|
HC SOM TESTOSTERONE TOTAL
|
Facility
|
IP
|
$9.06
|
|
|
Service Code
|
CPT 84403
|
| Hospital Charge Code |
900915375
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$1.81 |
| Max. Negotiated Rate |
$8.15 |
| Rate for Payer: Adventist Health Commercial |
$1.81
|
| Rate for Payer: Cash Price |
$9.06
|
| Rate for Payer: Central Health Plan Commercial |
$7.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.62
|
| Rate for Payer: EPIC Health Plan Senior |
$3.62
|
| Rate for Payer: Galaxy Health WC |
$7.70
|
| Rate for Payer: Global Benefits Group Commercial |
$5.44
|
| Rate for Payer: Health Management Network EPO/PPO |
$8.15
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.45
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.81
|
| Rate for Payer: Multiplan Commercial |
$6.79
|
| Rate for Payer: Networks By Design Commercial |
$5.89
|
| Rate for Payer: Prime Health Services Commercial |
$7.70
|
|
|
HC SOM TESTOSTERONE TOTAL
|
Facility
|
OP
|
$9.06
|
|
|
Service Code
|
CPT 84403
|
| Hospital Charge Code |
900915375
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$1.81 |
| Max. Negotiated Rate |
$187.78 |
| Rate for Payer: Adventist Health Commercial |
$1.81
|
| Rate for Payer: Adventist Health Medi-Cal |
$25.81
|
| Rate for Payer: Aetna of CA HMO/PPO |
$5.50
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$38.72
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$28.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$25.81
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$187.78
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$38.11
|
| Rate for Payer: Blue Shield of California Commercial |
$5.50
|
| Rate for Payer: Blue Shield of California EPN |
$3.60
|
| Rate for Payer: Cash Price |
$9.06
|
| Rate for Payer: Cash Price |
$9.06
|
| Rate for Payer: Central Health Plan Commercial |
$7.25
|
| Rate for Payer: Cigna of CA HMO |
$5.80
|
| Rate for Payer: Cigna of CA PPO |
$6.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$38.72
|
| Rate for Payer: Dignity Health Medi-Cal |
$28.39
|
| Rate for Payer: Dignity Health Medicare Advantage |
$25.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$34.84
|
| Rate for Payer: EPIC Health Plan Senior |
$25.81
|
| Rate for Payer: Galaxy Health WC |
$7.70
|
| Rate for Payer: Global Benefits Group Commercial |
$5.44
|
| Rate for Payer: Health Management Network EPO/PPO |
$8.15
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$42.33
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$39.22
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$25.81
|
| Rate for Payer: InnovAge PACE Commercial |
$38.72
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$43.32
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.81
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$34.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$34.59
|
| Rate for Payer: Multiplan Commercial |
$6.79
|
| Rate for Payer: Networks By Design Commercial |
$5.89
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$25.81
|
| Rate for Payer: Prime Health Services Commercial |
$7.70
|
| Rate for Payer: Prime Health Services Medicare |
$27.36
|
| Rate for Payer: Riverside University Health System MISP |
$28.39
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5.44
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5.44
|
| Rate for Payer: United Healthcare All Other Commercial |
$20.91
|
| Rate for Payer: United Healthcare All Other HMO |
$20.91
|
| Rate for Payer: United Healthcare HMO Rider |
$20.91
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$20.91
|
| Rate for Payer: Upland Medical Group Pediatric |
$25.81
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$38.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$28.39
|
| Rate for Payer: Vantage Medical Group Senior |
$25.81
|
|
|
HC SOM TETANUS ANTITOXOID (ELISA)
|
Facility
|
IP
|
$20.42
|
|
|
Service Code
|
CPT 86317
|
| Hospital Charge Code |
900911757
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.08 |
| Max. Negotiated Rate |
$18.38 |
| Rate for Payer: Adventist Health Commercial |
$4.08
|
| Rate for Payer: Cash Price |
$20.42
|
| Rate for Payer: Central Health Plan Commercial |
$16.34
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.17
|
| Rate for Payer: EPIC Health Plan Senior |
$8.17
|
| Rate for Payer: Galaxy Health WC |
$17.36
|
| Rate for Payer: Global Benefits Group Commercial |
$12.25
|
| Rate for Payer: Health Management Network EPO/PPO |
$18.38
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$13.62
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.08
|
| Rate for Payer: Multiplan Commercial |
$15.31
|
| Rate for Payer: Networks By Design Commercial |
$13.27
|
| Rate for Payer: Prime Health Services Commercial |
$17.36
|
|
|
HC SOM TETANUS ANTITOXOID (ELISA)
|
Facility
|
OP
|
$20.42
|
|
|
Service Code
|
CPT 86317
|
| Hospital Charge Code |
900911757
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.08 |
| Max. Negotiated Rate |
$109.07 |
| Rate for Payer: Adventist Health Commercial |
$4.08
|
| Rate for Payer: Adventist Health Medi-Cal |
$14.99
|
| Rate for Payer: Aetna of CA HMO/PPO |
$12.40
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$22.48
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$16.49
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14.99
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$109.07
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$22.14
|
| Rate for Payer: Blue Shield of California Commercial |
$12.39
|
| Rate for Payer: Blue Shield of California EPN |
$8.11
|
| Rate for Payer: Cash Price |
$20.42
|
| Rate for Payer: Cash Price |
$20.42
|
| Rate for Payer: Central Health Plan Commercial |
$16.34
|
| Rate for Payer: Cigna of CA HMO |
$13.07
|
| Rate for Payer: Cigna of CA PPO |
$15.11
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$22.48
|
| Rate for Payer: Dignity Health Medi-Cal |
$16.49
|
| Rate for Payer: Dignity Health Medicare Advantage |
$14.99
|
| Rate for Payer: EPIC Health Plan Commercial |
$20.24
|
| Rate for Payer: EPIC Health Plan Senior |
$14.99
|
| Rate for Payer: Galaxy Health WC |
$17.36
|
| Rate for Payer: Global Benefits Group Commercial |
$12.25
|
| Rate for Payer: Health Management Network EPO/PPO |
$18.38
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$24.58
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$18.04
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$14.99
|
| Rate for Payer: InnovAge PACE Commercial |
$22.48
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$13.62
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$19.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.08
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$20.09
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$20.09
|
| Rate for Payer: Multiplan Commercial |
$15.31
|
| Rate for Payer: Networks By Design Commercial |
$13.27
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$14.99
|
| Rate for Payer: Prime Health Services Commercial |
$17.36
|
| Rate for Payer: Prime Health Services Medicare |
$15.89
|
| Rate for Payer: Riverside University Health System MISP |
$16.49
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$12.25
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$12.25
|
| Rate for Payer: United Healthcare All Other Commercial |
$12.14
|
| Rate for Payer: United Healthcare All Other HMO |
$12.14
|
| Rate for Payer: United Healthcare HMO Rider |
$12.14
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$12.14
|
| Rate for Payer: Upland Medical Group Pediatric |
$14.99
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$22.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$16.49
|
| Rate for Payer: Vantage Medical Group Senior |
$14.99
|
|
|
HC SOM TGFBR2 FULL SEQUENCE
|
Facility
|
IP
|
$1,362.50
|
|
|
Service Code
|
CPT 81403
|
| Hospital Charge Code |
900914669
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$272.50 |
| Max. Negotiated Rate |
$1,226.25 |
| Rate for Payer: Adventist Health Commercial |
$272.50
|
| Rate for Payer: Cash Price |
$1,362.50
|
| Rate for Payer: Central Health Plan Commercial |
$1,090.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$545.00
|
| Rate for Payer: EPIC Health Plan Senior |
$545.00
|
| Rate for Payer: Galaxy Health WC |
$1,158.12
|
| Rate for Payer: Global Benefits Group Commercial |
$817.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,226.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$908.79
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$519.11
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$843.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$272.50
|
| Rate for Payer: Multiplan Commercial |
$1,021.88
|
| Rate for Payer: Networks By Design Commercial |
$885.62
|
| Rate for Payer: Prime Health Services Commercial |
$1,158.12
|
|
|
HC SOM TGFBR2 FULL SEQUENCE
|
Facility
|
OP
|
$1,362.50
|
|
|
Service Code
|
CPT 81403
|
| Hospital Charge Code |
900914669
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$150.01 |
| Max. Negotiated Rate |
$1,226.25 |
| Rate for Payer: Adventist Health Commercial |
$272.50
|
| Rate for Payer: Adventist Health Medi-Cal |
$185.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$827.45
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$277.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$203.72
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$185.20
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,088.71
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$220.96
|
| Rate for Payer: Blue Shield of California Commercial |
$827.04
|
| Rate for Payer: Blue Shield of California EPN |
$540.91
|
| Rate for Payer: Cash Price |
$1,362.50
|
| Rate for Payer: Cash Price |
$1,362.50
|
| Rate for Payer: Central Health Plan Commercial |
$1,090.00
|
| Rate for Payer: Cigna of CA HMO |
$872.00
|
| Rate for Payer: Cigna of CA PPO |
$1,008.25
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$277.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$203.72
|
| Rate for Payer: Dignity Health Medicare Advantage |
$185.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$250.02
|
| Rate for Payer: EPIC Health Plan Senior |
$185.20
|
| Rate for Payer: Galaxy Health WC |
$1,158.12
|
| Rate for Payer: Global Benefits Group Commercial |
$817.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,226.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$303.73
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$318.54
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$185.20
|
| Rate for Payer: InnovAge PACE Commercial |
$277.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$908.79
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$351.88
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$185.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$272.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$248.17
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$248.17
|
| Rate for Payer: Multiplan Commercial |
$1,021.88
|
| Rate for Payer: Networks By Design Commercial |
$885.62
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$185.20
|
| Rate for Payer: Prime Health Services Commercial |
$1,158.12
|
| Rate for Payer: Prime Health Services Medicare |
$196.31
|
| Rate for Payer: Riverside University Health System MISP |
$203.72
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$817.50
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$817.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$150.01
|
| Rate for Payer: United Healthcare All Other HMO |
$150.01
|
| Rate for Payer: United Healthcare HMO Rider |
$150.01
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$150.01
|
| Rate for Payer: Upland Medical Group Pediatric |
$185.20
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$277.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$203.72
|
| Rate for Payer: Vantage Medical Group Senior |
$185.20
|
|
|
HC SOM THALLIUM URINE
|
Facility
|
OP
|
$217.26
|
|
|
Service Code
|
CPT 83018
|
| Hospital Charge Code |
900911102
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$17.78 |
| Max. Negotiated Rate |
$195.53 |
| Rate for Payer: Adventist Health Commercial |
$43.45
|
| Rate for Payer: Adventist Health Medi-Cal |
$21.96
|
| Rate for Payer: Aetna of CA HMO/PPO |
$131.94
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$32.94
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$24.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$21.96
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$135.57
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$27.51
|
| Rate for Payer: Blue Shield of California Commercial |
$131.88
|
| Rate for Payer: Blue Shield of California EPN |
$86.25
|
| Rate for Payer: Cash Price |
$217.26
|
| Rate for Payer: Cash Price |
$217.26
|
| Rate for Payer: Central Health Plan Commercial |
$173.81
|
| Rate for Payer: Cigna of CA HMO |
$139.05
|
| Rate for Payer: Cigna of CA PPO |
$160.77
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$32.94
|
| Rate for Payer: Dignity Health Medi-Cal |
$24.16
|
| Rate for Payer: Dignity Health Medicare Advantage |
$21.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$29.65
|
| Rate for Payer: EPIC Health Plan Senior |
$21.96
|
| Rate for Payer: Galaxy Health WC |
$184.67
|
| Rate for Payer: Global Benefits Group Commercial |
$130.36
|
| Rate for Payer: Health Management Network EPO/PPO |
$195.53
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$36.01
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$33.57
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$21.96
|
| Rate for Payer: InnovAge PACE Commercial |
$32.94
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$144.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$37.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$43.45
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$29.43
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$29.43
|
| Rate for Payer: Multiplan Commercial |
$162.94
|
| Rate for Payer: Networks By Design Commercial |
$141.22
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$21.96
|
| Rate for Payer: Prime Health Services Commercial |
$184.67
|
| Rate for Payer: Prime Health Services Medicare |
$23.28
|
| Rate for Payer: Riverside University Health System MISP |
$24.16
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$130.36
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$130.36
|
| Rate for Payer: United Healthcare All Other Commercial |
$17.78
|
| Rate for Payer: United Healthcare All Other HMO |
$17.78
|
| Rate for Payer: United Healthcare HMO Rider |
$17.78
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$17.78
|
| Rate for Payer: Upland Medical Group Pediatric |
$21.96
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$32.94
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$24.16
|
| Rate for Payer: Vantage Medical Group Senior |
$21.96
|
|
|
HC SOM THALLIUM URINE
|
Facility
|
IP
|
$217.26
|
|
|
Service Code
|
CPT 83018
|
| Hospital Charge Code |
900911102
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$43.45 |
| Max. Negotiated Rate |
$195.53 |
| Rate for Payer: Adventist Health Commercial |
$43.45
|
| Rate for Payer: Cash Price |
$217.26
|
| Rate for Payer: Central Health Plan Commercial |
$173.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$86.90
|
| Rate for Payer: EPIC Health Plan Senior |
$86.90
|
| Rate for Payer: Galaxy Health WC |
$184.67
|
| Rate for Payer: Global Benefits Group Commercial |
$130.36
|
| Rate for Payer: Health Management Network EPO/PPO |
$195.53
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$144.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$82.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$134.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$43.45
|
| Rate for Payer: Multiplan Commercial |
$162.94
|
| Rate for Payer: Networks By Design Commercial |
$141.22
|
| Rate for Payer: Prime Health Services Commercial |
$184.67
|
|
|
HC SOM THC CONFIRMATION, U
|
Facility
|
OP
|
$31.60
|
|
|
Service Code
|
CPT 80349
|
| Hospital Charge Code |
900912921
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.32 |
| Max. Negotiated Rate |
$165.30 |
| Rate for Payer: Adventist Health Commercial |
$6.32
|
| Rate for Payer: Aetna of CA HMO/PPO |
$19.19
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$26.86
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$17.38
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$23.70
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$165.30
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$33.55
|
| Rate for Payer: Blue Shield of California Commercial |
$19.18
|
| Rate for Payer: Blue Shield of California EPN |
$12.55
|
| Rate for Payer: Cash Price |
$31.60
|
| Rate for Payer: Cash Price |
$31.60
|
| Rate for Payer: Central Health Plan Commercial |
$25.28
|
| Rate for Payer: Cigna of CA HMO |
$20.22
|
| Rate for Payer: Cigna of CA PPO |
$23.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$26.86
|
| Rate for Payer: Dignity Health Medi-Cal |
$26.86
|
| Rate for Payer: Dignity Health Medicare Advantage |
$26.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.64
|
| Rate for Payer: EPIC Health Plan Senior |
$12.64
|
| Rate for Payer: Galaxy Health WC |
$26.86
|
| Rate for Payer: Global Benefits Group Commercial |
$18.96
|
| Rate for Payer: Health Management Network EPO/PPO |
$28.44
|
| Rate for Payer: InnovAge PACE Commercial |
$15.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$21.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12.04
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$19.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$22.12
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$22.12
|
| Rate for Payer: Multiplan Commercial |
$23.70
|
| Rate for Payer: Networks By Design Commercial |
$20.54
|
| Rate for Payer: Prime Health Services Commercial |
$26.86
|
| Rate for Payer: Riverside University Health System MISP |
$12.64
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$18.96
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$18.96
|
| Rate for Payer: United Healthcare All Other Commercial |
$15.80
|
| Rate for Payer: United Healthcare All Other HMO |
$15.80
|
| Rate for Payer: United Healthcare HMO Rider |
$15.80
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15.80
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$26.86
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$26.86
|
| Rate for Payer: Vantage Medical Group Senior |
$26.86
|
|
|
HC SOM THC CONFIRMATION, U
|
Facility
|
IP
|
$31.60
|
|
|
Service Code
|
CPT 80349
|
| Hospital Charge Code |
900912921
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.32 |
| Max. Negotiated Rate |
$28.44 |
| Rate for Payer: Adventist Health Commercial |
$6.32
|
| Rate for Payer: Cash Price |
$31.60
|
| Rate for Payer: Central Health Plan Commercial |
$25.28
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.64
|
| Rate for Payer: EPIC Health Plan Senior |
$12.64
|
| Rate for Payer: Galaxy Health WC |
$26.86
|
| Rate for Payer: Global Benefits Group Commercial |
$18.96
|
| Rate for Payer: Health Management Network EPO/PPO |
$28.44
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$21.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12.04
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$19.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.32
|
| Rate for Payer: Multiplan Commercial |
$23.70
|
| Rate for Payer: Networks By Design Commercial |
$20.54
|
| Rate for Payer: Prime Health Services Commercial |
$26.86
|
|
|
HC SOM THIOPURINE METAB
|
Facility
|
OP
|
$178.00
|
|
|
Service Code
|
CPT 80299
|
| Hospital Charge Code |
900914912
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$15.10 |
| Max. Negotiated Rate |
$160.20 |
| Rate for Payer: Adventist Health Commercial |
$35.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$18.64
|
| Rate for Payer: Aetna of CA HMO/PPO |
$108.10
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$27.96
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$20.50
|
| Rate for Payer: Alpha Care 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 |
$21.50
|
| Rate for Payer: Blue Shield of California Commercial |
$108.05
|
| Rate for Payer: Blue Shield of California EPN |
$70.67
|
| Rate for Payer: Cash Price |
$178.00
|
| Rate for Payer: Cash Price |
$178.00
|
| Rate for Payer: Central Health Plan Commercial |
$142.40
|
| Rate for Payer: Cigna of CA HMO |
$113.92
|
| Rate for Payer: Cigna of CA PPO |
$131.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$27.96
|
| Rate for Payer: Dignity Health Medi-Cal |
$20.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$18.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$25.16
|
| Rate for Payer: EPIC Health Plan Senior |
$18.64
|
| Rate for Payer: Galaxy Health WC |
$151.30
|
| Rate for Payer: Global Benefits Group Commercial |
$106.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$160.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$30.57
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$21.65
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$18.64
|
| Rate for Payer: InnovAge PACE Commercial |
$27.96
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$118.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$23.92
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$35.60
|
| 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 |
$133.50
|
| Rate for Payer: Networks By Design Commercial |
$115.70
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$18.64
|
| Rate for Payer: Prime Health Services Commercial |
$151.30
|
| Rate for Payer: Prime Health Services Medicare |
$19.76
|
| Rate for Payer: Riverside University Health System MISP |
$20.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$106.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$106.80
|
| 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: Upland Medical Group Pediatric |
$18.64
|
| 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 THIOPURINE METAB
|
Facility
|
IP
|
$178.00
|
|
|
Service Code
|
CPT 80299
|
| Hospital Charge Code |
900914912
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$35.60 |
| Max. Negotiated Rate |
$160.20 |
| Rate for Payer: Adventist Health Commercial |
$35.60
|
| Rate for Payer: Cash Price |
$178.00
|
| Rate for Payer: Central Health Plan Commercial |
$142.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$71.20
|
| Rate for Payer: EPIC Health Plan Senior |
$71.20
|
| Rate for Payer: Galaxy Health WC |
$151.30
|
| Rate for Payer: Global Benefits Group Commercial |
$106.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$160.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$118.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$67.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$110.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$35.60
|
| Rate for Payer: Multiplan Commercial |
$133.50
|
| Rate for Payer: Networks By Design Commercial |
$115.70
|
| Rate for Payer: Prime Health Services Commercial |
$151.30
|
|
|
HC SOM THYROBLUBULIN AB
|
Facility
|
OP
|
$15.00
|
|
|
Service Code
|
CPT 86800
|
| Hospital Charge Code |
900910558
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.00 |
| Max. Negotiated Rate |
$115.68 |
| Rate for Payer: Adventist Health Commercial |
$3.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$15.91
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9.11
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$23.86
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$17.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$15.91
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$115.68
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$23.48
|
| Rate for Payer: Blue Shield of California Commercial |
$9.11
|
| Rate for Payer: Blue Shield of California EPN |
$5.96
|
| Rate for Payer: Cash Price |
$15.00
|
| Rate for Payer: Cash Price |
$15.00
|
| Rate for Payer: Central Health Plan Commercial |
$12.00
|
| Rate for Payer: Cigna of CA HMO |
$9.60
|
| Rate for Payer: Cigna of CA PPO |
$11.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$23.86
|
| Rate for Payer: Dignity Health Medi-Cal |
$17.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$15.91
|
| Rate for Payer: EPIC Health Plan Commercial |
$21.48
|
| Rate for Payer: EPIC Health Plan Senior |
$15.91
|
| Rate for Payer: Galaxy Health WC |
$12.75
|
| Rate for Payer: Global Benefits Group Commercial |
$9.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$13.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$26.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$19.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$15.91
|
| Rate for Payer: InnovAge PACE Commercial |
$23.86
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$21.17
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$21.32
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$21.32
|
| Rate for Payer: Multiplan Commercial |
$11.25
|
| Rate for Payer: Networks By Design Commercial |
$9.75
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$15.91
|
| Rate for Payer: Prime Health Services Commercial |
$12.75
|
| Rate for Payer: Prime Health Services Medicare |
$16.86
|
| Rate for Payer: Riverside University Health System MISP |
$17.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$12.89
|
| Rate for Payer: United Healthcare All Other HMO |
$12.89
|
| Rate for Payer: United Healthcare HMO Rider |
$12.89
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$12.89
|
| Rate for Payer: Upland Medical Group Pediatric |
$15.91
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$23.86
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$17.50
|
| Rate for Payer: Vantage Medical Group Senior |
$15.91
|
|
|
HC SOM THYROBLUBULIN AB
|
Facility
|
IP
|
$15.00
|
|
|
Service Code
|
CPT 86800
|
| Hospital Charge Code |
900910558
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.00 |
| Max. Negotiated Rate |
$13.50 |
| Rate for Payer: Adventist Health Commercial |
$3.00
|
| Rate for Payer: Cash Price |
$15.00
|
| Rate for Payer: Central Health Plan Commercial |
$12.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.00
|
| Rate for Payer: EPIC Health Plan Senior |
$6.00
|
| Rate for Payer: Galaxy Health WC |
$12.75
|
| Rate for Payer: Global Benefits Group Commercial |
$9.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$13.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.71
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.00
|
| Rate for Payer: Multiplan Commercial |
$11.25
|
| Rate for Payer: Networks By Design Commercial |
$9.75
|
| Rate for Payer: Prime Health Services Commercial |
$12.75
|
|
|
HC SOM THYROGLOBULIN TM THYRO AB
|
Facility
|
IP
|
$22.78
|
|
|
Service Code
|
CPT 86800
|
| Hospital Charge Code |
900915315
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.56 |
| Max. Negotiated Rate |
$20.50 |
| Rate for Payer: Adventist Health Commercial |
$4.56
|
| Rate for Payer: Cash Price |
$22.78
|
| Rate for Payer: Central Health Plan Commercial |
$18.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.11
|
| Rate for Payer: EPIC Health Plan Senior |
$9.11
|
| Rate for Payer: Galaxy Health WC |
$19.36
|
| Rate for Payer: Global Benefits Group Commercial |
$13.67
|
| Rate for Payer: Health Management Network EPO/PPO |
$20.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15.19
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.56
|
| Rate for Payer: Multiplan Commercial |
$17.09
|
| Rate for Payer: Networks By Design Commercial |
$14.81
|
| Rate for Payer: Prime Health Services Commercial |
$19.36
|
|
|
HC SOM THYROGLOBULIN TM THYRO AB
|
Facility
|
OP
|
$22.78
|
|
|
Service Code
|
CPT 86800
|
| Hospital Charge Code |
900915315
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.56 |
| Max. Negotiated Rate |
$115.68 |
| Rate for Payer: Adventist Health Commercial |
$4.56
|
| Rate for Payer: Adventist Health Medi-Cal |
$15.91
|
| Rate for Payer: Aetna of CA HMO/PPO |
$13.83
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$23.86
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$17.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$15.91
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$115.68
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$23.48
|
| Rate for Payer: Blue Shield of California Commercial |
$13.83
|
| Rate for Payer: Blue Shield of California EPN |
$9.04
|
| Rate for Payer: Cash Price |
$22.78
|
| Rate for Payer: Cash Price |
$22.78
|
| Rate for Payer: Central Health Plan Commercial |
$18.22
|
| Rate for Payer: Cigna of CA HMO |
$14.58
|
| Rate for Payer: Cigna of CA PPO |
$16.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$23.86
|
| Rate for Payer: Dignity Health Medi-Cal |
$17.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$15.91
|
| Rate for Payer: EPIC Health Plan Commercial |
$21.48
|
| Rate for Payer: EPIC Health Plan Senior |
$15.91
|
| Rate for Payer: Galaxy Health WC |
$19.36
|
| Rate for Payer: Global Benefits Group Commercial |
$13.67
|
| Rate for Payer: Health Management Network EPO/PPO |
$20.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$26.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$19.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$15.91
|
| Rate for Payer: InnovAge PACE Commercial |
$23.86
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15.19
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$21.17
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.56
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$21.32
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$21.32
|
| Rate for Payer: Multiplan Commercial |
$17.09
|
| Rate for Payer: Networks By Design Commercial |
$14.81
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$15.91
|
| Rate for Payer: Prime Health Services Commercial |
$19.36
|
| Rate for Payer: Prime Health Services Medicare |
$16.86
|
| Rate for Payer: Riverside University Health System MISP |
$17.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$13.67
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$13.67
|
| Rate for Payer: United Healthcare All Other Commercial |
$12.89
|
| Rate for Payer: United Healthcare All Other HMO |
$12.89
|
| Rate for Payer: United Healthcare HMO Rider |
$12.89
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$12.89
|
| Rate for Payer: Upland Medical Group Pediatric |
$15.91
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$23.86
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$17.50
|
| Rate for Payer: Vantage Medical Group Senior |
$15.91
|
|
|
HC SOM THYROGLOBULIN TUMOR MARKER AB
|
Facility
|
IP
|
$10.10
|
|
|
Service Code
|
CPT 86800
|
| Hospital Charge Code |
900915360
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.02 |
| Max. Negotiated Rate |
$9.09 |
| Rate for Payer: Adventist Health Commercial |
$2.02
|
| Rate for Payer: Cash Price |
$10.10
|
| Rate for Payer: Central Health Plan Commercial |
$8.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.04
|
| Rate for Payer: EPIC Health Plan Senior |
$4.04
|
| Rate for Payer: Galaxy Health WC |
$8.59
|
| Rate for Payer: Global Benefits Group Commercial |
$6.06
|
| Rate for Payer: Health Management Network EPO/PPO |
$9.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6.74
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.85
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.02
|
| Rate for Payer: Multiplan Commercial |
$7.58
|
| Rate for Payer: Networks By Design Commercial |
$6.57
|
| Rate for Payer: Prime Health Services Commercial |
$8.59
|
|
|
HC SOM THYROGLOBULIN TUMOR MARKER AB
|
Facility
|
OP
|
$10.10
|
|
|
Service Code
|
CPT 86800
|
| Hospital Charge Code |
900915360
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.02 |
| Max. Negotiated Rate |
$115.68 |
| Rate for Payer: Adventist Health Commercial |
$2.02
|
| Rate for Payer: Adventist Health Medi-Cal |
$15.91
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6.13
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$23.86
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$17.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$15.91
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$115.68
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$23.48
|
| Rate for Payer: Blue Shield of California Commercial |
$6.13
|
| Rate for Payer: Blue Shield of California EPN |
$4.01
|
| Rate for Payer: Cash Price |
$10.10
|
| Rate for Payer: Cash Price |
$10.10
|
| Rate for Payer: Central Health Plan Commercial |
$8.08
|
| Rate for Payer: Cigna of CA HMO |
$6.46
|
| Rate for Payer: Cigna of CA PPO |
$7.47
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$23.86
|
| Rate for Payer: Dignity Health Medi-Cal |
$17.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$15.91
|
| Rate for Payer: EPIC Health Plan Commercial |
$21.48
|
| Rate for Payer: EPIC Health Plan Senior |
$15.91
|
| Rate for Payer: Galaxy Health WC |
$8.59
|
| Rate for Payer: Global Benefits Group Commercial |
$6.06
|
| Rate for Payer: Health Management Network EPO/PPO |
$9.09
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$26.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$19.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$15.91
|
| Rate for Payer: InnovAge PACE Commercial |
$23.86
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6.74
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$21.17
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.02
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$21.32
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$21.32
|
| Rate for Payer: Multiplan Commercial |
$7.58
|
| Rate for Payer: Networks By Design Commercial |
$6.57
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$15.91
|
| Rate for Payer: Prime Health Services Commercial |
$8.59
|
| Rate for Payer: Prime Health Services Medicare |
$16.86
|
| Rate for Payer: Riverside University Health System MISP |
$17.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6.06
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6.06
|
| Rate for Payer: United Healthcare All Other Commercial |
$12.89
|
| Rate for Payer: United Healthcare All Other HMO |
$12.89
|
| Rate for Payer: United Healthcare HMO Rider |
$12.89
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$12.89
|
| Rate for Payer: Upland Medical Group Pediatric |
$15.91
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$23.86
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$17.50
|
| Rate for Payer: Vantage Medical Group Senior |
$15.91
|
|
|
HC SOM THYROGLOBULIN TUMOR MARKER TM
|
Facility
|
OP
|
$10.20
|
|
|
Service Code
|
CPT 84432
|
| Hospital Charge Code |
900912645
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.04 |
| Max. Negotiated Rate |
$119.16 |
| Rate for Payer: Adventist Health Commercial |
$2.04
|
| Rate for Payer: Adventist Health Medi-Cal |
$16.06
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6.19
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$24.09
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$17.67
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$16.06
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$119.16
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$24.18
|
| Rate for Payer: Blue Shield of California Commercial |
$6.19
|
| Rate for Payer: Blue Shield of California EPN |
$4.05
|
| Rate for Payer: Cash Price |
$10.20
|
| Rate for Payer: Cash Price |
$10.20
|
| Rate for Payer: Central Health Plan Commercial |
$8.16
|
| Rate for Payer: Cigna of CA HMO |
$6.53
|
| Rate for Payer: Cigna of CA PPO |
$7.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$24.09
|
| Rate for Payer: Dignity Health Medi-Cal |
$17.67
|
| Rate for Payer: Dignity Health Medicare Advantage |
$16.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$21.68
|
| Rate for Payer: EPIC Health Plan Senior |
$16.06
|
| Rate for Payer: Galaxy Health WC |
$8.67
|
| Rate for Payer: Global Benefits Group Commercial |
$6.12
|
| Rate for Payer: Health Management Network EPO/PPO |
$9.18
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$26.34
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$24.56
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$16.06
|
| Rate for Payer: InnovAge PACE Commercial |
$24.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$27.13
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.04
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$21.52
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$21.52
|
| Rate for Payer: Multiplan Commercial |
$7.65
|
| Rate for Payer: Networks By Design Commercial |
$6.63
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$16.06
|
| Rate for Payer: Prime Health Services Commercial |
$8.67
|
| Rate for Payer: Prime Health Services Medicare |
$17.02
|
| Rate for Payer: Riverside University Health System MISP |
$17.67
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6.12
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6.12
|
| Rate for Payer: United Healthcare All Other Commercial |
$13.01
|
| Rate for Payer: United Healthcare All Other HMO |
$13.01
|
| Rate for Payer: United Healthcare HMO Rider |
$13.01
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$13.01
|
| Rate for Payer: Upland Medical Group Pediatric |
$16.06
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$24.09
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$17.67
|
| Rate for Payer: Vantage Medical Group Senior |
$16.06
|
|
|
HC SOM THYROGLOBULIN TUMOR MARKER TM
|
Facility
|
IP
|
$10.20
|
|
|
Service Code
|
CPT 84432
|
| Hospital Charge Code |
900912645
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.04 |
| Max. Negotiated Rate |
$9.18 |
| Rate for Payer: Adventist Health Commercial |
$2.04
|
| Rate for Payer: Cash Price |
$10.20
|
| Rate for Payer: Central Health Plan Commercial |
$8.16
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.08
|
| Rate for Payer: EPIC Health Plan Senior |
$4.08
|
| Rate for Payer: Galaxy Health WC |
$8.67
|
| Rate for Payer: Global Benefits Group Commercial |
$6.12
|
| Rate for Payer: Health Management Network EPO/PPO |
$9.18
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.89
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.04
|
| Rate for Payer: Multiplan Commercial |
$7.65
|
| Rate for Payer: Networks By Design Commercial |
$6.63
|
| Rate for Payer: Prime Health Services Commercial |
$8.67
|
|
|
HC SOM THYROID BINDING GLOBULIN
|
Facility
|
OP
|
$20.00
|
|
|
Service Code
|
CPT 84442
|
| Hospital Charge Code |
900911006
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.00 |
| Max. Negotiated Rate |
$100.50 |
| Rate for Payer: Adventist Health Commercial |
$4.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$14.78
|
| Rate for Payer: Aetna of CA HMO/PPO |
$12.15
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$22.17
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$16.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14.78
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$100.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$20.40
|
| Rate for Payer: Blue Shield of California Commercial |
$12.14
|
| Rate for Payer: Blue Shield of California EPN |
$7.94
|
| Rate for Payer: Cash Price |
$20.00
|
| Rate for Payer: Cash Price |
$20.00
|
| Rate for Payer: Central Health Plan Commercial |
$16.00
|
| Rate for Payer: Cigna of CA HMO |
$12.80
|
| Rate for Payer: Cigna of CA PPO |
$14.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$22.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$16.26
|
| Rate for Payer: Dignity Health Medicare Advantage |
$14.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.95
|
| Rate for Payer: EPIC Health Plan Senior |
$14.78
|
| 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: Heritage Provider Network Commercial/Senior |
$24.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$22.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$14.78
|
| Rate for Payer: InnovAge PACE Commercial |
$22.17
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$13.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$24.97
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$19.81
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$19.81
|
| Rate for Payer: Multiplan Commercial |
$15.00
|
| Rate for Payer: Networks By Design Commercial |
$13.00
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$14.78
|
| Rate for Payer: Prime Health Services Commercial |
$17.00
|
| Rate for Payer: Prime Health Services Medicare |
$15.67
|
| Rate for Payer: Riverside University Health System MISP |
$16.26
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$12.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$12.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$11.97
|
| Rate for Payer: United Healthcare All Other HMO |
$11.97
|
| Rate for Payer: United Healthcare HMO Rider |
$11.97
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.97
|
| Rate for Payer: Upland Medical Group Pediatric |
$14.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$22.17
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$16.26
|
| Rate for Payer: Vantage Medical Group Senior |
$14.78
|
|
|
HC SOM THYROID BINDING GLOBULIN
|
Facility
|
IP
|
$20.00
|
|
|
Service Code
|
CPT 84442
|
| Hospital Charge Code |
900911006
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.00 |
| Max. Negotiated Rate |
$18.00 |
| Rate for Payer: Adventist Health Commercial |
$4.00
|
| Rate for Payer: Cash Price |
$20.00
|
| Rate for Payer: Central Health Plan Commercial |
$16.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.00
|
| Rate for Payer: EPIC Health Plan Senior |
$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: Kaiser Permanente of CA Medi-Cal |
$7.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12.38
|
| 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 THYROID STIMULATING IG
|
Facility
|
IP
|
$43.00
|
|
|
Service Code
|
CPT 84445
|
| Hospital Charge Code |
900915372
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.60 |
| Max. Negotiated Rate |
$38.70 |
| Rate for Payer: Adventist Health Commercial |
$8.60
|
| Rate for Payer: Cash Price |
$43.00
|
| Rate for Payer: Central Health Plan Commercial |
$34.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$17.20
|
| Rate for Payer: EPIC Health Plan Senior |
$17.20
|
| Rate for Payer: Galaxy Health WC |
$36.55
|
| Rate for Payer: Global Benefits Group Commercial |
$25.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$38.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$28.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$16.38
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$26.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.60
|
| Rate for Payer: Multiplan Commercial |
$32.25
|
| Rate for Payer: Networks By Design Commercial |
$27.95
|
| Rate for Payer: Prime Health Services Commercial |
$36.55
|
|
|
HC SOM THYROID STIMULATING IG
|
Facility
|
OP
|
$43.00
|
|
|
Service Code
|
CPT 84445
|
| Hospital Charge Code |
900915372
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.60 |
| Max. Negotiated Rate |
$292.15 |
| Rate for Payer: Adventist Health Commercial |
$8.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$50.86
|
| Rate for Payer: Aetna of CA HMO/PPO |
$26.11
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$76.29
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$55.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$50.86
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$292.15
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$59.29
|
| Rate for Payer: Blue Shield of California Commercial |
$26.10
|
| Rate for Payer: Blue Shield of California EPN |
$17.07
|
| Rate for Payer: Cash Price |
$43.00
|
| Rate for Payer: Cash Price |
$43.00
|
| Rate for Payer: Central Health Plan Commercial |
$34.40
|
| Rate for Payer: Cigna of CA HMO |
$27.52
|
| Rate for Payer: Cigna of CA PPO |
$31.82
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$76.29
|
| Rate for Payer: Dignity Health Medi-Cal |
$55.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$50.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$68.66
|
| Rate for Payer: EPIC Health Plan Senior |
$50.86
|
| Rate for Payer: Galaxy Health WC |
$36.55
|
| Rate for Payer: Global Benefits Group Commercial |
$25.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$38.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$83.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$77.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$50.86
|
| Rate for Payer: InnovAge PACE Commercial |
$76.29
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$28.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$85.88
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$50.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$68.15
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$68.15
|
| Rate for Payer: Multiplan Commercial |
$32.25
|
| Rate for Payer: Networks By Design Commercial |
$27.95
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$50.86
|
| Rate for Payer: Prime Health Services Commercial |
$36.55
|
| Rate for Payer: Prime Health Services Medicare |
$53.91
|
| Rate for Payer: Riverside University Health System MISP |
$55.95
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$25.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$25.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$41.19
|
| Rate for Payer: United Healthcare All Other HMO |
$41.19
|
| Rate for Payer: United Healthcare HMO Rider |
$41.19
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$41.19
|
| Rate for Payer: Upland Medical Group Pediatric |
$50.86
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$76.29
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$55.95
|
| Rate for Payer: Vantage Medical Group Senior |
$50.86
|
|
|
HC SOM THYROPEROXIDASE AB
|
Facility
|
OP
|
$11.90
|
|
|
Service Code
|
CPT 86376
|
| Hospital Charge Code |
900911315
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.38 |
| Max. Negotiated Rate |
$106.52 |
| Rate for Payer: Adventist Health Commercial |
$2.38
|
| Rate for Payer: Adventist Health Medi-Cal |
$14.55
|
| Rate for Payer: Aetna of CA HMO/PPO |
$7.23
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$16.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14.55
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$106.52
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$21.62
|
| Rate for Payer: Blue Shield of California Commercial |
$7.22
|
| Rate for Payer: Blue Shield of California EPN |
$4.72
|
| Rate for Payer: Cash Price |
$11.90
|
| Rate for Payer: Cash Price |
$11.90
|
| Rate for Payer: Central Health Plan Commercial |
$9.52
|
| Rate for Payer: Cigna of CA HMO |
$7.62
|
| Rate for Payer: Cigna of CA PPO |
$8.81
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$16.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$14.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.64
|
| Rate for Payer: EPIC Health Plan Senior |
$14.55
|
| Rate for Payer: Galaxy Health WC |
$10.12
|
| Rate for Payer: Global Benefits Group Commercial |
$7.14
|
| Rate for Payer: Health Management Network EPO/PPO |
$10.71
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$23.86
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$22.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$14.55
|
| Rate for Payer: InnovAge PACE Commercial |
$21.82
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$24.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.38
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$19.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$19.50
|
| Rate for Payer: Multiplan Commercial |
$8.93
|
| Rate for Payer: Networks By Design Commercial |
$7.74
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$14.55
|
| Rate for Payer: Prime Health Services Commercial |
$10.12
|
| Rate for Payer: Prime Health Services Medicare |
$15.42
|
| Rate for Payer: Riverside University Health System MISP |
$16.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7.14
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7.14
|
| Rate for Payer: United Healthcare All Other Commercial |
$11.79
|
| Rate for Payer: United Healthcare All Other HMO |
$11.79
|
| Rate for Payer: United Healthcare HMO Rider |
$11.79
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.79
|
| Rate for Payer: Upland Medical Group Pediatric |
$14.55
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$16.00
|
| Rate for Payer: Vantage Medical Group Senior |
$14.55
|
|
