|
HC SOUOC NSD1 DEL/DUP
|
Facility
OP
|
$525.00
|
|
|
Service Code
|
CPT 81407
|
| Hospital Charge Code |
900914719
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$105.00 |
| Max. Negotiated Rate |
$17,196.22 |
| Rate for Payer: Adventist Health Medi-Cal |
$846.27
|
| Rate for Payer: Aetna of CA HMO/PPO |
$4,417.70
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,269.40
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$930.90
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$846.27
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$14,098.08
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$17,196.22
|
| Rate for Payer: BCBS Transplant Transplant |
$315.00
|
| Rate for Payer: Blue Shield of California Commercial |
$324.45
|
| Rate for Payer: Blue Shield of California EPN |
$255.15
|
| Rate for Payer: Caremore Medicare Advantage |
$846.27
|
| Rate for Payer: Cash Price |
$236.25
|
| Rate for Payer: Cash Price |
$236.25
|
| Rate for Payer: Central Health Plan Commercial |
$420.00
|
| Rate for Payer: Cigna of CA HMO |
$336.00
|
| Rate for Payer: Cigna of CA PPO |
$388.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,269.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,142.46
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$846.27
|
| Rate for Payer: EPIC Health Plan Transplant |
$846.27
|
| Rate for Payer: Galaxy Health WC |
$446.25
|
| Rate for Payer: Global Benefits Group Commercial |
$315.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$472.50
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$393.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,387.88
|
| Rate for Payer: IEHP medi-cal |
$1,396.35
|
| Rate for Payer: IEHP Medicare Advantage |
$846.27
|
| Rate for Payer: Innovage PACE Commercial |
$1,269.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$350.18
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$846.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$105.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,134.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,134.00
|
| Rate for Payer: Multiplan Commercial |
$393.75
|
| Rate for Payer: Networks By Design Commercial |
$341.25
|
| Rate for Payer: Prime Health Services Commercial |
$446.25
|
| Rate for Payer: Prime Health Services Medicare |
$897.05
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$315.00
|
| Rate for Payer: Riverside University Health MISP |
$930.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$315.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$315.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$685.48
|
| Rate for Payer: United Healthcare All Other HMO |
$685.48
|
| Rate for Payer: United Healthcare HMO Rider |
$685.48
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$685.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,269.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$930.90
|
| Rate for Payer: Vantage Medical Group Senior |
$846.27
|
|
|
HC SOUOC NSD1 SEQ
|
Facility
OP
|
$2,425.00
|
|
|
Service Code
|
CPT 81406
|
| Hospital Charge Code |
900914718
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$229.13 |
| Max. Negotiated Rate |
$2,182.50 |
| Rate for Payer: Adventist Health Medi-Cal |
$282.88
|
| Rate for Payer: Aetna of CA HMO/PPO |
$366.91
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$424.32
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$311.17
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$282.88
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,748.87
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,133.20
|
| Rate for Payer: BCBS Transplant Transplant |
$1,455.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,498.65
|
| Rate for Payer: Blue Shield of California EPN |
$1,178.55
|
| Rate for Payer: Caremore Medicare Advantage |
$282.88
|
| Rate for Payer: Cash Price |
$1,091.25
|
| Rate for Payer: Cash Price |
$1,091.25
|
| Rate for Payer: Central Health Plan Commercial |
$1,940.00
|
| Rate for Payer: Cigna of CA HMO |
$1,552.00
|
| Rate for Payer: Cigna of CA PPO |
$1,794.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$424.32
|
| Rate for Payer: EPIC Health Plan Commercial |
$381.89
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$282.88
|
| Rate for Payer: EPIC Health Plan Transplant |
$282.88
|
| Rate for Payer: Galaxy Health WC |
$2,061.25
|
| Rate for Payer: Global Benefits Group Commercial |
$1,455.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,182.50
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,818.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$463.92
|
| Rate for Payer: IEHP medi-cal |
$466.75
|
| Rate for Payer: IEHP Medicare Advantage |
$282.88
|
| Rate for Payer: Innovage PACE Commercial |
$424.32
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,617.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$282.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$485.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$379.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$379.06
|
| Rate for Payer: Multiplan Commercial |
$1,818.75
|
| Rate for Payer: Networks By Design Commercial |
$1,576.25
|
| Rate for Payer: Prime Health Services Commercial |
$2,061.25
|
| Rate for Payer: Prime Health Services Medicare |
$299.85
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,455.00
|
| Rate for Payer: Riverside University Health MISP |
$311.17
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,455.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,455.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$229.13
|
| Rate for Payer: United Healthcare All Other HMO |
$229.13
|
| Rate for Payer: United Healthcare HMO Rider |
$229.13
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$229.13
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$424.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$311.17
|
| Rate for Payer: Vantage Medical Group Senior |
$282.88
|
|
|
HC SOUOC NSD1 SEQ
|
Facility
IP
|
$2,425.00
|
|
|
Service Code
|
CPT 81406
|
| Hospital Charge Code |
900914718
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$485.00 |
| Max. Negotiated Rate |
$2,182.50 |
| Rate for Payer: Cash Price |
$1,091.25
|
| Rate for Payer: Central Health Plan Commercial |
$1,940.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$970.00
|
| Rate for Payer: Galaxy Health WC |
$2,061.25
|
| Rate for Payer: Global Benefits Group Commercial |
$1,455.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,182.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,617.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$485.00
|
| Rate for Payer: Multiplan Commercial |
$1,818.75
|
| Rate for Payer: Networks By Design Commercial |
$1,576.25
|
| Rate for Payer: Prime Health Services Commercial |
$2,061.25
|
|
|
HC SOV HYPERSENSITIVITY PNEUMONITIS PAN 1
|
Facility
IP
|
$19.17
|
|
|
Service Code
|
CPT 86001
|
| Hospital Charge Code |
900915332
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.83 |
| Max. Negotiated Rate |
$17.25 |
| Rate for Payer: Cash Price |
$8.63
|
| Rate for Payer: Central Health Plan Commercial |
$15.34
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.67
|
| Rate for Payer: Galaxy Health WC |
$16.29
|
| Rate for Payer: Global Benefits Group Commercial |
$11.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$17.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.83
|
| Rate for Payer: Multiplan Commercial |
$14.38
|
| Rate for Payer: Networks By Design Commercial |
$12.46
|
| Rate for Payer: Prime Health Services Commercial |
$16.29
|
|
|
HC SOV HYPERSENSITIVITY PNEUMONITIS PAN 1
|
Facility
OP
|
$19.17
|
|
|
Service Code
|
CPT 86001
|
| Hospital Charge Code |
900915332
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.83 |
| Max. Negotiated Rate |
$46.36 |
| Rate for Payer: Adventist Health Medi-Cal |
$7.82
|
| Rate for Payer: Aetna of CA HMO/PPO |
$38.29
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$11.73
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$8.60
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$7.82
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$38.01
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$46.36
|
| Rate for Payer: BCBS Transplant Transplant |
$11.50
|
| Rate for Payer: Blue Shield of California Commercial |
$11.85
|
| Rate for Payer: Blue Shield of California EPN |
$9.32
|
| Rate for Payer: Caremore Medicare Advantage |
$7.82
|
| Rate for Payer: Cash Price |
$8.63
|
| Rate for Payer: Cash Price |
$8.63
|
| Rate for Payer: Central Health Plan Commercial |
$15.34
|
| Rate for Payer: Cigna of CA HMO |
$12.27
|
| Rate for Payer: Cigna of CA PPO |
$14.19
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.56
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$7.82
|
| Rate for Payer: EPIC Health Plan Transplant |
$7.82
|
| Rate for Payer: Galaxy Health WC |
$16.29
|
| Rate for Payer: Global Benefits Group Commercial |
$11.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$17.25
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$14.38
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$12.82
|
| Rate for Payer: IEHP medi-cal |
$12.90
|
| Rate for Payer: IEHP Medicare Advantage |
$7.82
|
| Rate for Payer: Innovage PACE Commercial |
$11.73
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12.79
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.83
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.48
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10.48
|
| Rate for Payer: Multiplan Commercial |
$14.38
|
| Rate for Payer: Networks By Design Commercial |
$12.46
|
| Rate for Payer: Prime Health Services Commercial |
$16.29
|
| Rate for Payer: Prime Health Services Medicare |
$8.29
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$11.50
|
| Rate for Payer: Riverside University Health MISP |
$8.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$11.50
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$11.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.34
|
| Rate for Payer: United Healthcare All Other HMO |
$6.34
|
| Rate for Payer: United Healthcare HMO Rider |
$6.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.34
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11.73
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.60
|
| Rate for Payer: Vantage Medical Group Senior |
$7.82
|
|
|
HC SOV HYPERSENSITIVITY PNEUMONITIS PAN 2
|
Facility
OP
|
$19.17
|
|
|
Service Code
|
CPT 86001
|
| Hospital Charge Code |
900915333
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.83 |
| Max. Negotiated Rate |
$46.36 |
| Rate for Payer: Adventist Health Medi-Cal |
$7.82
|
| Rate for Payer: Aetna of CA HMO/PPO |
$38.29
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$11.73
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$8.60
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$7.82
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$38.01
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$46.36
|
| Rate for Payer: BCBS Transplant Transplant |
$11.50
|
| Rate for Payer: Blue Shield of California Commercial |
$11.85
|
| Rate for Payer: Blue Shield of California EPN |
$9.32
|
| Rate for Payer: Caremore Medicare Advantage |
$7.82
|
| Rate for Payer: Cash Price |
$8.63
|
| Rate for Payer: Cash Price |
$8.63
|
| Rate for Payer: Central Health Plan Commercial |
$15.34
|
| Rate for Payer: Cigna of CA HMO |
$12.27
|
| Rate for Payer: Cigna of CA PPO |
$14.19
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.56
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$7.82
|
| Rate for Payer: EPIC Health Plan Transplant |
$7.82
|
| Rate for Payer: Galaxy Health WC |
$16.29
|
| Rate for Payer: Global Benefits Group Commercial |
$11.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$17.25
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$14.38
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$12.82
|
| Rate for Payer: IEHP medi-cal |
$12.90
|
| Rate for Payer: IEHP Medicare Advantage |
$7.82
|
| Rate for Payer: Innovage PACE Commercial |
$11.73
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12.79
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.83
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.48
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10.48
|
| Rate for Payer: Multiplan Commercial |
$14.38
|
| Rate for Payer: Networks By Design Commercial |
$12.46
|
| Rate for Payer: Prime Health Services Commercial |
$16.29
|
| Rate for Payer: Prime Health Services Medicare |
$8.29
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$11.50
|
| Rate for Payer: Riverside University Health MISP |
$8.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$11.50
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$11.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.34
|
| Rate for Payer: United Healthcare All Other HMO |
$6.34
|
| Rate for Payer: United Healthcare HMO Rider |
$6.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.34
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11.73
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.60
|
| Rate for Payer: Vantage Medical Group Senior |
$7.82
|
|
|
HC SOV HYPERSENSITIVITY PNEUMONITIS PAN 2
|
Facility
IP
|
$19.17
|
|
|
Service Code
|
CPT 86001
|
| Hospital Charge Code |
900915333
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.83 |
| Max. Negotiated Rate |
$17.25 |
| Rate for Payer: Cash Price |
$8.63
|
| Rate for Payer: Central Health Plan Commercial |
$15.34
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.67
|
| Rate for Payer: Galaxy Health WC |
$16.29
|
| Rate for Payer: Global Benefits Group Commercial |
$11.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$17.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.83
|
| Rate for Payer: Multiplan Commercial |
$14.38
|
| Rate for Payer: Networks By Design Commercial |
$12.46
|
| Rate for Payer: Prime Health Services Commercial |
$16.29
|
|
|
HC SOV HYPERSENSITIVITY PNEUMONITIS PAN 3
|
Facility
IP
|
$19.17
|
|
|
Service Code
|
CPT 86001
|
| Hospital Charge Code |
900915334
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.83 |
| Max. Negotiated Rate |
$17.25 |
| Rate for Payer: Cash Price |
$8.63
|
| Rate for Payer: Central Health Plan Commercial |
$15.34
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.67
|
| Rate for Payer: Galaxy Health WC |
$16.29
|
| Rate for Payer: Global Benefits Group Commercial |
$11.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$17.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.83
|
| Rate for Payer: Multiplan Commercial |
$14.38
|
| Rate for Payer: Networks By Design Commercial |
$12.46
|
| Rate for Payer: Prime Health Services Commercial |
$16.29
|
|
|
HC SOV HYPERSENSITIVITY PNEUMONITIS PAN 3
|
Facility
OP
|
$19.17
|
|
|
Service Code
|
CPT 86001
|
| Hospital Charge Code |
900915334
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.83 |
| Max. Negotiated Rate |
$46.36 |
| Rate for Payer: Adventist Health Medi-Cal |
$7.82
|
| Rate for Payer: Aetna of CA HMO/PPO |
$38.29
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$11.73
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$8.60
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$7.82
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$38.01
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$46.36
|
| Rate for Payer: BCBS Transplant Transplant |
$11.50
|
| Rate for Payer: Blue Shield of California Commercial |
$11.85
|
| Rate for Payer: Blue Shield of California EPN |
$9.32
|
| Rate for Payer: Caremore Medicare Advantage |
$7.82
|
| Rate for Payer: Cash Price |
$8.63
|
| Rate for Payer: Cash Price |
$8.63
|
| Rate for Payer: Central Health Plan Commercial |
$15.34
|
| Rate for Payer: Cigna of CA HMO |
$12.27
|
| Rate for Payer: Cigna of CA PPO |
$14.19
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.56
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$7.82
|
| Rate for Payer: EPIC Health Plan Transplant |
$7.82
|
| Rate for Payer: Galaxy Health WC |
$16.29
|
| Rate for Payer: Global Benefits Group Commercial |
$11.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$17.25
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$14.38
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$12.82
|
| Rate for Payer: IEHP medi-cal |
$12.90
|
| Rate for Payer: IEHP Medicare Advantage |
$7.82
|
| Rate for Payer: Innovage PACE Commercial |
$11.73
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12.79
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.83
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.48
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10.48
|
| Rate for Payer: Multiplan Commercial |
$14.38
|
| Rate for Payer: Networks By Design Commercial |
$12.46
|
| Rate for Payer: Prime Health Services Commercial |
$16.29
|
| Rate for Payer: Prime Health Services Medicare |
$8.29
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$11.50
|
| Rate for Payer: Riverside University Health MISP |
$8.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$11.50
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$11.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.34
|
| Rate for Payer: United Healthcare All Other HMO |
$6.34
|
| Rate for Payer: United Healthcare HMO Rider |
$6.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.34
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11.73
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.60
|
| Rate for Payer: Vantage Medical Group Senior |
$7.82
|
|
|
HC SOV HYPERSENSITIVITY PNEUMONITIS PAN 4
|
Facility
IP
|
$19.17
|
|
|
Service Code
|
CPT 86001
|
| Hospital Charge Code |
900915335
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.83 |
| Max. Negotiated Rate |
$17.25 |
| Rate for Payer: Cash Price |
$8.63
|
| Rate for Payer: Central Health Plan Commercial |
$15.34
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.67
|
| Rate for Payer: Galaxy Health WC |
$16.29
|
| Rate for Payer: Global Benefits Group Commercial |
$11.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$17.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.83
|
| Rate for Payer: Multiplan Commercial |
$14.38
|
| Rate for Payer: Networks By Design Commercial |
$12.46
|
| Rate for Payer: Prime Health Services Commercial |
$16.29
|
|
|
HC SOV HYPERSENSITIVITY PNEUMONITIS PAN 4
|
Facility
OP
|
$19.17
|
|
|
Service Code
|
CPT 86001
|
| Hospital Charge Code |
900915335
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.83 |
| Max. Negotiated Rate |
$46.36 |
| Rate for Payer: Adventist Health Medi-Cal |
$7.82
|
| Rate for Payer: Aetna of CA HMO/PPO |
$38.29
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$11.73
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$8.60
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$7.82
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$38.01
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$46.36
|
| Rate for Payer: BCBS Transplant Transplant |
$11.50
|
| Rate for Payer: Blue Shield of California Commercial |
$11.85
|
| Rate for Payer: Blue Shield of California EPN |
$9.32
|
| Rate for Payer: Caremore Medicare Advantage |
$7.82
|
| Rate for Payer: Cash Price |
$8.63
|
| Rate for Payer: Cash Price |
$8.63
|
| Rate for Payer: Central Health Plan Commercial |
$15.34
|
| Rate for Payer: Cigna of CA HMO |
$12.27
|
| Rate for Payer: Cigna of CA PPO |
$14.19
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.56
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$7.82
|
| Rate for Payer: EPIC Health Plan Transplant |
$7.82
|
| Rate for Payer: Galaxy Health WC |
$16.29
|
| Rate for Payer: Global Benefits Group Commercial |
$11.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$17.25
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$14.38
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$12.82
|
| Rate for Payer: IEHP medi-cal |
$12.90
|
| Rate for Payer: IEHP Medicare Advantage |
$7.82
|
| Rate for Payer: Innovage PACE Commercial |
$11.73
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12.79
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.83
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.48
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10.48
|
| Rate for Payer: Multiplan Commercial |
$14.38
|
| Rate for Payer: Networks By Design Commercial |
$12.46
|
| Rate for Payer: Prime Health Services Commercial |
$16.29
|
| Rate for Payer: Prime Health Services Medicare |
$8.29
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$11.50
|
| Rate for Payer: Riverside University Health MISP |
$8.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$11.50
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$11.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.34
|
| Rate for Payer: United Healthcare All Other HMO |
$6.34
|
| Rate for Payer: United Healthcare HMO Rider |
$6.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.34
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11.73
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.60
|
| Rate for Payer: Vantage Medical Group Senior |
$7.82
|
|
|
HC SOV HYPERSENSITIVITY PNEUMONITIS PAN 5
|
Facility
IP
|
$19.17
|
|
|
Service Code
|
CPT 86001
|
| Hospital Charge Code |
900915336
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.83 |
| Max. Negotiated Rate |
$17.25 |
| Rate for Payer: Cash Price |
$8.63
|
| Rate for Payer: Central Health Plan Commercial |
$15.34
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.67
|
| Rate for Payer: Galaxy Health WC |
$16.29
|
| Rate for Payer: Global Benefits Group Commercial |
$11.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$17.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.83
|
| Rate for Payer: Multiplan Commercial |
$14.38
|
| Rate for Payer: Networks By Design Commercial |
$12.46
|
| Rate for Payer: Prime Health Services Commercial |
$16.29
|
|
|
HC SOV HYPERSENSITIVITY PNEUMONITIS PAN 5
|
Facility
OP
|
$19.17
|
|
|
Service Code
|
CPT 86001
|
| Hospital Charge Code |
900915336
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.83 |
| Max. Negotiated Rate |
$46.36 |
| Rate for Payer: Adventist Health Medi-Cal |
$7.82
|
| Rate for Payer: Aetna of CA HMO/PPO |
$38.29
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$11.73
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$8.60
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$7.82
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$38.01
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$46.36
|
| Rate for Payer: BCBS Transplant Transplant |
$11.50
|
| Rate for Payer: Blue Shield of California Commercial |
$11.85
|
| Rate for Payer: Blue Shield of California EPN |
$9.32
|
| Rate for Payer: Caremore Medicare Advantage |
$7.82
|
| Rate for Payer: Cash Price |
$8.63
|
| Rate for Payer: Cash Price |
$8.63
|
| Rate for Payer: Central Health Plan Commercial |
$15.34
|
| Rate for Payer: Cigna of CA HMO |
$12.27
|
| Rate for Payer: Cigna of CA PPO |
$14.19
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.56
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$7.82
|
| Rate for Payer: EPIC Health Plan Transplant |
$7.82
|
| Rate for Payer: Galaxy Health WC |
$16.29
|
| Rate for Payer: Global Benefits Group Commercial |
$11.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$17.25
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$14.38
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$12.82
|
| Rate for Payer: IEHP medi-cal |
$12.90
|
| Rate for Payer: IEHP Medicare Advantage |
$7.82
|
| Rate for Payer: Innovage PACE Commercial |
$11.73
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12.79
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.83
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.48
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10.48
|
| Rate for Payer: Multiplan Commercial |
$14.38
|
| Rate for Payer: Networks By Design Commercial |
$12.46
|
| Rate for Payer: Prime Health Services Commercial |
$16.29
|
| Rate for Payer: Prime Health Services Medicare |
$8.29
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$11.50
|
| Rate for Payer: Riverside University Health MISP |
$8.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$11.50
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$11.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.34
|
| Rate for Payer: United Healthcare All Other HMO |
$6.34
|
| Rate for Payer: United Healthcare HMO Rider |
$6.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.34
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11.73
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.60
|
| Rate for Payer: Vantage Medical Group Senior |
$7.82
|
|
|
HC SOV HYPERSENSITIVITY PNEUMONITIS PAN 6
|
Facility
IP
|
$19.17
|
|
|
Service Code
|
CPT 86001
|
| Hospital Charge Code |
900915337
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.83 |
| Max. Negotiated Rate |
$17.25 |
| Rate for Payer: Cash Price |
$8.63
|
| Rate for Payer: Central Health Plan Commercial |
$15.34
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.67
|
| Rate for Payer: Galaxy Health WC |
$16.29
|
| Rate for Payer: Global Benefits Group Commercial |
$11.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$17.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.83
|
| Rate for Payer: Multiplan Commercial |
$14.38
|
| Rate for Payer: Networks By Design Commercial |
$12.46
|
| Rate for Payer: Prime Health Services Commercial |
$16.29
|
|
|
HC SOV HYPERSENSITIVITY PNEUMONITIS PAN 6
|
Facility
OP
|
$19.17
|
|
|
Service Code
|
CPT 86001
|
| Hospital Charge Code |
900915337
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.83 |
| Max. Negotiated Rate |
$46.36 |
| Rate for Payer: Adventist Health Medi-Cal |
$7.82
|
| Rate for Payer: Aetna of CA HMO/PPO |
$38.29
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$11.73
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$8.60
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$7.82
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$38.01
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$46.36
|
| Rate for Payer: BCBS Transplant Transplant |
$11.50
|
| Rate for Payer: Blue Shield of California Commercial |
$11.85
|
| Rate for Payer: Blue Shield of California EPN |
$9.32
|
| Rate for Payer: Caremore Medicare Advantage |
$7.82
|
| Rate for Payer: Cash Price |
$8.63
|
| Rate for Payer: Cash Price |
$8.63
|
| Rate for Payer: Central Health Plan Commercial |
$15.34
|
| Rate for Payer: Cigna of CA HMO |
$12.27
|
| Rate for Payer: Cigna of CA PPO |
$14.19
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.56
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$7.82
|
| Rate for Payer: EPIC Health Plan Transplant |
$7.82
|
| Rate for Payer: Galaxy Health WC |
$16.29
|
| Rate for Payer: Global Benefits Group Commercial |
$11.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$17.25
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$14.38
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$12.82
|
| Rate for Payer: IEHP medi-cal |
$12.90
|
| Rate for Payer: IEHP Medicare Advantage |
$7.82
|
| Rate for Payer: Innovage PACE Commercial |
$11.73
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12.79
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.83
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.48
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10.48
|
| Rate for Payer: Multiplan Commercial |
$14.38
|
| Rate for Payer: Networks By Design Commercial |
$12.46
|
| Rate for Payer: Prime Health Services Commercial |
$16.29
|
| Rate for Payer: Prime Health Services Medicare |
$8.29
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$11.50
|
| Rate for Payer: Riverside University Health MISP |
$8.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$11.50
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$11.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.34
|
| Rate for Payer: United Healthcare All Other HMO |
$6.34
|
| Rate for Payer: United Healthcare HMO Rider |
$6.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.34
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11.73
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.60
|
| Rate for Payer: Vantage Medical Group Senior |
$7.82
|
|
|
HC SOV HYPERSENSITIVITY PNEUMONITIS PAN 7
|
Facility
IP
|
$19.17
|
|
|
Service Code
|
CPT 86001
|
| Hospital Charge Code |
900915338
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.83 |
| Max. Negotiated Rate |
$17.25 |
| Rate for Payer: Cash Price |
$8.63
|
| Rate for Payer: Central Health Plan Commercial |
$15.34
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.67
|
| Rate for Payer: Galaxy Health WC |
$16.29
|
| Rate for Payer: Global Benefits Group Commercial |
$11.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$17.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.83
|
| Rate for Payer: Multiplan Commercial |
$14.38
|
| Rate for Payer: Networks By Design Commercial |
$12.46
|
| Rate for Payer: Prime Health Services Commercial |
$16.29
|
|
|
HC SOV HYPERSENSITIVITY PNEUMONITIS PAN 7
|
Facility
OP
|
$19.17
|
|
|
Service Code
|
CPT 86001
|
| Hospital Charge Code |
900915338
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.83 |
| Max. Negotiated Rate |
$46.36 |
| Rate for Payer: Adventist Health Medi-Cal |
$7.82
|
| Rate for Payer: Aetna of CA HMO/PPO |
$38.29
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$11.73
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$8.60
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$7.82
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$38.01
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$46.36
|
| Rate for Payer: BCBS Transplant Transplant |
$11.50
|
| Rate for Payer: Blue Shield of California Commercial |
$11.85
|
| Rate for Payer: Blue Shield of California EPN |
$9.32
|
| Rate for Payer: Caremore Medicare Advantage |
$7.82
|
| Rate for Payer: Cash Price |
$8.63
|
| Rate for Payer: Cash Price |
$8.63
|
| Rate for Payer: Central Health Plan Commercial |
$15.34
|
| Rate for Payer: Cigna of CA HMO |
$12.27
|
| Rate for Payer: Cigna of CA PPO |
$14.19
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.56
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$7.82
|
| Rate for Payer: EPIC Health Plan Transplant |
$7.82
|
| Rate for Payer: Galaxy Health WC |
$16.29
|
| Rate for Payer: Global Benefits Group Commercial |
$11.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$17.25
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$14.38
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$12.82
|
| Rate for Payer: IEHP medi-cal |
$12.90
|
| Rate for Payer: IEHP Medicare Advantage |
$7.82
|
| Rate for Payer: Innovage PACE Commercial |
$11.73
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12.79
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.83
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.48
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10.48
|
| Rate for Payer: Multiplan Commercial |
$14.38
|
| Rate for Payer: Networks By Design Commercial |
$12.46
|
| Rate for Payer: Prime Health Services Commercial |
$16.29
|
| Rate for Payer: Prime Health Services Medicare |
$8.29
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$11.50
|
| Rate for Payer: Riverside University Health MISP |
$8.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$11.50
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$11.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.34
|
| Rate for Payer: United Healthcare All Other HMO |
$6.34
|
| Rate for Payer: United Healthcare HMO Rider |
$6.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.34
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11.73
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.60
|
| Rate for Payer: Vantage Medical Group Senior |
$7.82
|
|
|
HC SOV HYPERSENSITIVITY PNEUMONITIS PAN 8
|
Facility
OP
|
$19.21
|
|
|
Service Code
|
CPT 86001
|
| Hospital Charge Code |
900915339
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.84 |
| Max. Negotiated Rate |
$46.36 |
| Rate for Payer: Adventist Health Medi-Cal |
$7.82
|
| Rate for Payer: Aetna of CA HMO/PPO |
$38.29
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$11.73
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$8.60
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$7.82
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$38.01
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$46.36
|
| Rate for Payer: BCBS Transplant Transplant |
$11.53
|
| Rate for Payer: Blue Shield of California Commercial |
$11.87
|
| Rate for Payer: Blue Shield of California EPN |
$9.34
|
| Rate for Payer: Caremore Medicare Advantage |
$7.82
|
| Rate for Payer: Cash Price |
$8.64
|
| Rate for Payer: Cash Price |
$8.64
|
| Rate for Payer: Central Health Plan Commercial |
$15.37
|
| Rate for Payer: Cigna of CA HMO |
$12.29
|
| Rate for Payer: Cigna of CA PPO |
$14.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.56
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$7.82
|
| Rate for Payer: EPIC Health Plan Transplant |
$7.82
|
| Rate for Payer: Galaxy Health WC |
$16.33
|
| Rate for Payer: Global Benefits Group Commercial |
$11.53
|
| Rate for Payer: Health Management Network EPO/PPO |
$17.29
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$14.41
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$12.82
|
| Rate for Payer: IEHP medi-cal |
$12.90
|
| Rate for Payer: IEHP Medicare Advantage |
$7.82
|
| Rate for Payer: Innovage PACE Commercial |
$11.73
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.84
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.48
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10.48
|
| Rate for Payer: Multiplan Commercial |
$14.41
|
| Rate for Payer: Networks By Design Commercial |
$12.49
|
| Rate for Payer: Prime Health Services Commercial |
$16.33
|
| Rate for Payer: Prime Health Services Medicare |
$8.29
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$11.53
|
| Rate for Payer: Riverside University Health MISP |
$8.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$11.53
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$11.53
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.34
|
| Rate for Payer: United Healthcare All Other HMO |
$6.34
|
| Rate for Payer: United Healthcare HMO Rider |
$6.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.34
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11.73
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.60
|
| Rate for Payer: Vantage Medical Group Senior |
$7.82
|
|
|
HC SOV HYPERSENSITIVITY PNEUMONITIS PAN 8
|
Facility
IP
|
$19.21
|
|
|
Service Code
|
CPT 86001
|
| Hospital Charge Code |
900915339
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.84 |
| Max. Negotiated Rate |
$17.29 |
| Rate for Payer: Cash Price |
$8.64
|
| Rate for Payer: Central Health Plan Commercial |
$15.37
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.68
|
| Rate for Payer: Galaxy Health WC |
$16.33
|
| Rate for Payer: Global Benefits Group Commercial |
$11.53
|
| Rate for Payer: Health Management Network EPO/PPO |
$17.29
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.84
|
| Rate for Payer: Multiplan Commercial |
$14.41
|
| Rate for Payer: Networks By Design Commercial |
$12.49
|
| Rate for Payer: Prime Health Services Commercial |
$16.33
|
|
|
HC SPCL TRT PROC LG SGL RAD DOSE
|
Facility
OP
|
$5,368.00
|
|
|
Service Code
|
CPT 77470
|
| Hospital Charge Code |
909100313
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$545.40 |
| Max. Negotiated Rate |
$4,831.20 |
| Rate for Payer: Adventist Health Medi-Cal |
$735.49
|
| Rate for Payer: Aetna of CA HMO/PPO |
$545.40
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,103.24
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$809.04
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$735.49
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,020.35
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,464.33
|
| Rate for Payer: BCBS Transplant Transplant |
$3,220.80
|
| Rate for Payer: Blue Shield of California Commercial |
$3,317.42
|
| Rate for Payer: Blue Shield of California EPN |
$2,608.85
|
| Rate for Payer: Caremore Medicare Advantage |
$735.49
|
| Rate for Payer: Cash Price |
$2,415.60
|
| Rate for Payer: Cash Price |
$2,415.60
|
| Rate for Payer: Cash Price |
$2,415.60
|
| Rate for Payer: Central Health Plan Commercial |
$4,294.40
|
| Rate for Payer: Cigna of CA HMO |
$3,435.52
|
| Rate for Payer: Cigna of CA PPO |
$3,972.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,103.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$992.91
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$735.49
|
| Rate for Payer: EPIC Health Plan Transplant |
$735.49
|
| Rate for Payer: Galaxy Health WC |
$4,562.80
|
| Rate for Payer: Global Benefits Group Commercial |
$3,220.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,831.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$4,026.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,206.20
|
| Rate for Payer: IEHP medi-cal |
$1,213.56
|
| Rate for Payer: IEHP Medicare Advantage |
$735.49
|
| Rate for Payer: Innovage PACE Commercial |
$1,103.24
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,580.46
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$735.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,073.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$985.56
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$985.56
|
| Rate for Payer: Multiplan Commercial |
$4,026.00
|
| Rate for Payer: Networks By Design Commercial |
$3,489.20
|
| Rate for Payer: Prime Health Services Commercial |
$4,562.80
|
| Rate for Payer: Prime Health Services Medicare |
$779.62
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$3,220.80
|
| Rate for Payer: Riverside University Health MISP |
$809.04
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,220.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,659.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,675.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,269.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,161.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,103.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$809.04
|
| Rate for Payer: Vantage Medical Group Senior |
$735.49
|
|
|
HC SPCL TRT PROC LG SGL RAD DOSE
|
Facility
IP
|
$5,368.00
|
|
|
Service Code
|
CPT 77470
|
| Hospital Charge Code |
909100313
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$1,073.60 |
| Max. Negotiated Rate |
$4,831.20 |
| Rate for Payer: Cash Price |
$2,415.60
|
| Rate for Payer: Central Health Plan Commercial |
$4,294.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,147.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,147.20
|
| Rate for Payer: Galaxy Health WC |
$4,562.80
|
| Rate for Payer: Global Benefits Group Commercial |
$3,220.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,831.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,580.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,073.60
|
| Rate for Payer: Multiplan Commercial |
$4,026.00
|
| Rate for Payer: Networks By Design Commercial |
$3,489.20
|
| Rate for Payer: Prime Health Services Commercial |
$4,562.80
|
|
|
HC SPEC DOSIMETRY-TLD MICRO
|
Facility
OP
|
$1,328.00
|
|
|
Service Code
|
CPT 77331
|
| Hospital Charge Code |
904810814
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$107.41 |
| Max. Negotiated Rate |
$1,675.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$169.53
|
| Rate for Payer: Aetna of CA HMO/PPO |
$107.93
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$254.30
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$186.48
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$169.53
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$107.41
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$131.01
|
| Rate for Payer: BCBS Transplant Transplant |
$796.80
|
| Rate for Payer: Blue Shield of California Commercial |
$820.70
|
| Rate for Payer: Blue Shield of California EPN |
$645.41
|
| Rate for Payer: Caremore Medicare Advantage |
$169.53
|
| Rate for Payer: Cash Price |
$597.60
|
| Rate for Payer: Cash Price |
$597.60
|
| Rate for Payer: Cash Price |
$597.60
|
| Rate for Payer: Central Health Plan Commercial |
$1,062.40
|
| Rate for Payer: Cigna of CA HMO |
$849.92
|
| Rate for Payer: Cigna of CA PPO |
$982.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$254.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$228.87
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$169.53
|
| Rate for Payer: EPIC Health Plan Transplant |
$169.53
|
| Rate for Payer: Galaxy Health WC |
$1,128.80
|
| Rate for Payer: Global Benefits Group Commercial |
$796.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,195.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$996.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$278.03
|
| Rate for Payer: IEHP medi-cal |
$279.72
|
| Rate for Payer: IEHP Medicare Advantage |
$169.53
|
| Rate for Payer: Innovage PACE Commercial |
$254.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$885.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$169.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$265.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$227.17
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$227.17
|
| Rate for Payer: Multiplan Commercial |
$996.00
|
| Rate for Payer: Networks By Design Commercial |
$863.20
|
| Rate for Payer: Prime Health Services Commercial |
$1,128.80
|
| Rate for Payer: Prime Health Services Medicare |
$179.70
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$796.80
|
| Rate for Payer: Riverside University Health MISP |
$186.48
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$796.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,659.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,675.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,269.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,161.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$254.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$186.48
|
| Rate for Payer: Vantage Medical Group Senior |
$169.53
|
|
|
HC SPEC DOSIMETRY-TLD MICRO
|
Facility
IP
|
$1,328.00
|
|
|
Service Code
|
CPT 77331
|
| Hospital Charge Code |
904810814
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$265.60 |
| Max. Negotiated Rate |
$1,195.20 |
| Rate for Payer: Cash Price |
$597.60
|
| Rate for Payer: Central Health Plan Commercial |
$1,062.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$531.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$531.20
|
| Rate for Payer: Galaxy Health WC |
$1,128.80
|
| Rate for Payer: Global Benefits Group Commercial |
$796.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,195.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$885.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$265.60
|
| Rate for Payer: Multiplan Commercial |
$996.00
|
| Rate for Payer: Networks By Design Commercial |
$863.20
|
| Rate for Payer: Prime Health Services Commercial |
$1,128.80
|
|
|
HC SPEC GRAVITY HEMATOLOGY
|
Facility
OP
|
$12.00
|
|
|
Service Code
|
CPT 81002
|
| Hospital Charge Code |
900910178
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$2.40 |
| Max. Negotiated Rate |
$21.09 |
| Rate for Payer: Adventist Health Medi-Cal |
$3.48
|
| Rate for Payer: Aetna of CA HMO/PPO |
$18.78
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$5.22
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$3.83
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$3.48
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$17.29
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$21.09
|
| Rate for Payer: BCBS Transplant Transplant |
$7.20
|
| Rate for Payer: Blue Shield of California Commercial |
$7.42
|
| Rate for Payer: Blue Shield of California EPN |
$5.83
|
| Rate for Payer: Caremore Medicare Advantage |
$3.48
|
| Rate for Payer: Cash Price |
$5.40
|
| Rate for Payer: Cash Price |
$5.40
|
| Rate for Payer: Central Health Plan Commercial |
$9.60
|
| Rate for Payer: Cigna of CA HMO |
$7.68
|
| Rate for Payer: Cigna of CA PPO |
$8.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.70
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$3.48
|
| Rate for Payer: EPIC Health Plan Transplant |
$3.48
|
| Rate for Payer: Galaxy Health WC |
$10.20
|
| Rate for Payer: Global Benefits Group Commercial |
$7.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$10.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$9.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$5.71
|
| Rate for Payer: IEHP medi-cal |
$5.74
|
| Rate for Payer: IEHP Medicare Advantage |
$3.48
|
| Rate for Payer: Innovage PACE Commercial |
$5.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4.66
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4.66
|
| Rate for Payer: Multiplan Commercial |
$9.00
|
| Rate for Payer: Networks By Design Commercial |
$7.80
|
| Rate for Payer: Prime Health Services Commercial |
$10.20
|
| Rate for Payer: Prime Health Services Medicare |
$3.69
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$7.20
|
| Rate for Payer: Riverside University Health MISP |
$3.83
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.82
|
| Rate for Payer: United Healthcare All Other HMO |
$2.82
|
| Rate for Payer: United Healthcare HMO Rider |
$2.82
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.82
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3.83
|
| Rate for Payer: Vantage Medical Group Senior |
$3.48
|
|
|
HC SPEC GRAVITY HEMATOLOGY
|
Facility
IP
|
$82.00
|
|
|
Service Code
|
CPT 81002
|
| Hospital Charge Code |
900910178
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$16.40 |
| Max. Negotiated Rate |
$73.80 |
| Rate for Payer: Cash Price |
$36.90
|
| Rate for Payer: Central Health Plan Commercial |
$65.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$32.80
|
| Rate for Payer: Galaxy Health WC |
$69.70
|
| Rate for Payer: Global Benefits Group Commercial |
$49.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$73.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$54.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.40
|
| Rate for Payer: Multiplan Commercial |
$61.50
|
| Rate for Payer: Networks By Design Commercial |
$53.30
|
| Rate for Payer: Prime Health Services Commercial |
$69.70
|
|
