|
HC SOM WEST NILE VIRUS PCR
|
Facility
IP
|
$84.00
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
900912543
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$16.80 |
| Max. Negotiated Rate |
$75.60 |
| Rate for Payer: Cash Price |
$37.80
|
| Rate for Payer: Central Health Plan Commercial |
$67.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$33.60
|
| Rate for Payer: Galaxy Health WC |
$71.40
|
| Rate for Payer: Global Benefits Group Commercial |
$50.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$75.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$56.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.80
|
| Rate for Payer: Multiplan Commercial |
$63.00
|
| Rate for Payer: Networks By Design Commercial |
$54.60
|
| Rate for Payer: Prime Health Services Commercial |
$71.40
|
|
|
HC SOM WEST NILE VIRUS PCR (CSF)
|
Facility
IP
|
$84.00
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
900912764
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$16.80 |
| Max. Negotiated Rate |
$75.60 |
| Rate for Payer: Cash Price |
$37.80
|
| Rate for Payer: Central Health Plan Commercial |
$67.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$33.60
|
| Rate for Payer: Galaxy Health WC |
$71.40
|
| Rate for Payer: Global Benefits Group Commercial |
$50.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$75.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$56.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.80
|
| Rate for Payer: Multiplan Commercial |
$63.00
|
| Rate for Payer: Networks By Design Commercial |
$54.60
|
| Rate for Payer: Prime Health Services Commercial |
$71.40
|
|
|
HC SOM WEST NILE VIRUS PCR (CSF)
|
Facility
OP
|
$84.00
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
900912764
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$16.80 |
| 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 |
$50.40
|
| Rate for Payer: Blue Shield of California Commercial |
$51.91
|
| Rate for Payer: Blue Shield of California EPN |
$40.82
|
| Rate for Payer: Caremore Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$37.80
|
| Rate for Payer: Cash Price |
$37.80
|
| Rate for Payer: Central Health Plan Commercial |
$67.20
|
| Rate for Payer: Cigna of CA HMO |
$53.76
|
| Rate for Payer: Cigna of CA PPO |
$62.16
|
| 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 |
$71.40
|
| Rate for Payer: Global Benefits Group Commercial |
$50.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$75.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$63.00
|
| 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 |
$56.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$35.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.80
|
| 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 |
$63.00
|
| Rate for Payer: Networks By Design Commercial |
$54.60
|
| Rate for Payer: Prime Health Services Commercial |
$71.40
|
| Rate for Payer: Prime Health Services Medicare |
$37.20
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$50.40
|
| Rate for Payer: Riverside University Health MISP |
$38.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$50.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$50.40
|
| 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 WHEY IGE
|
Facility
IP
|
$7.47
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
900914677
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$1.49 |
| Max. Negotiated Rate |
$6.72 |
| Rate for Payer: Cash Price |
$3.36
|
| Rate for Payer: Central Health Plan Commercial |
$5.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.99
|
| Rate for Payer: Galaxy Health WC |
$6.35
|
| Rate for Payer: Global Benefits Group Commercial |
$4.48
|
| Rate for Payer: Health Management Network EPO/PPO |
$6.72
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.49
|
| Rate for Payer: Multiplan Commercial |
$5.60
|
| Rate for Payer: Networks By Design Commercial |
$4.86
|
| Rate for Payer: Prime Health Services Commercial |
$6.35
|
|
|
HC SOM WHEY IGE
|
Facility
OP
|
$7.47
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
900914677
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$1.49 |
| Max. Negotiated Rate |
$140.27 |
| Rate for Payer: Adventist Health Medi-Cal |
$5.22
|
| Rate for Payer: Aetna of CA HMO/PPO |
$38.29
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$7.83
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$5.74
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$5.22
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$115.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$140.27
|
| Rate for Payer: BCBS Transplant Transplant |
$4.48
|
| Rate for Payer: Blue Shield of California Commercial |
$4.62
|
| Rate for Payer: Blue Shield of California EPN |
$3.63
|
| Rate for Payer: Caremore Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$3.36
|
| Rate for Payer: Cash Price |
$3.36
|
| Rate for Payer: Central Health Plan Commercial |
$5.98
|
| Rate for Payer: Cigna of CA HMO |
$4.78
|
| Rate for Payer: Cigna of CA PPO |
$5.53
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.83
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.05
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$5.22
|
| Rate for Payer: EPIC Health Plan Transplant |
$5.22
|
| Rate for Payer: Galaxy Health WC |
$6.35
|
| Rate for Payer: Global Benefits Group Commercial |
$4.48
|
| Rate for Payer: Health Management Network EPO/PPO |
$6.72
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$5.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$8.56
|
| Rate for Payer: IEHP medi-cal |
$8.61
|
| Rate for Payer: IEHP Medicare Advantage |
$5.22
|
| Rate for Payer: Innovage PACE Commercial |
$7.83
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.49
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.99
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.99
|
| Rate for Payer: Multiplan Commercial |
$5.60
|
| Rate for Payer: Networks By Design Commercial |
$4.86
|
| Rate for Payer: Prime Health Services Commercial |
$6.35
|
| Rate for Payer: Prime Health Services Medicare |
$5.53
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$4.48
|
| Rate for Payer: Riverside University Health MISP |
$5.74
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4.48
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4.48
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.23
|
| Rate for Payer: United Healthcare All Other HMO |
$4.23
|
| Rate for Payer: United Healthcare HMO Rider |
$4.23
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.23
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.74
|
| Rate for Payer: Vantage Medical Group Senior |
$5.22
|
|
|
HC SOM Y ENTEROCOL AB A G M
|
Facility
OP
|
$224.65
|
|
|
Service Code
|
CPT 86793
|
| Hospital Charge Code |
900914716
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.68 |
| Max. Negotiated Rate |
$202.18 |
| Rate for Payer: Adventist Health Medi-Cal |
$13.19
|
| Rate for Payer: Aetna of CA HMO/PPO |
$96.82
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$19.78
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$14.51
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$13.19
|
| 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 |
$134.79
|
| Rate for Payer: Blue Shield of California Commercial |
$138.83
|
| Rate for Payer: Blue Shield of California EPN |
$109.18
|
| Rate for Payer: Caremore Medicare Advantage |
$13.19
|
| Rate for Payer: Cash Price |
$101.09
|
| Rate for Payer: Cash Price |
$101.09
|
| Rate for Payer: Central Health Plan Commercial |
$179.72
|
| Rate for Payer: Cigna of CA HMO |
$143.78
|
| Rate for Payer: Cigna of CA PPO |
$166.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$17.81
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$13.19
|
| Rate for Payer: EPIC Health Plan Transplant |
$13.19
|
| Rate for Payer: Galaxy Health WC |
$190.95
|
| Rate for Payer: Global Benefits Group Commercial |
$134.79
|
| Rate for Payer: Health Management Network EPO/PPO |
$202.18
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$168.49
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$21.63
|
| Rate for Payer: IEHP medi-cal |
$21.76
|
| Rate for Payer: IEHP Medicare Advantage |
$13.19
|
| Rate for Payer: Innovage PACE Commercial |
$19.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$149.84
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$44.93
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17.67
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17.67
|
| Rate for Payer: Multiplan Commercial |
$168.49
|
| Rate for Payer: Networks By Design Commercial |
$146.02
|
| Rate for Payer: Prime Health Services Commercial |
$190.95
|
| Rate for Payer: Prime Health Services Medicare |
$13.98
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$134.79
|
| Rate for Payer: Riverside University Health MISP |
$14.51
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$134.79
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$134.79
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.68
|
| Rate for Payer: United Healthcare All Other HMO |
$10.68
|
| Rate for Payer: United Healthcare HMO Rider |
$10.68
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.68
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.51
|
| Rate for Payer: Vantage Medical Group Senior |
$13.19
|
|
|
HC SOM Y ENTEROCOL AB A G M
|
Facility
IP
|
$224.65
|
|
|
Service Code
|
CPT 86793
|
| Hospital Charge Code |
900914716
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$44.93 |
| Max. Negotiated Rate |
$202.18 |
| Rate for Payer: Cash Price |
$101.09
|
| Rate for Payer: Central Health Plan Commercial |
$179.72
|
| Rate for Payer: EPIC Health Plan Commercial |
$89.86
|
| Rate for Payer: Galaxy Health WC |
$190.95
|
| Rate for Payer: Global Benefits Group Commercial |
$134.79
|
| Rate for Payer: Health Management Network EPO/PPO |
$202.18
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$149.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$44.93
|
| Rate for Payer: Multiplan Commercial |
$168.49
|
| Rate for Payer: Networks By Design Commercial |
$146.02
|
| Rate for Payer: Prime Health Services Commercial |
$190.95
|
|
|
HC SOM ZINC
|
Facility
OP
|
$12.17
|
|
|
Service Code
|
CPT 84630
|
| Hospital Charge Code |
900911152
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.43 |
| Max. Negotiated Rate |
$101.08 |
| Rate for Payer: Adventist Health Medi-Cal |
$11.39
|
| Rate for Payer: Aetna of CA HMO/PPO |
$83.57
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$17.08
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$12.53
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$11.39
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$82.87
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$101.08
|
| Rate for Payer: BCBS Transplant Transplant |
$7.30
|
| Rate for Payer: Blue Shield of California Commercial |
$7.52
|
| Rate for Payer: Blue Shield of California EPN |
$5.91
|
| Rate for Payer: Caremore Medicare Advantage |
$11.39
|
| Rate for Payer: Cash Price |
$5.48
|
| Rate for Payer: Cash Price |
$5.48
|
| Rate for Payer: Central Health Plan Commercial |
$9.74
|
| Rate for Payer: Cigna of CA HMO |
$7.79
|
| Rate for Payer: Cigna of CA PPO |
$9.01
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$17.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.38
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$11.39
|
| Rate for Payer: EPIC Health Plan Transplant |
$11.39
|
| Rate for Payer: Galaxy Health WC |
$10.34
|
| Rate for Payer: Global Benefits Group Commercial |
$7.30
|
| Rate for Payer: Health Management Network EPO/PPO |
$10.95
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$9.13
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$18.68
|
| Rate for Payer: IEHP medi-cal |
$18.79
|
| Rate for Payer: IEHP Medicare Advantage |
$11.39
|
| Rate for Payer: Innovage PACE Commercial |
$17.08
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$11.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.43
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$15.26
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$15.26
|
| Rate for Payer: Multiplan Commercial |
$9.13
|
| Rate for Payer: Networks By Design Commercial |
$7.91
|
| Rate for Payer: Prime Health Services Commercial |
$10.34
|
| Rate for Payer: Prime Health Services Medicare |
$12.07
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$7.30
|
| Rate for Payer: Riverside University Health MISP |
$12.53
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7.30
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7.30
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.22
|
| Rate for Payer: United Healthcare All Other HMO |
$9.22
|
| Rate for Payer: United Healthcare HMO Rider |
$9.22
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.22
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$17.08
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$12.53
|
| Rate for Payer: Vantage Medical Group Senior |
$11.39
|
|
|
HC SOM ZINC
|
Facility
IP
|
$12.17
|
|
|
Service Code
|
CPT 84630
|
| Hospital Charge Code |
900911152
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.43 |
| Max. Negotiated Rate |
$10.95 |
| Rate for Payer: Cash Price |
$5.48
|
| Rate for Payer: Central Health Plan Commercial |
$9.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.87
|
| Rate for Payer: Galaxy Health WC |
$10.34
|
| Rate for Payer: Global Benefits Group Commercial |
$7.30
|
| Rate for Payer: Health Management Network EPO/PPO |
$10.95
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.43
|
| Rate for Payer: Multiplan Commercial |
$9.13
|
| Rate for Payer: Networks By Design Commercial |
$7.91
|
| Rate for Payer: Prime Health Services Commercial |
$10.34
|
|
|
HC SOM ZINC TRANSPORTER 8 AUTOAB
|
Facility
OP
|
$150.00
|
|
|
Service Code
|
CPT 86341
|
| Hospital Charge Code |
900915260
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$19.09 |
| Max. Negotiated Rate |
$136.45 |
| Rate for Payer: Adventist Health Medi-Cal |
$23.57
|
| Rate for Payer: Aetna of CA HMO/PPO |
$121.92
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$35.36
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$25.93
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$23.57
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$111.86
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$136.45
|
| Rate for Payer: BCBS Transplant Transplant |
$90.00
|
| Rate for Payer: Blue Shield of California Commercial |
$92.70
|
| Rate for Payer: Blue Shield of California EPN |
$72.90
|
| Rate for Payer: Caremore Medicare Advantage |
$23.57
|
| Rate for Payer: Cash Price |
$67.50
|
| Rate for Payer: Cash Price |
$67.50
|
| Rate for Payer: Central Health Plan Commercial |
$120.00
|
| Rate for Payer: Cigna of CA HMO |
$96.00
|
| Rate for Payer: Cigna of CA PPO |
$111.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$35.36
|
| Rate for Payer: EPIC Health Plan Commercial |
$31.82
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$23.57
|
| Rate for Payer: EPIC Health Plan Transplant |
$23.57
|
| Rate for Payer: Galaxy Health WC |
$127.50
|
| Rate for Payer: Global Benefits Group Commercial |
$90.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$135.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$112.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$38.65
|
| Rate for Payer: IEHP medi-cal |
$38.89
|
| Rate for Payer: IEHP Medicare Advantage |
$23.57
|
| Rate for Payer: Innovage PACE Commercial |
$35.36
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$100.05
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$23.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$30.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$31.58
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$31.58
|
| Rate for Payer: Multiplan Commercial |
$112.50
|
| Rate for Payer: Networks By Design Commercial |
$97.50
|
| Rate for Payer: Prime Health Services Commercial |
$127.50
|
| Rate for Payer: Prime Health Services Medicare |
$24.98
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$90.00
|
| Rate for Payer: Riverside University Health MISP |
$25.93
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$90.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$90.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$19.09
|
| Rate for Payer: United Healthcare All Other HMO |
$19.09
|
| Rate for Payer: United Healthcare HMO Rider |
$19.09
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$19.09
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$35.36
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25.93
|
| Rate for Payer: Vantage Medical Group Senior |
$23.57
|
|
|
HC SOM ZINC TRANSPORTER 8 AUTOAB
|
Facility
IP
|
$150.00
|
|
|
Service Code
|
CPT 86341
|
| Hospital Charge Code |
900915260
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$30.00 |
| Max. Negotiated Rate |
$135.00 |
| Rate for Payer: Cash Price |
$67.50
|
| Rate for Payer: Central Health Plan Commercial |
$120.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$60.00
|
| Rate for Payer: Galaxy Health WC |
$127.50
|
| Rate for Payer: Global Benefits Group Commercial |
$90.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$135.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$100.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$30.00
|
| Rate for Payer: Multiplan Commercial |
$112.50
|
| Rate for Payer: Networks By Design Commercial |
$97.50
|
| Rate for Payer: Prime Health Services Commercial |
$127.50
|
|
|
HC SOM ZONISAMIDE LEVEL
|
Facility
IP
|
$39.85
|
|
|
Service Code
|
CPT 80203
|
| Hospital Charge Code |
900912714
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.97 |
| Max. Negotiated Rate |
$35.86 |
| Rate for Payer: Cash Price |
$17.93
|
| Rate for Payer: Central Health Plan Commercial |
$31.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.94
|
| Rate for Payer: Galaxy Health WC |
$33.87
|
| Rate for Payer: Global Benefits Group Commercial |
$23.91
|
| Rate for Payer: Health Management Network EPO/PPO |
$35.86
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$26.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.97
|
| Rate for Payer: Multiplan Commercial |
$29.89
|
| Rate for Payer: Networks By Design Commercial |
$25.90
|
| Rate for Payer: Prime Health Services Commercial |
$33.87
|
|
|
HC SOM ZONISAMIDE LEVEL
|
Facility
OP
|
$39.85
|
|
|
Service Code
|
CPT 80203
|
| Hospital Charge Code |
900912714
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.97 |
| Max. Negotiated Rate |
$94.37 |
| Rate for Payer: Adventist Health Medi-Cal |
$13.25
|
| Rate for Payer: Aetna of CA HMO/PPO |
$94.37
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$19.88
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$14.58
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$13.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$57.99
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$70.73
|
| Rate for Payer: BCBS Transplant Transplant |
$23.91
|
| Rate for Payer: Blue Shield of California Commercial |
$24.63
|
| Rate for Payer: Blue Shield of California EPN |
$19.37
|
| Rate for Payer: Caremore Medicare Advantage |
$13.25
|
| Rate for Payer: Cash Price |
$17.93
|
| Rate for Payer: Cash Price |
$17.93
|
| Rate for Payer: Central Health Plan Commercial |
$31.88
|
| Rate for Payer: Cigna of CA HMO |
$25.50
|
| Rate for Payer: Cigna of CA PPO |
$29.49
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$17.89
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$13.25
|
| Rate for Payer: EPIC Health Plan Transplant |
$13.25
|
| Rate for Payer: Galaxy Health WC |
$33.87
|
| Rate for Payer: Global Benefits Group Commercial |
$23.91
|
| Rate for Payer: Health Management Network EPO/PPO |
$35.86
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$29.89
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$21.73
|
| Rate for Payer: IEHP medi-cal |
$21.86
|
| Rate for Payer: IEHP Medicare Advantage |
$13.25
|
| Rate for Payer: Innovage PACE Commercial |
$19.88
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$26.58
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.97
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17.76
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17.76
|
| Rate for Payer: Multiplan Commercial |
$29.89
|
| Rate for Payer: Networks By Design Commercial |
$25.90
|
| Rate for Payer: Prime Health Services Commercial |
$33.87
|
| Rate for Payer: Prime Health Services Medicare |
$14.04
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$23.91
|
| Rate for Payer: Riverside University Health MISP |
$14.58
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$23.91
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$23.91
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.74
|
| Rate for Payer: United Healthcare All Other HMO |
$10.74
|
| Rate for Payer: United Healthcare HMO Rider |
$10.74
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.74
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.58
|
| Rate for Payer: Vantage Medical Group Senior |
$13.25
|
|
|
HC SON ASPARAGINASE ASSAY
|
Facility
OP
|
$165.00
|
|
|
Service Code
|
CPT 82657
|
| Hospital Charge Code |
900915353
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$17.96 |
| Max. Negotiated Rate |
$159.57 |
| Rate for Payer: Adventist Health Medi-Cal |
$22.17
|
| Rate for Payer: Aetna of CA HMO/PPO |
$132.53
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$33.26
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$24.39
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$22.17
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$130.82
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$159.57
|
| Rate for Payer: BCBS Transplant Transplant |
$99.00
|
| Rate for Payer: Blue Shield of California Commercial |
$101.97
|
| Rate for Payer: Blue Shield of California EPN |
$80.19
|
| Rate for Payer: Caremore Medicare Advantage |
$22.17
|
| Rate for Payer: Cash Price |
$74.25
|
| Rate for Payer: Cash Price |
$74.25
|
| Rate for Payer: Central Health Plan Commercial |
$132.00
|
| Rate for Payer: Cigna of CA HMO |
$105.60
|
| Rate for Payer: Cigna of CA PPO |
$122.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$33.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$29.93
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$22.17
|
| Rate for Payer: EPIC Health Plan Transplant |
$22.17
|
| Rate for Payer: Galaxy Health WC |
$140.25
|
| Rate for Payer: Global Benefits Group Commercial |
$99.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$148.50
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$123.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$36.36
|
| Rate for Payer: IEHP medi-cal |
$36.58
|
| Rate for Payer: IEHP Medicare Advantage |
$22.17
|
| Rate for Payer: Innovage PACE Commercial |
$33.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$110.06
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$33.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$29.71
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$29.71
|
| Rate for Payer: Multiplan Commercial |
$123.75
|
| Rate for Payer: Networks By Design Commercial |
$107.25
|
| Rate for Payer: Prime Health Services Commercial |
$140.25
|
| Rate for Payer: Prime Health Services Medicare |
$23.50
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$99.00
|
| Rate for Payer: Riverside University Health MISP |
$24.39
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$99.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$99.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$17.96
|
| Rate for Payer: United Healthcare All Other HMO |
$17.96
|
| Rate for Payer: United Healthcare HMO Rider |
$17.96
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$17.96
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$33.26
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$24.39
|
| Rate for Payer: Vantage Medical Group Senior |
$22.17
|
|
|
HC SON ASPARAGINASE ASSAY
|
Facility
IP
|
$165.00
|
|
|
Service Code
|
CPT 82657
|
| Hospital Charge Code |
900915353
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$33.00 |
| Max. Negotiated Rate |
$148.50 |
| Rate for Payer: Cash Price |
$74.25
|
| Rate for Payer: Central Health Plan Commercial |
$132.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$66.00
|
| Rate for Payer: Galaxy Health WC |
$140.25
|
| Rate for Payer: Global Benefits Group Commercial |
$99.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$148.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$110.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$33.00
|
| Rate for Payer: Multiplan Commercial |
$123.75
|
| Rate for Payer: Networks By Design Commercial |
$107.25
|
| Rate for Payer: Prime Health Services Commercial |
$140.25
|
|
|
HC SONGI 14011200 HCV PCR QL
|
Facility
IP
|
$235.00
|
|
|
Service Code
|
CPT 87521
|
| Hospital Charge Code |
900914766
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$47.00 |
| Max. Negotiated Rate |
$211.50 |
| Rate for Payer: Cash Price |
$105.75
|
| Rate for Payer: Central Health Plan Commercial |
$188.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$94.00
|
| Rate for Payer: Galaxy Health WC |
$199.75
|
| Rate for Payer: Global Benefits Group Commercial |
$141.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$211.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$156.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$47.00
|
| Rate for Payer: Multiplan Commercial |
$176.25
|
| Rate for Payer: Networks By Design Commercial |
$152.75
|
| Rate for Payer: Prime Health Services Commercial |
$199.75
|
|
|
HC SONGI 14011200 HCV PCR QL
|
Facility
OP
|
$235.00
|
|
|
Service Code
|
CPT 87521
|
| Hospital Charge Code |
900914766
|
|
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 |
$141.00
|
| Rate for Payer: Blue Shield of California Commercial |
$145.23
|
| Rate for Payer: Blue Shield of California EPN |
$114.21
|
| Rate for Payer: Caremore Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$105.75
|
| Rate for Payer: Cash Price |
$105.75
|
| Rate for Payer: Central Health Plan Commercial |
$188.00
|
| Rate for Payer: Cigna of CA HMO |
$150.40
|
| Rate for Payer: Cigna of CA PPO |
$173.90
|
| 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 |
$199.75
|
| Rate for Payer: Global Benefits Group Commercial |
$141.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$211.50
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$176.25
|
| 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 |
$156.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$35.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$47.00
|
| 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 |
$176.25
|
| Rate for Payer: Networks By Design Commercial |
$152.75
|
| Rate for Payer: Prime Health Services Commercial |
$199.75
|
| Rate for Payer: Prime Health Services Medicare |
$37.20
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$141.00
|
| Rate for Payer: Riverside University Health MISP |
$38.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$141.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$141.00
|
| 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 SOP CELIAC PLUS
|
Facility
OP
|
$127.50
|
|
|
Service Code
|
CPT 88346
|
| Hospital Charge Code |
900914910
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$25.50 |
| Max. Negotiated Rate |
$352.13 |
| Rate for Payer: Adventist Health Medi-Cal |
$213.41
|
| Rate for Payer: Aetna of CA HMO/PPO |
$340.96
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$320.12
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$234.75
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$213.41
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$54.90
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$66.97
|
| Rate for Payer: BCBS Transplant Transplant |
$76.50
|
| Rate for Payer: Blue Shield of California Commercial |
$78.80
|
| Rate for Payer: Blue Shield of California EPN |
$61.96
|
| Rate for Payer: Caremore Medicare Advantage |
$213.41
|
| Rate for Payer: Cash Price |
$57.38
|
| Rate for Payer: Cash Price |
$57.38
|
| Rate for Payer: Central Health Plan Commercial |
$102.00
|
| Rate for Payer: Cigna of CA HMO |
$81.60
|
| Rate for Payer: Cigna of CA PPO |
$94.35
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$320.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$288.10
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$213.41
|
| Rate for Payer: EPIC Health Plan Transplant |
$213.41
|
| Rate for Payer: Galaxy Health WC |
$108.38
|
| Rate for Payer: Global Benefits Group Commercial |
$76.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$114.75
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$95.62
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$349.99
|
| Rate for Payer: IEHP medi-cal |
$352.13
|
| Rate for Payer: IEHP Medicare Advantage |
$213.41
|
| Rate for Payer: Innovage PACE Commercial |
$320.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$85.04
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$213.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$285.97
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$285.97
|
| Rate for Payer: Multiplan Commercial |
$95.62
|
| Rate for Payer: Networks By Design Commercial |
$82.88
|
| Rate for Payer: Prime Health Services Commercial |
$108.38
|
| Rate for Payer: Prime Health Services Medicare |
$226.21
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$76.50
|
| Rate for Payer: Riverside University Health MISP |
$234.75
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$76.50
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$76.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$240.94
|
| Rate for Payer: United Healthcare All Other HMO |
$240.94
|
| Rate for Payer: United Healthcare HMO Rider |
$240.94
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$240.94
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$320.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$234.75
|
| Rate for Payer: Vantage Medical Group Senior |
$213.41
|
|
|
HC SOP CELIAC PLUS
|
Facility
IP
|
$127.50
|
|
|
Service Code
|
CPT 88346
|
| Hospital Charge Code |
900914910
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$25.50 |
| Max. Negotiated Rate |
$114.75 |
| Rate for Payer: Cash Price |
$57.38
|
| Rate for Payer: Central Health Plan Commercial |
$102.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$51.00
|
| Rate for Payer: Galaxy Health WC |
$108.38
|
| Rate for Payer: Global Benefits Group Commercial |
$76.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$114.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$85.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.50
|
| Rate for Payer: Multiplan Commercial |
$95.62
|
| Rate for Payer: Networks By Design Commercial |
$82.88
|
| Rate for Payer: Prime Health Services Commercial |
$108.38
|
|
|
HC SOP CELIAC PLUS 81382
|
Facility
OP
|
$276.25
|
|
|
Service Code
|
CPT 81382
|
| Hospital Charge Code |
900914907
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$55.25 |
| Max. Negotiated Rate |
$747.35 |
| Rate for Payer: Adventist Health Medi-Cal |
$123.68
|
| Rate for Payer: Aetna of CA HMO/PPO |
$353.23
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$185.52
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$136.05
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$123.68
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$612.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$747.35
|
| Rate for Payer: BCBS Transplant Transplant |
$165.75
|
| Rate for Payer: Blue Shield of California Commercial |
$170.72
|
| Rate for Payer: Blue Shield of California EPN |
$134.26
|
| Rate for Payer: Caremore Medicare Advantage |
$123.68
|
| Rate for Payer: Cash Price |
$124.31
|
| Rate for Payer: Cash Price |
$124.31
|
| Rate for Payer: Central Health Plan Commercial |
$221.00
|
| Rate for Payer: Cigna of CA HMO |
$176.80
|
| Rate for Payer: Cigna of CA PPO |
$204.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$185.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$166.97
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$123.68
|
| Rate for Payer: EPIC Health Plan Transplant |
$123.68
|
| Rate for Payer: Galaxy Health WC |
$234.81
|
| Rate for Payer: Global Benefits Group Commercial |
$165.75
|
| Rate for Payer: Health Management Network EPO/PPO |
$248.62
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$207.19
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$202.84
|
| Rate for Payer: IEHP medi-cal |
$204.07
|
| Rate for Payer: IEHP Medicare Advantage |
$123.68
|
| Rate for Payer: Innovage PACE Commercial |
$185.52
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$184.26
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$123.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$55.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$165.73
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$165.73
|
| Rate for Payer: Multiplan Commercial |
$207.19
|
| Rate for Payer: Networks By Design Commercial |
$179.56
|
| Rate for Payer: Prime Health Services Commercial |
$234.81
|
| Rate for Payer: Prime Health Services Medicare |
$131.10
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$165.75
|
| Rate for Payer: Riverside University Health MISP |
$136.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$165.75
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$165.75
|
| Rate for Payer: United Healthcare All Other Commercial |
$100.18
|
| Rate for Payer: United Healthcare All Other HMO |
$100.18
|
| Rate for Payer: United Healthcare HMO Rider |
$100.18
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$100.18
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$185.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$136.05
|
| Rate for Payer: Vantage Medical Group Senior |
$123.68
|
|
|
HC SOP CELIAC PLUS 81382
|
Facility
IP
|
$276.25
|
|
|
Service Code
|
CPT 81382
|
| Hospital Charge Code |
900914907
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$55.25 |
| Max. Negotiated Rate |
$248.62 |
| Rate for Payer: Cash Price |
$124.31
|
| Rate for Payer: Central Health Plan Commercial |
$221.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$110.50
|
| Rate for Payer: Galaxy Health WC |
$234.81
|
| Rate for Payer: Global Benefits Group Commercial |
$165.75
|
| Rate for Payer: Health Management Network EPO/PPO |
$248.62
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$184.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$55.25
|
| Rate for Payer: Multiplan Commercial |
$207.19
|
| Rate for Payer: Networks By Design Commercial |
$179.56
|
| Rate for Payer: Prime Health Services Commercial |
$234.81
|
|
|
HC SOP CELIAC PLUS 82784
|
Facility
IP
|
$21.26
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
900914909
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$4.25 |
| Max. Negotiated Rate |
$19.13 |
| Rate for Payer: Cash Price |
$9.57
|
| Rate for Payer: Central Health Plan Commercial |
$17.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.50
|
| Rate for Payer: Galaxy Health WC |
$18.07
|
| Rate for Payer: Global Benefits Group Commercial |
$12.76
|
| Rate for Payer: Health Management Network EPO/PPO |
$19.13
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$14.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.25
|
| Rate for Payer: Multiplan Commercial |
$15.94
|
| Rate for Payer: Networks By Design Commercial |
$13.82
|
| Rate for Payer: Prime Health Services Commercial |
$18.07
|
|
|
HC SOP CELIAC PLUS 82784
|
Facility
OP
|
$21.26
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
900914909
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$4.25 |
| Max. Negotiated Rate |
$68.76 |
| Rate for Payer: Adventist Health Medi-Cal |
$9.30
|
| Rate for Payer: Aetna of CA HMO/PPO |
$48.10
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$13.95
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$10.23
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$9.30
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$56.37
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$68.76
|
| Rate for Payer: BCBS Transplant Transplant |
$12.76
|
| Rate for Payer: Blue Shield of California Commercial |
$13.14
|
| Rate for Payer: Blue Shield of California EPN |
$10.33
|
| Rate for Payer: Caremore Medicare Advantage |
$9.30
|
| Rate for Payer: Cash Price |
$9.57
|
| Rate for Payer: Cash Price |
$9.57
|
| Rate for Payer: Central Health Plan Commercial |
$17.01
|
| Rate for Payer: Cigna of CA HMO |
$13.61
|
| Rate for Payer: Cigna of CA PPO |
$15.73
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.56
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$9.30
|
| Rate for Payer: EPIC Health Plan Transplant |
$9.30
|
| Rate for Payer: Galaxy Health WC |
$18.07
|
| Rate for Payer: Global Benefits Group Commercial |
$12.76
|
| Rate for Payer: Health Management Network EPO/PPO |
$19.13
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$15.94
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$15.25
|
| Rate for Payer: IEHP medi-cal |
$15.34
|
| Rate for Payer: IEHP Medicare Advantage |
$9.30
|
| Rate for Payer: Innovage PACE Commercial |
$13.95
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$14.18
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$12.46
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$12.46
|
| Rate for Payer: Multiplan Commercial |
$15.94
|
| Rate for Payer: Networks By Design Commercial |
$13.82
|
| Rate for Payer: Prime Health Services Commercial |
$18.07
|
| Rate for Payer: Prime Health Services Medicare |
$9.86
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$12.76
|
| Rate for Payer: Riverside University Health MISP |
$10.23
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$12.76
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$12.76
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.53
|
| Rate for Payer: United Healthcare All Other HMO |
$7.53
|
| Rate for Payer: United Healthcare HMO Rider |
$7.53
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.53
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.23
|
| Rate for Payer: Vantage Medical Group Senior |
$9.30
|
|
|
HC SOP CELIAC PLUS 83520
|
Facility
IP
|
$32.58
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
900914908
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$6.52 |
| Max. Negotiated Rate |
$29.32 |
| Rate for Payer: Cash Price |
$14.66
|
| Rate for Payer: Central Health Plan Commercial |
$26.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.03
|
| Rate for Payer: Galaxy Health WC |
$27.69
|
| Rate for Payer: Global Benefits Group Commercial |
$19.55
|
| Rate for Payer: Health Management Network EPO/PPO |
$29.32
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$21.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.52
|
| Rate for Payer: Multiplan Commercial |
$24.44
|
| Rate for Payer: Networks By Design Commercial |
$21.18
|
| Rate for Payer: Prime Health Services Commercial |
$27.69
|
|
|
HC SOP CELIAC PLUS 83520
|
Facility
OP
|
$32.58
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
900914908
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$6.52 |
| 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 |
$19.55
|
| Rate for Payer: Blue Shield of California Commercial |
$20.13
|
| Rate for Payer: Blue Shield of California EPN |
$15.83
|
| Rate for Payer: Caremore Medicare Advantage |
$17.27
|
| Rate for Payer: Cash Price |
$14.66
|
| Rate for Payer: Cash Price |
$14.66
|
| Rate for Payer: Central Health Plan Commercial |
$26.06
|
| Rate for Payer: Cigna of CA HMO |
$20.85
|
| Rate for Payer: Cigna of CA PPO |
$24.11
|
| 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 |
$27.69
|
| Rate for Payer: Global Benefits Group Commercial |
$19.55
|
| Rate for Payer: Health Management Network EPO/PPO |
$29.32
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$24.44
|
| 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 |
$21.73
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$17.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.52
|
| 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 |
$24.44
|
| Rate for Payer: Networks By Design Commercial |
$21.18
|
| Rate for Payer: Prime Health Services Commercial |
$27.69
|
| Rate for Payer: Prime Health Services Medicare |
$18.31
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$19.55
|
| Rate for Payer: Riverside University Health MISP |
$19.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$19.55
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$19.55
|
| 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
|
|
