Rate for Payer: Multiplan Commercial |
$7.81
|
| Rate for Payer: Networks By Design Commercial |
$6.77
|
| Rate for Payer: Prime Health Services Commercial |
$8.85
|
| Rate for Payer: Prime Health Services Medicare |
$14.03
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$6.25
|
| Rate for Payer: Riverside University Health MISP |
$14.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6.25
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6.25
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.73
|
| Rate for Payer: United Healthcare All Other HMO |
$10.73
|
| Rate for Payer: United Healthcare HMO Rider |
$10.73
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.73
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.86
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.56
|
| Rate for Payer: Vantage Medical Group Senior |
$13.24
|
|
|
HC SOM MYCOPLASMA PNEUMONIAE AB IGM
|
Facility
IP
|
$10.41
|
|
|
Service Code
|
CPT 86738
|
| Hospital Charge Code |
900912639
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.08 |
| Max. Negotiated Rate |
$9.37 |
| Rate for Payer: Cash Price |
$4.68
|
| Rate for Payer: Central Health Plan Commercial |
$8.33
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.16
|
| Rate for Payer: Galaxy Health WC |
$8.85
|
| Rate for Payer: Global Benefits Group Commercial |
$6.25
|
| Rate for Payer: Health Management Network EPO/PPO |
$9.37
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.08
|
| Rate for Payer: Multiplan Commercial |
$7.81
|
| Rate for Payer: Networks By Design Commercial |
$6.77
|
| Rate for Payer: Prime Health Services Commercial |
$8.85
|
|
|
HC SOM MYCOPLASMA PNEUMON IGA
|
Facility
OP
|
$82.00
|
|
|
Service Code
|
CPT 86738
|
| Hospital Charge Code |
900914684
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.73 |
| Max. Negotiated Rate |
$117.03 |
| Rate for Payer: Adventist Health Medi-Cal |
$13.24
|
| Rate for Payer: Aetna of CA HMO/PPO |
$97.19
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$19.86
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$14.56
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$13.24
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$95.95
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$117.03
|
| Rate for Payer: BCBS Transplant Transplant |
$49.20
|
| Rate for Payer: Blue Shield of California Commercial |
$50.68
|
| Rate for Payer: Blue Shield of California EPN |
$39.85
|
| Rate for Payer: Caremore Medicare Advantage |
$13.24
|
| Rate for Payer: Cash Price |
$36.90
|
| Rate for Payer: Cash Price |
$36.90
|
| Rate for Payer: Central Health Plan Commercial |
$65.60
|
| Rate for Payer: Cigna of CA HMO |
$52.48
|
| Rate for Payer: Cigna of CA PPO |
$60.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$17.87
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$13.24
|
| Rate for Payer: EPIC Health Plan Transplant |
$13.24
|
| Rate for Payer: Galaxy Health WC |
$69.70
|
| Rate for Payer: Global Benefits Group Commercial |
$49.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$73.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$61.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$21.71
|
| Rate for Payer: IEHP medi-cal |
$21.85
|
| Rate for Payer: IEHP Medicare Advantage |
$13.24
|
| Rate for Payer: Innovage PACE Commercial |
$19.86
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$54.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17.74
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17.74
|
| Rate for Payer: Multiplan Commercial |
$61.50
|
| Rate for Payer: Networks By Design Commercial |
$53.30
|
| Rate for Payer: Prime Health Services Commercial |
$69.70
|
| Rate for Payer: Prime Health Services Medicare |
$14.03
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$49.20
|
| Rate for Payer: Riverside University Health MISP |
$14.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$49.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$49.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.73
|
| Rate for Payer: United Healthcare All Other HMO |
$10.73
|
| Rate for Payer: United Healthcare HMO Rider |
$10.73
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.73
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.86
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.56
|
| Rate for Payer: Vantage Medical Group Senior |
$13.24
|
|
|
HC SOM MYCOPLASMA PNEUMON IGA
|
Facility
IP
|
$82.00
|
|
|
Service Code
|
CPT 86738
|
| Hospital Charge Code |
900914684
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.40 |
| Max. Negotiated Rate |
$73.80 |
| Rate for Payer: Cash Price |
$36.90
|
| Rate for Payer: Central Health Plan Commercial |
$65.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$32.80
|
| Rate for Payer: Galaxy Health WC |
$69.70
|
| Rate for Payer: Global Benefits Group Commercial |
$49.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$73.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$54.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.40
|
| Rate for Payer: Multiplan Commercial |
$61.50
|
| Rate for Payer: Networks By Design Commercial |
$53.30
|
| Rate for Payer: Prime Health Services Commercial |
$69.70
|
|
|
HC SOM MYCO PNEUM DNA PCR
|
Facility
OP
|
$175.00
|
|
|
Service Code
|
CPT 87581
|
| Hospital Charge Code |
900914442
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$28.42 |
| Max. Negotiated Rate |
$301.33 |
| Rate for Payer: Adventist Health Medi-Cal |
$35.09
|
| Rate for Payer: Aetna of CA HMO/PPO |
$257.58
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$52.64
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$38.60
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$35.09
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$247.04
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$301.33
|
| Rate for Payer: BCBS Transplant Transplant |
$105.00
|
| Rate for Payer: Blue Shield of California Commercial |
$108.15
|
| Rate for Payer: Blue Shield of California EPN |
$85.05
|
| Rate for Payer: Caremore Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$78.75
|
| Rate for Payer: Cash Price |
$78.75
|
| Rate for Payer: Central Health Plan Commercial |
$140.00
|
| Rate for Payer: Cigna of CA HMO |
$112.00
|
| Rate for Payer: Cigna of CA PPO |
$129.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$52.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$47.37
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$35.09
|
| Rate for Payer: EPIC Health Plan Transplant |
$35.09
|
| Rate for Payer: Galaxy Health WC |
$148.75
|
| Rate for Payer: Global Benefits Group Commercial |
$105.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$157.50
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$131.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$57.55
|
| Rate for Payer: IEHP medi-cal |
$57.90
|
| Rate for Payer: IEHP Medicare Advantage |
$35.09
|
| Rate for Payer: Innovage PACE Commercial |
$52.64
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$116.72
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$35.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$35.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$47.02
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$47.02
|
| Rate for Payer: Multiplan Commercial |
$131.25
|
| Rate for Payer: Networks By Design Commercial |
$113.75
|
| Rate for Payer: Prime Health Services Commercial |
$148.75
|
| Rate for Payer: Prime Health Services Medicare |
$37.20
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$105.00
|
| Rate for Payer: Riverside University Health MISP |
$38.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$105.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$105.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$28.42
|
| Rate for Payer: United Healthcare All Other HMO |
$28.42
|
| Rate for Payer: United Healthcare HMO Rider |
$28.42
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$28.42
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$52.64
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$38.60
|
| Rate for Payer: Vantage Medical Group Senior |
$35.09
|
|
|
HC SOM MYCO PNEUM DNA PCR
|
Facility
IP
|
$175.00
|
|
|
Service Code
|
CPT 87581
|
| Hospital Charge Code |
900914442
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$35.00 |
| Max. Negotiated Rate |
$157.50 |
| Rate for Payer: Cash Price |
$78.75
|
| Rate for Payer: Central Health Plan Commercial |
$140.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$70.00
|
| Rate for Payer: Galaxy Health WC |
$148.75
|
| Rate for Payer: Global Benefits Group Commercial |
$105.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$157.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$116.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$35.00
|
| Rate for Payer: Multiplan Commercial |
$131.25
|
| Rate for Payer: Networks By Design Commercial |
$113.75
|
| Rate for Payer: Prime Health Services Commercial |
$148.75
|
|
|
HC SOM MYELOPEROXIDASE
|
Facility
IP
|
$27.90
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
900910578
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.58 |
| Max. Negotiated Rate |
$25.11 |
| Rate for Payer: Cash Price |
$12.56
|
| Rate for Payer: Central Health Plan Commercial |
$22.32
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.16
|
| Rate for Payer: Galaxy Health WC |
$23.72
|
| Rate for Payer: Global Benefits Group Commercial |
$16.74
|
| Rate for Payer: Health Management Network EPO/PPO |
$25.11
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$18.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.58
|
| Rate for Payer: Multiplan Commercial |
$20.92
|
| Rate for Payer: Networks By Design Commercial |
$18.14
|
| Rate for Payer: Prime Health Services Commercial |
$23.72
|
|
|
HC SOM MYELOPEROXIDASE
|
Facility
OP
|
$27.90
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
900910578
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.58 |
| Max. Negotiated Rate |
$207.60 |
| Rate for Payer: Adventist Health Medi-Cal |
$11.53
|
| Rate for Payer: Aetna of CA HMO/PPO |
$68.17
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$17.30
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$12.68
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$11.53
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$170.20
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$207.60
|
| Rate for Payer: BCBS Transplant Transplant |
$16.74
|
| Rate for Payer: Blue Shield of California Commercial |
$17.24
|
| Rate for Payer: Blue Shield of California EPN |
$13.56
|
| Rate for Payer: Caremore Medicare Advantage |
$11.53
|
| Rate for Payer: Cash Price |
$12.56
|
| Rate for Payer: Cash Price |
$12.56
|
| Rate for Payer: Central Health Plan Commercial |
$22.32
|
| Rate for Payer: Cigna of CA HMO |
$17.86
|
| Rate for Payer: Cigna of CA PPO |
$20.65
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$17.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.57
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$11.53
|
| Rate for Payer: EPIC Health Plan Transplant |
$11.53
|
| Rate for Payer: Galaxy Health WC |
$23.72
|
| Rate for Payer: Global Benefits Group Commercial |
$16.74
|
| Rate for Payer: Health Management Network EPO/PPO |
$25.11
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$20.92
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$18.91
|
| Rate for Payer: IEHP medi-cal |
$19.02
|
| Rate for Payer: IEHP Medicare Advantage |
$11.53
|
| Rate for Payer: Innovage PACE Commercial |
$17.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$18.61
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$11.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.58
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$15.45
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$15.45
|
| Rate for Payer: Multiplan Commercial |
$20.92
|
| Rate for Payer: Networks By Design Commercial |
$18.14
|
| Rate for Payer: Prime Health Services Commercial |
$23.72
|
| Rate for Payer: Prime Health Services Medicare |
$12.22
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$16.74
|
| Rate for Payer: Riverside University Health MISP |
$12.68
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$16.74
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$16.74
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.34
|
| Rate for Payer: United Healthcare All Other HMO |
$9.34
|
| Rate for Payer: United Healthcare HMO Rider |
$9.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.34
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$17.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$12.68
|
| Rate for Payer: Vantage Medical Group Senior |
$11.53
|
|
|
HC SOM MYOGLOBINURIA PROFILE
|
Facility
OP
|
$875.00
|
|
|
Service Code
|
CPT 84999
|
| Hospital Charge Code |
900914702
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$175.00 |
| Max. Negotiated Rate |
$787.50 |
| Rate for Payer: Aetna of CA HMO/PPO |
$531.39
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$743.75
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$481.25
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$481.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$423.68
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$516.95
|
| Rate for Payer: BCBS Transplant Transplant |
$525.00
|
| Rate for Payer: Blue Shield of California Commercial |
$540.75
|
| Rate for Payer: Blue Shield of California EPN |
$425.25
|
| Rate for Payer: Cash Price |
$393.75
|
| Rate for Payer: Central Health Plan Commercial |
$700.00
|
| Rate for Payer: Cigna of CA HMO |
$560.00
|
| Rate for Payer: Cigna of CA PPO |
$647.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$743.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$350.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$350.00
|
| Rate for Payer: Galaxy Health WC |
$743.75
|
| Rate for Payer: Global Benefits Group Commercial |
$525.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$787.50
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$656.25
|
| Rate for Payer: IEHP medi-cal |
$306.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$583.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$175.00
|
| Rate for Payer: Multiplan Commercial |
$656.25
|
| Rate for Payer: Networks By Design Commercial |
$568.75
|
| Rate for Payer: Prime Health Services Commercial |
$743.75
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$525.00
|
| Rate for Payer: Riverside University Health MISP |
$350.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$525.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$525.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$437.50
|
| Rate for Payer: United Healthcare All Other HMO |
$437.50
|
| Rate for Payer: United Healthcare HMO Rider |
$437.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$437.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$743.75
|
| Rate for Payer: Vantage Medical Group Senior |
$743.75
|
|
|
HC SOM MYOGLOBINURIA PROFILE
|
Facility
IP
|
$875.00
|
|
|
Service Code
|
CPT 84999
|
| Hospital Charge Code |
900914702
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$175.00 |
| Max. Negotiated Rate |
$787.50 |
| Rate for Payer: Cash Price |
$393.75
|
| Rate for Payer: Central Health Plan Commercial |
$700.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$350.00
|
| Rate for Payer: Galaxy Health WC |
$743.75
|
| Rate for Payer: Global Benefits Group Commercial |
$525.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$787.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$583.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$175.00
|
| Rate for Payer: Multiplan Commercial |
$656.25
|
| Rate for Payer: Networks By Design Commercial |
$568.75
|
| Rate for Payer: Prime Health Services Commercial |
$743.75
|
|
|
HC SOM MYOGLOBIN URINE
|
Facility
IP
|
$18.00
|
|
|
Service Code
|
CPT 83874
|
| Hospital Charge Code |
900910762
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.60 |
| Max. Negotiated Rate |
$16.20 |
| Rate for Payer: Cash Price |
$8.10
|
| Rate for Payer: Central Health Plan Commercial |
$14.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.20
|
| Rate for Payer: Galaxy Health WC |
$15.30
|
| Rate for Payer: Global Benefits Group Commercial |
$10.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$16.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.60
|
| Rate for Payer: Multiplan Commercial |
$13.50
|
| Rate for Payer: Networks By Design Commercial |
$11.70
|
| Rate for Payer: Prime Health Services Commercial |
$15.30
|
|
|
HC SOM MYOGLOBIN URINE
|
Facility
OP
|
$18.00
|
|
|
Service Code
|
CPT 83874
|
| Hospital Charge Code |
900910762
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.60 |
| Max. Negotiated Rate |
$114.94 |
| Rate for Payer: Adventist Health Medi-Cal |
$12.92
|
| Rate for Payer: Aetna of CA HMO/PPO |
$94.74
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$19.38
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$14.21
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$12.92
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$94.23
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$114.94
|
| Rate for Payer: BCBS Transplant Transplant |
$10.80
|
| Rate for Payer: Blue Shield of California Commercial |
$11.12
|
| Rate for Payer: Blue Shield of California EPN |
$8.75
|
| Rate for Payer: Caremore Medicare Advantage |
$12.92
|
| Rate for Payer: Cash Price |
$8.10
|
| Rate for Payer: Cash Price |
$8.10
|
| Rate for Payer: Central Health Plan Commercial |
$14.40
|
| Rate for Payer: Cigna of CA HMO |
$11.52
|
| Rate for Payer: Cigna of CA PPO |
$13.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.38
|
| Rate for Payer: EPIC Health Plan Commercial |
$17.44
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$12.92
|
| Rate for Payer: EPIC Health Plan Transplant |
$12.92
|
| Rate for Payer: Galaxy Health WC |
$15.30
|
| Rate for Payer: Global Benefits Group Commercial |
$10.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$16.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$13.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$21.19
|
| Rate for Payer: IEHP medi-cal |
$21.32
|
| Rate for Payer: IEHP Medicare Advantage |
$12.92
|
| Rate for Payer: Innovage PACE Commercial |
$19.38
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12.01
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17.31
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17.31
|
| Rate for Payer: Multiplan Commercial |
$13.50
|
| Rate for Payer: Networks By Design Commercial |
$11.70
|
| Rate for Payer: Prime Health Services Commercial |
$15.30
|
| Rate for Payer: Prime Health Services Medicare |
$13.70
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$10.80
|
| Rate for Payer: Riverside University Health MISP |
$14.21
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$10.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.47
|
| Rate for Payer: United Healthcare All Other HMO |
$10.47
|
| Rate for Payer: United Healthcare HMO Rider |
$10.47
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.47
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.38
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.21
|
| Rate for Payer: Vantage Medical Group Senior |
$12.92
|
|
|
HC SOM NEOPTERIN
|
Facility
IP
|
$179.25
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
900913946
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$35.85 |
| Max. Negotiated Rate |
$161.32 |
| Rate for Payer: Cash Price |
$80.66
|
| Rate for Payer: Central Health Plan Commercial |
$143.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$71.70
|
| Rate for Payer: Galaxy Health WC |
$152.36
|
| Rate for Payer: Global Benefits Group Commercial |
$107.55
|
| Rate for Payer: Health Management Network EPO/PPO |
$161.32
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$119.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$35.85
|
| Rate for Payer: Multiplan Commercial |
$134.44
|
| Rate for Payer: Networks By Design Commercial |
$116.51
|
| Rate for Payer: Prime Health Services Commercial |
$152.36
|
|
|
HC SOM NEOPTERIN
|
Facility
OP
|
$179.25
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
900913946
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.99 |
| Max. Negotiated Rate |
$161.32 |
| 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 |
$107.55
|
| Rate for Payer: Blue Shield of California Commercial |
$110.78
|
| Rate for Payer: Blue Shield of California EPN |
$87.12
|
| Rate for Payer: Caremore Medicare Advantage |
$17.27
|
| Rate for Payer: Cash Price |
$80.66
|
| Rate for Payer: Cash Price |
$80.66
|
| Rate for Payer: Central Health Plan Commercial |
$143.40
|
| Rate for Payer: Cigna of CA HMO |
$114.72
|
| Rate for Payer: Cigna of CA PPO |
$132.64
|
| 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 |
$152.36
|
| Rate for Payer: Global Benefits Group Commercial |
$107.55
|
| Rate for Payer: Health Management Network EPO/PPO |
$161.32
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$134.44
|
| 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 |
$119.56
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$17.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$35.85
|
| 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 |
$134.44
|
| Rate for Payer: Networks By Design Commercial |
$116.51
|
| Rate for Payer: Prime Health Services Commercial |
$152.36
|
| Rate for Payer: Prime Health Services Medicare |
$18.31
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$107.55
|
| Rate for Payer: Riverside University Health MISP |
$19.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$107.55
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$107.55
|
| 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 NEUROCONDRIN IFA
|
Facility
OP
|
$53.52
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
900915453
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$9.76 |
| Max. Negotiated Rate |
$106.99 |
| Rate for Payer: Adventist Health Medi-Cal |
$12.05
|
| Rate for Payer: Aetna of CA HMO/PPO |
$88.48
|
| 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 |
$87.72
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$106.99
|
| Rate for Payer: BCBS Transplant Transplant |
$32.11
|
| Rate for Payer: Blue Shield of California Commercial |
$33.08
|
| Rate for Payer: Blue Shield of California EPN |
$26.01
|
| Rate for Payer: Caremore Medicare Advantage |
$12.05
|
| Rate for Payer: Cash Price |
$24.08
|
| Rate for Payer: Cash Price |
$24.08
|
| Rate for Payer: Central Health Plan Commercial |
$42.82
|
| Rate for Payer: Cigna of CA HMO |
$34.25
|
| Rate for Payer: Cigna of CA PPO |
$39.60
|
| 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 |
$45.49
|
| Rate for Payer: Global Benefits Group Commercial |
$32.11
|
| Rate for Payer: Health Management Network EPO/PPO |
$48.17
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$40.14
|
| 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 |
$35.70
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.70
|
| 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 |
$40.14
|
| Rate for Payer: Networks By Design Commercial |
$34.79
|
| Rate for Payer: Prime Health Services Commercial |
$45.49
|
| Rate for Payer: Prime Health Services Medicare |
$12.77
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$32.11
|
| Rate for Payer: Riverside University Health MISP |
$13.26
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$32.11
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$32.11
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.76
|
| Rate for Payer: United Healthcare All Other HMO |
$9.76
|
| Rate for Payer: United Healthcare HMO Rider |
$9.76
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.76
|
| 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
|
|
|
HC SOM NEUROCONDRIN IFA
|
Facility
IP
|
$53.52
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
900915453
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$10.70 |
| Max. Negotiated Rate |
$48.17 |
| Rate for Payer: Cash Price |
$24.08
|
| Rate for Payer: Central Health Plan Commercial |
$42.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$21.41
|
| Rate for Payer: Galaxy Health WC |
$45.49
|
| Rate for Payer: Global Benefits Group Commercial |
$32.11
|
| Rate for Payer: Health Management Network EPO/PPO |
$48.17
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$35.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.70
|
| Rate for Payer: Multiplan Commercial |
$40.14
|
| Rate for Payer: Networks By Design Commercial |
$34.79
|
| Rate for Payer: Prime Health Services Commercial |
$45.49
|
|
|
HC SOM NEURON SPECIFIC ENOLASE CSF
|
Facility
OP
|
$30.00
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
900910766
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.00 |
| 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 |
$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 |
$17.27
|
| 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 |
$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 |
$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 |
$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 |
$20.01
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$17.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.00
|
| 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 |
$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 |
$18.31
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$18.00
|
| Rate for Payer: Riverside University Health MISP |
$19.00
|
| 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 |
$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 NEURON SPECIFIC ENOLASE CSF
|
Facility
IP
|
$30.00
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
900910766
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.00 |
| Max. Negotiated Rate |
$27.00 |
| Rate for Payer: Cash Price |
$13.50
|
| Rate for Payer: Central Health Plan Commercial |
$24.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.00
|
| Rate for Payer: Galaxy Health WC |
$25.50
|
| Rate for Payer: Global Benefits Group Commercial |
$18.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$27.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.00
|
| Rate for Payer: Multiplan Commercial |
$22.50
|
| Rate for Payer: Networks By Design Commercial |
$19.50
|
| Rate for Payer: Prime Health Services Commercial |
$25.50
|
|
