|
HC TOXOABM
|
Facility
|
IP
|
$18.00
|
|
|
Service Code
|
CPT 86778
|
| Hospital Charge Code |
900913714
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.60 |
| Max. Negotiated Rate |
$16.20 |
| Rate for Payer: Adventist Health Commercial |
$3.60
|
| Rate for Payer: Cash Price |
$8.10
|
| Rate for Payer: Central Health Plan Commercial |
$14.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$12.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.20
|
| Rate for Payer: EPIC Health Plan Senior |
$7.20
|
| Rate for Payer: Galaxy Health WC |
$15.30
|
| Rate for Payer: Global Benefits Group Commercial |
$10.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$16.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$11.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.60
|
| Rate for Payer: Multiplan Commercial |
$13.50
|
| Rate for Payer: Networks By Design Commercial |
$11.70
|
| Rate for Payer: Prime Health Services Commercial |
$15.30
|
|
|
HC TOXOPLASMA AB IGG
|
Facility
|
IP
|
$278.00
|
|
|
Service Code
|
CPT 86777
|
| Hospital Charge Code |
900910989
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$55.60 |
| Max. Negotiated Rate |
$250.20 |
| Rate for Payer: Adventist Health Commercial |
$55.60
|
| Rate for Payer: Cash Price |
$125.10
|
| Rate for Payer: Central Health Plan Commercial |
$222.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$194.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$111.20
|
| Rate for Payer: EPIC Health Plan Senior |
$111.20
|
| Rate for Payer: Galaxy Health WC |
$236.30
|
| Rate for Payer: Global Benefits Group Commercial |
$166.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$250.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$176.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$164.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$55.60
|
| Rate for Payer: Multiplan Commercial |
$208.50
|
| Rate for Payer: Networks By Design Commercial |
$180.70
|
| Rate for Payer: Prime Health Services Commercial |
$236.30
|
|
|
HC TOXOPLASMA AB IGG
|
Facility
|
OP
|
$130.00
|
|
|
Service Code
|
CPT 86777
|
| Hospital Charge Code |
900910989
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.65 |
| Max. Negotiated Rate |
$145.10 |
| Rate for Payer: Adventist Health Commercial |
$26.00
|
| Rate for Payer: Adventist Health Commercial |
$55.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$14.39
|
| Rate for Payer: Adventist Health Medi-Cal |
$14.39
|
| Rate for Payer: Aetna of CA HMO/PPO |
$105.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$105.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21.59
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21.59
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15.83
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15.83
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14.39
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$104.37
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$104.37
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$145.10
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$145.10
|
| Rate for Payer: Blue Shield of California Commercial |
$175.14
|
| Rate for Payer: Blue Shield of California Commercial |
$81.90
|
| Rate for Payer: Blue Shield of California EPN |
$110.37
|
| Rate for Payer: Blue Shield of California EPN |
$51.61
|
| Rate for Payer: Cash Price |
$125.10
|
| Rate for Payer: Cash Price |
$125.10
|
| Rate for Payer: Cash Price |
$58.50
|
| Rate for Payer: Cash Price |
$58.50
|
| Rate for Payer: Central Health Plan Commercial |
$104.00
|
| Rate for Payer: Central Health Plan Commercial |
$222.40
|
| Rate for Payer: Cigna of CA HMO |
$177.92
|
| Rate for Payer: Cigna of CA HMO |
$83.20
|
| Rate for Payer: Cigna of CA PPO |
$205.72
|
| Rate for Payer: Cigna of CA PPO |
$96.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21.59
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21.59
|
| Rate for Payer: Dignity Health Medi-Cal |
$15.83
|
| Rate for Payer: Dignity Health Medi-Cal |
$15.83
|
| Rate for Payer: Dignity Health Medicare Advantage |
$14.39
|
| Rate for Payer: Dignity Health Medicare Advantage |
$14.39
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$91.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$194.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$23.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$23.74
|
| Rate for Payer: EPIC Health Plan Senior |
$15.83
|
| Rate for Payer: EPIC Health Plan Senior |
$15.83
|
| Rate for Payer: Galaxy Health WC |
$236.30
|
| Rate for Payer: Galaxy Health WC |
$110.50
|
| Rate for Payer: Global Benefits Group Commercial |
$166.80
|
| Rate for Payer: Global Benefits Group Commercial |
$78.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$250.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$117.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$23.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$23.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$22.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$22.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$14.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$14.39
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$82.55
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$176.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$24.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$24.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$20.15
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$20.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$26.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$55.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$19.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$19.28
|
| Rate for Payer: Multiplan Commercial |
$208.50
|
| Rate for Payer: Multiplan Commercial |
$97.50
|
| Rate for Payer: Networks By Design Commercial |
$84.50
|
| Rate for Payer: Networks By Design Commercial |
$180.70
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$14.39
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$14.39
|
| Rate for Payer: Prime Health Services Commercial |
$236.30
|
| Rate for Payer: Prime Health Services Commercial |
$110.50
|
| Rate for Payer: Prime Health Services Medicare |
$15.25
|
| Rate for Payer: Prime Health Services Medicare |
$15.25
|
| Rate for Payer: Riverside University Health System MISP |
$15.83
|
| Rate for Payer: Riverside University Health System MISP |
$15.83
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$78.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$166.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$166.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$78.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$11.65
|
| Rate for Payer: United Healthcare All Other Commercial |
$11.65
|
| Rate for Payer: United Healthcare All Other HMO |
$11.65
|
| Rate for Payer: United Healthcare All Other HMO |
$11.65
|
| Rate for Payer: United Healthcare HMO Rider |
$11.65
|
| Rate for Payer: United Healthcare HMO Rider |
$11.65
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.65
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.65
|
| Rate for Payer: Upland Medical Group Pediatric |
$14.39
|
| Rate for Payer: Upland Medical Group Pediatric |
$14.39
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21.59
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21.59
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15.83
|
| Rate for Payer: Vantage Medical Group Senior |
$14.39
|
| Rate for Payer: Vantage Medical Group Senior |
$14.39
|
|
|
HC TOXOPLASMA AB IGM
|
Facility
|
OP
|
$130.00
|
|
|
Service Code
|
CPT 86778
|
| Hospital Charge Code |
900912320
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$11.67 |
| Max. Negotiated Rate |
$150.62 |
| Rate for Payer: Adventist Health Commercial |
$26.00
|
| Rate for Payer: Adventist Health Commercial |
$55.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$14.41
|
| Rate for Payer: Adventist Health Medi-Cal |
$14.41
|
| Rate for Payer: Aetna of CA HMO/PPO |
$105.72
|
| Rate for Payer: Aetna of CA HMO/PPO |
$105.72
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21.61
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21.61
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14.41
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14.41
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$108.34
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$108.34
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$150.62
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$150.62
|
| Rate for Payer: Blue Shield of California Commercial |
$175.14
|
| Rate for Payer: Blue Shield of California Commercial |
$81.90
|
| Rate for Payer: Blue Shield of California EPN |
$110.37
|
| Rate for Payer: Blue Shield of California EPN |
$51.61
|
| Rate for Payer: Cash Price |
$125.10
|
| Rate for Payer: Cash Price |
$125.10
|
| Rate for Payer: Cash Price |
$58.50
|
| Rate for Payer: Cash Price |
$58.50
|
| Rate for Payer: Central Health Plan Commercial |
$104.00
|
| Rate for Payer: Central Health Plan Commercial |
$222.40
|
| Rate for Payer: Cigna of CA HMO |
$177.92
|
| Rate for Payer: Cigna of CA HMO |
$83.20
|
| Rate for Payer: Cigna of CA PPO |
$205.72
|
| Rate for Payer: Cigna of CA PPO |
$96.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21.61
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21.61
|
| Rate for Payer: Dignity Health Medi-Cal |
$15.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$15.85
|
| Rate for Payer: Dignity Health Medicare Advantage |
$14.41
|
| Rate for Payer: Dignity Health Medicare Advantage |
$14.41
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$91.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$194.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$23.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$23.78
|
| Rate for Payer: EPIC Health Plan Senior |
$15.85
|
| Rate for Payer: EPIC Health Plan Senior |
$15.85
|
| Rate for Payer: Galaxy Health WC |
$236.30
|
| Rate for Payer: Galaxy Health WC |
$110.50
|
| Rate for Payer: Global Benefits Group Commercial |
$166.80
|
| Rate for Payer: Global Benefits Group Commercial |
$78.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$250.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$117.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$23.63
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$23.63
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$22.02
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$22.02
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$14.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$14.41
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$82.55
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$176.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$24.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$24.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$20.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$20.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$26.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$55.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$19.31
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$19.31
|
| Rate for Payer: Multiplan Commercial |
$208.50
|
| Rate for Payer: Multiplan Commercial |
$97.50
|
| Rate for Payer: Networks By Design Commercial |
$84.50
|
| Rate for Payer: Networks By Design Commercial |
$180.70
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$14.41
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$14.41
|
| Rate for Payer: Prime Health Services Commercial |
$236.30
|
| Rate for Payer: Prime Health Services Commercial |
$110.50
|
| Rate for Payer: Prime Health Services Medicare |
$15.27
|
| Rate for Payer: Prime Health Services Medicare |
$15.27
|
| Rate for Payer: Riverside University Health System MISP |
$15.85
|
| Rate for Payer: Riverside University Health System MISP |
$15.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$78.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$166.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$166.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$78.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$11.67
|
| Rate for Payer: United Healthcare All Other Commercial |
$11.67
|
| Rate for Payer: United Healthcare All Other HMO |
$11.67
|
| Rate for Payer: United Healthcare All Other HMO |
$11.67
|
| Rate for Payer: United Healthcare HMO Rider |
$11.67
|
| Rate for Payer: United Healthcare HMO Rider |
$11.67
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.67
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.67
|
| Rate for Payer: Upland Medical Group Pediatric |
$14.41
|
| Rate for Payer: Upland Medical Group Pediatric |
$14.41
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21.61
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21.61
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15.85
|
| Rate for Payer: Vantage Medical Group Senior |
$14.41
|
| Rate for Payer: Vantage Medical Group Senior |
$14.41
|
|
|
HC TOXOPLASMA AB IGM
|
Facility
|
IP
|
$278.00
|
|
|
Service Code
|
CPT 86778
|
| Hospital Charge Code |
900912320
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$55.60 |
| Max. Negotiated Rate |
$250.20 |
| Rate for Payer: Adventist Health Commercial |
$55.60
|
| Rate for Payer: Cash Price |
$125.10
|
| Rate for Payer: Central Health Plan Commercial |
$222.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$194.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$111.20
|
| Rate for Payer: EPIC Health Plan Senior |
$111.20
|
| Rate for Payer: Galaxy Health WC |
$236.30
|
| Rate for Payer: Global Benefits Group Commercial |
$166.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$250.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$176.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$164.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$55.60
|
| Rate for Payer: Multiplan Commercial |
$208.50
|
| Rate for Payer: Networks By Design Commercial |
$180.70
|
| Rate for Payer: Prime Health Services Commercial |
$236.30
|
|
|
HC TOXOPLASMA ANTIBODY IGG
|
Facility
|
OP
|
$134.00
|
|
|
Service Code
|
CPT 86777
|
| Hospital Charge Code |
900913667
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.65 |
| Max. Negotiated Rate |
$145.10 |
| Rate for Payer: Adventist Health Commercial |
$26.80
|
| Rate for Payer: Adventist Health Commercial |
$19.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$14.39
|
| Rate for Payer: Adventist Health Medi-Cal |
$14.39
|
| Rate for Payer: Aetna of CA HMO/PPO |
$105.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$105.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21.59
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21.59
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15.83
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15.83
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14.39
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$104.37
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$104.37
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$145.10
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$145.10
|
| Rate for Payer: Blue Shield of California Commercial |
$61.74
|
| Rate for Payer: Blue Shield of California Commercial |
$84.42
|
| Rate for Payer: Blue Shield of California EPN |
$38.91
|
| Rate for Payer: Blue Shield of California EPN |
$53.20
|
| Rate for Payer: Cash Price |
$44.10
|
| Rate for Payer: Cash Price |
$44.10
|
| Rate for Payer: Cash Price |
$60.30
|
| Rate for Payer: Cash Price |
$60.30
|
| Rate for Payer: Central Health Plan Commercial |
$107.20
|
| Rate for Payer: Central Health Plan Commercial |
$78.40
|
| Rate for Payer: Cigna of CA HMO |
$62.72
|
| Rate for Payer: Cigna of CA HMO |
$85.76
|
| Rate for Payer: Cigna of CA PPO |
$72.52
|
| Rate for Payer: Cigna of CA PPO |
$99.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21.59
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21.59
|
| Rate for Payer: Dignity Health Medi-Cal |
$15.83
|
| Rate for Payer: Dignity Health Medi-Cal |
$15.83
|
| Rate for Payer: Dignity Health Medicare Advantage |
$14.39
|
| Rate for Payer: Dignity Health Medicare Advantage |
$14.39
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$93.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$68.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$23.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$23.74
|
| Rate for Payer: EPIC Health Plan Senior |
$15.83
|
| Rate for Payer: EPIC Health Plan Senior |
$15.83
|
| Rate for Payer: Galaxy Health WC |
$83.30
|
| Rate for Payer: Galaxy Health WC |
$113.90
|
| Rate for Payer: Global Benefits Group Commercial |
$58.80
|
| Rate for Payer: Global Benefits Group Commercial |
$80.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$88.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$120.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$23.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$23.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$22.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$22.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$14.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$14.39
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$85.09
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$62.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$24.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$24.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$20.15
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$20.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$26.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$19.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$19.28
|
| Rate for Payer: Multiplan Commercial |
$73.50
|
| Rate for Payer: Multiplan Commercial |
$100.50
|
| Rate for Payer: Networks By Design Commercial |
$87.10
|
| Rate for Payer: Networks By Design Commercial |
$63.70
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$14.39
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$14.39
|
| Rate for Payer: Prime Health Services Commercial |
$83.30
|
| Rate for Payer: Prime Health Services Commercial |
$113.90
|
| Rate for Payer: Prime Health Services Medicare |
$15.25
|
| Rate for Payer: Prime Health Services Medicare |
$15.25
|
| Rate for Payer: Riverside University Health System MISP |
$15.83
|
| Rate for Payer: Riverside University Health System MISP |
$15.83
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$80.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$58.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$58.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$80.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$11.65
|
| Rate for Payer: United Healthcare All Other Commercial |
$11.65
|
| Rate for Payer: United Healthcare All Other HMO |
$11.65
|
| Rate for Payer: United Healthcare All Other HMO |
$11.65
|
| Rate for Payer: United Healthcare HMO Rider |
$11.65
|
| Rate for Payer: United Healthcare HMO Rider |
$11.65
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.65
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.65
|
| Rate for Payer: Upland Medical Group Pediatric |
$14.39
|
| Rate for Payer: Upland Medical Group Pediatric |
$14.39
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21.59
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21.59
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15.83
|
| Rate for Payer: Vantage Medical Group Senior |
$14.39
|
| Rate for Payer: Vantage Medical Group Senior |
$14.39
|
|
|
HC TOXOPLASMA ANTIBODY IGG
|
Facility
|
IP
|
$134.00
|
|
|
Service Code
|
CPT 86777
|
| Hospital Charge Code |
900913667
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$26.80 |
| Max. Negotiated Rate |
$120.60 |
| Rate for Payer: Adventist Health Commercial |
$26.80
|
| Rate for Payer: Cash Price |
$60.30
|
| Rate for Payer: Central Health Plan Commercial |
$107.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$93.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$53.60
|
| Rate for Payer: EPIC Health Plan Senior |
$53.60
|
| Rate for Payer: Galaxy Health WC |
$113.90
|
| Rate for Payer: Global Benefits Group Commercial |
$80.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$120.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$85.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$79.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$26.80
|
| Rate for Payer: Multiplan Commercial |
$100.50
|
| Rate for Payer: Networks By Design Commercial |
$87.10
|
| Rate for Payer: Prime Health Services Commercial |
$113.90
|
|
|
HC TOXOPLASMA ANTIBODY IGM
|
Facility
|
OP
|
$134.00
|
|
|
Service Code
|
CPT 86778
|
| Hospital Charge Code |
900913668
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.67 |
| Max. Negotiated Rate |
$150.62 |
| Rate for Payer: Adventist Health Commercial |
$26.80
|
| Rate for Payer: Adventist Health Commercial |
$19.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$14.41
|
| Rate for Payer: Adventist Health Medi-Cal |
$14.41
|
| Rate for Payer: Aetna of CA HMO/PPO |
$105.72
|
| Rate for Payer: Aetna of CA HMO/PPO |
$105.72
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21.61
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21.61
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14.41
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14.41
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$108.34
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$108.34
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$150.62
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$150.62
|
| Rate for Payer: Blue Shield of California Commercial |
$61.74
|
| Rate for Payer: Blue Shield of California Commercial |
$84.42
|
| Rate for Payer: Blue Shield of California EPN |
$38.91
|
| Rate for Payer: Blue Shield of California EPN |
$53.20
|
| Rate for Payer: Cash Price |
$44.10
|
| Rate for Payer: Cash Price |
$44.10
|
| Rate for Payer: Cash Price |
$60.30
|
| Rate for Payer: Cash Price |
$60.30
|
| Rate for Payer: Central Health Plan Commercial |
$107.20
|
| Rate for Payer: Central Health Plan Commercial |
$78.40
|
| Rate for Payer: Cigna of CA HMO |
$62.72
|
| Rate for Payer: Cigna of CA HMO |
$85.76
|
| Rate for Payer: Cigna of CA PPO |
$72.52
|
| Rate for Payer: Cigna of CA PPO |
$99.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21.61
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21.61
|
| Rate for Payer: Dignity Health Medi-Cal |
$15.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$15.85
|
| Rate for Payer: Dignity Health Medicare Advantage |
$14.41
|
| Rate for Payer: Dignity Health Medicare Advantage |
$14.41
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$93.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$68.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$23.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$23.78
|
| Rate for Payer: EPIC Health Plan Senior |
$15.85
|
| Rate for Payer: EPIC Health Plan Senior |
$15.85
|
| Rate for Payer: Galaxy Health WC |
$83.30
|
| Rate for Payer: Galaxy Health WC |
$113.90
|
| Rate for Payer: Global Benefits Group Commercial |
$58.80
|
| Rate for Payer: Global Benefits Group Commercial |
$80.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$88.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$120.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$23.63
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$23.63
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$22.02
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$22.02
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$14.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$14.41
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$85.09
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$62.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$24.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$24.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$20.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$20.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$26.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$19.31
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$19.31
|
| Rate for Payer: Multiplan Commercial |
$73.50
|
| Rate for Payer: Multiplan Commercial |
$100.50
|
| Rate for Payer: Networks By Design Commercial |
$87.10
|
| Rate for Payer: Networks By Design Commercial |
$63.70
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$14.41
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$14.41
|
| Rate for Payer: Prime Health Services Commercial |
$83.30
|
| Rate for Payer: Prime Health Services Commercial |
$113.90
|
| Rate for Payer: Prime Health Services Medicare |
$15.27
|
| Rate for Payer: Prime Health Services Medicare |
$15.27
|
| Rate for Payer: Riverside University Health System MISP |
$15.85
|
| Rate for Payer: Riverside University Health System MISP |
$15.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$80.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$58.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$58.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$80.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$11.67
|
| Rate for Payer: United Healthcare All Other Commercial |
$11.67
|
| Rate for Payer: United Healthcare All Other HMO |
$11.67
|
| Rate for Payer: United Healthcare All Other HMO |
$11.67
|
| Rate for Payer: United Healthcare HMO Rider |
$11.67
|
| Rate for Payer: United Healthcare HMO Rider |
$11.67
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.67
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.67
|
| Rate for Payer: Upland Medical Group Pediatric |
$14.41
|
| Rate for Payer: Upland Medical Group Pediatric |
$14.41
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21.61
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21.61
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15.85
|
| Rate for Payer: Vantage Medical Group Senior |
$14.41
|
| Rate for Payer: Vantage Medical Group Senior |
$14.41
|
|
|
HC TOXOPLASMA ANTIBODY IGM
|
Facility
|
IP
|
$134.00
|
|
|
Service Code
|
CPT 86778
|
| Hospital Charge Code |
900913668
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$26.80 |
| Max. Negotiated Rate |
$120.60 |
| Rate for Payer: Adventist Health Commercial |
$26.80
|
| Rate for Payer: Cash Price |
$60.30
|
| Rate for Payer: Central Health Plan Commercial |
$107.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$93.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$53.60
|
| Rate for Payer: EPIC Health Plan Senior |
$53.60
|
| Rate for Payer: Galaxy Health WC |
$113.90
|
| Rate for Payer: Global Benefits Group Commercial |
$80.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$120.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$85.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$79.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$26.80
|
| Rate for Payer: Multiplan Commercial |
$100.50
|
| Rate for Payer: Networks By Design Commercial |
$87.10
|
| Rate for Payer: Prime Health Services Commercial |
$113.90
|
|
|
HC TPN/QUINTON CATH DUAL
|
Facility
|
IP
|
$414.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
909081727
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$82.80 |
| Max. Negotiated Rate |
$372.60 |
| Rate for Payer: Adventist Health Commercial |
$82.80
|
| Rate for Payer: Blue Shield of California Commercial |
$332.03
|
| Rate for Payer: Blue Shield of California EPN |
$208.66
|
| Rate for Payer: Cash Price |
$186.30
|
| Rate for Payer: Central Health Plan Commercial |
$331.20
|
| Rate for Payer: Cigna of CA HMO |
$289.80
|
| Rate for Payer: Cigna of CA PPO |
$289.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$289.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$165.60
|
| Rate for Payer: EPIC Health Plan Senior |
$165.60
|
| Rate for Payer: Galaxy Health WC |
$351.90
|
| Rate for Payer: Global Benefits Group Commercial |
$248.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$372.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$262.89
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$244.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$82.80
|
| Rate for Payer: Multiplan Commercial |
$310.50
|
| Rate for Payer: Networks By Design Commercial |
$207.00
|
| Rate for Payer: Prime Health Services Commercial |
$351.90
|
| Rate for Payer: United Healthcare All Other Commercial |
$155.37
|
| Rate for Payer: United Healthcare All Other HMO |
$151.23
|
| Rate for Payer: United Healthcare HMO Rider |
$147.96
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$135.59
|
|
|
HC TPN/QUINTON CATH DUAL
|
Facility
|
OP
|
$414.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
909081727
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$82.80 |
| Max. Negotiated Rate |
$372.60 |
| Rate for Payer: Adventist Health Commercial |
$82.80
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$351.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$227.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$310.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$189.03
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$227.04
|
| Rate for Payer: Blue Shield of California Commercial |
$332.03
|
| Rate for Payer: Blue Shield of California EPN |
$208.66
|
| Rate for Payer: Cash Price |
$186.30
|
| Rate for Payer: Central Health Plan Commercial |
$331.20
|
| Rate for Payer: Cigna of CA HMO |
$289.80
|
| Rate for Payer: Cigna of CA PPO |
$289.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$351.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$351.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$351.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$289.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$165.60
|
| Rate for Payer: EPIC Health Plan Senior |
$165.60
|
| Rate for Payer: Galaxy Health WC |
$351.90
|
| Rate for Payer: Global Benefits Group Commercial |
$248.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$372.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$262.89
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$150.28
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$244.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$82.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$289.80
|
| Rate for Payer: Multiplan Commercial |
$310.50
|
| Rate for Payer: Networks By Design Commercial |
$207.00
|
| Rate for Payer: Prime Health Services Commercial |
$351.90
|
| Rate for Payer: Riverside University Health System MISP |
$165.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$248.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$248.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$155.37
|
| Rate for Payer: United Healthcare All Other HMO |
$151.23
|
| Rate for Payer: United Healthcare HMO Rider |
$147.96
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$135.59
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$351.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$351.90
|
| Rate for Payer: Vantage Medical Group Senior |
$351.90
|
|
|
HC TPN/QUINTON CATH SIMPLE
|
Facility
|
OP
|
$393.60
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
909081726
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$78.72 |
| Max. Negotiated Rate |
$354.24 |
| Rate for Payer: Adventist Health Commercial |
$78.72
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$334.56
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$216.48
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$295.20
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$179.72
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$215.85
|
| Rate for Payer: Blue Shield of California Commercial |
$315.67
|
| Rate for Payer: Blue Shield of California EPN |
$198.37
|
| Rate for Payer: Cash Price |
$177.12
|
| Rate for Payer: Central Health Plan Commercial |
$314.88
|
| Rate for Payer: Cigna of CA HMO |
$275.52
|
| Rate for Payer: Cigna of CA PPO |
$275.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$334.56
|
| Rate for Payer: Dignity Health Medi-Cal |
$334.56
|
| Rate for Payer: Dignity Health Medicare Advantage |
$334.56
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$275.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$157.44
|
| Rate for Payer: EPIC Health Plan Senior |
$157.44
|
| Rate for Payer: Galaxy Health WC |
$334.56
|
| Rate for Payer: Global Benefits Group Commercial |
$236.16
|
| Rate for Payer: Health Management Network EPO/PPO |
$354.24
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$249.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$142.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$232.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$78.72
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$275.52
|
| Rate for Payer: Multiplan Commercial |
$295.20
|
| Rate for Payer: Networks By Design Commercial |
$196.80
|
| Rate for Payer: Prime Health Services Commercial |
$334.56
|
| Rate for Payer: Riverside University Health System MISP |
$157.44
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$236.16
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$236.16
|
| Rate for Payer: United Healthcare All Other Commercial |
$147.72
|
| Rate for Payer: United Healthcare All Other HMO |
$143.78
|
| Rate for Payer: United Healthcare HMO Rider |
$140.67
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$128.90
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$334.56
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$334.56
|
| Rate for Payer: Vantage Medical Group Senior |
$334.56
|
|
|
HC TPN/QUINTON CATH SIMPLE
|
Facility
|
IP
|
$393.60
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
909081726
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$78.72 |
| Max. Negotiated Rate |
$354.24 |
| Rate for Payer: Adventist Health Commercial |
$78.72
|
| Rate for Payer: Blue Shield of California Commercial |
$315.67
|
| Rate for Payer: Blue Shield of California EPN |
$198.37
|
| Rate for Payer: Cash Price |
$177.12
|
| Rate for Payer: Central Health Plan Commercial |
$314.88
|
| Rate for Payer: Cigna of CA HMO |
$275.52
|
| Rate for Payer: Cigna of CA PPO |
$275.52
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$275.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$157.44
|
| Rate for Payer: EPIC Health Plan Senior |
$157.44
|
| Rate for Payer: Galaxy Health WC |
$334.56
|
| Rate for Payer: Global Benefits Group Commercial |
$236.16
|
| Rate for Payer: Health Management Network EPO/PPO |
$354.24
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$249.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$232.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$78.72
|
| Rate for Payer: Multiplan Commercial |
$295.20
|
| Rate for Payer: Networks By Design Commercial |
$196.80
|
| Rate for Payer: Prime Health Services Commercial |
$334.56
|
| Rate for Payer: United Healthcare All Other Commercial |
$147.72
|
| Rate for Payer: United Healthcare All Other HMO |
$143.78
|
| Rate for Payer: United Healthcare HMO Rider |
$140.67
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$128.90
|
|
|
HC TRACH CARE KIT
|
Facility
|
OP
|
$10.58
|
|
| Hospital Charge Code |
901698816
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.12 |
| Max. Negotiated Rate |
$9.52 |
| Rate for Payer: Adventist Health Commercial |
$2.12
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6.43
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$8.99
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.82
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7.93
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6.15
|
| Rate for Payer: Blue Shield of California Commercial |
$6.71
|
| Rate for Payer: Blue Shield of California EPN |
$4.22
|
| Rate for Payer: Cash Price |
$4.76
|
| Rate for Payer: Central Health Plan Commercial |
$8.46
|
| Rate for Payer: Cigna of CA HMO |
$6.77
|
| Rate for Payer: Cigna of CA PPO |
$7.83
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$8.99
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8.99
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7.41
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.23
|
| Rate for Payer: EPIC Health Plan Senior |
$4.23
|
| Rate for Payer: Galaxy Health WC |
$8.99
|
| Rate for Payer: Global Benefits Group Commercial |
$6.35
|
| Rate for Payer: Health Management Network EPO/PPO |
$9.52
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6.72
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$3.84
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$7.41
|
| Rate for Payer: Multiplan Commercial |
$7.93
|
| Rate for Payer: Networks By Design Commercial |
$6.88
|
| Rate for Payer: Prime Health Services Commercial |
$8.99
|
| Rate for Payer: Riverside University Health System MISP |
$4.23
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6.35
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6.35
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.29
|
| Rate for Payer: United Healthcare All Other HMO |
$5.29
|
| Rate for Payer: United Healthcare HMO Rider |
$5.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.29
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$8.99
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.99
|
| Rate for Payer: Vantage Medical Group Senior |
$8.99
|
|
|
HC TRACH CARE KIT
|
Facility
|
IP
|
$10.58
|
|
| Hospital Charge Code |
901698816
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.12 |
| Max. Negotiated Rate |
$9.52 |
| Rate for Payer: Adventist Health Commercial |
$2.12
|
| Rate for Payer: Cash Price |
$4.76
|
| Rate for Payer: Central Health Plan Commercial |
$8.46
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7.41
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.23
|
| Rate for Payer: EPIC Health Plan Senior |
$4.23
|
| Rate for Payer: Galaxy Health WC |
$8.99
|
| Rate for Payer: Global Benefits Group Commercial |
$6.35
|
| Rate for Payer: Health Management Network EPO/PPO |
$9.52
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6.72
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.12
|
| Rate for Payer: Multiplan Commercial |
$7.93
|
| Rate for Payer: Networks By Design Commercial |
$6.88
|
| Rate for Payer: Prime Health Services Commercial |
$8.99
|
|
|
HC TRACH CARE TRAY
|
Facility
|
OP
|
$8.36
|
|
| Hospital Charge Code |
901698275
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.67 |
| Max. Negotiated Rate |
$7.52 |
| Rate for Payer: Adventist Health Commercial |
$1.67
|
| Rate for Payer: Aetna of CA HMO/PPO |
$5.08
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.11
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6.27
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4.86
|
| Rate for Payer: Blue Shield of California Commercial |
$5.30
|
| Rate for Payer: Blue Shield of California EPN |
$3.34
|
| Rate for Payer: Cash Price |
$3.76
|
| Rate for Payer: Central Health Plan Commercial |
$6.69
|
| Rate for Payer: Cigna of CA HMO |
$5.35
|
| Rate for Payer: Cigna of CA PPO |
$6.19
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.11
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.11
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7.11
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.34
|
| Rate for Payer: EPIC Health Plan Senior |
$3.34
|
| Rate for Payer: Galaxy Health WC |
$7.11
|
| Rate for Payer: Global Benefits Group Commercial |
$5.02
|
| Rate for Payer: Health Management Network EPO/PPO |
$7.52
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$3.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.67
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5.85
|
| Rate for Payer: Multiplan Commercial |
$6.27
|
| Rate for Payer: Networks By Design Commercial |
$5.43
|
| Rate for Payer: Prime Health Services Commercial |
$7.11
|
| Rate for Payer: Riverside University Health System MISP |
$3.34
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5.02
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5.02
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.18
|
| Rate for Payer: United Healthcare All Other HMO |
$4.18
|
| Rate for Payer: United Healthcare HMO Rider |
$4.18
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.18
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.11
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.11
|
| Rate for Payer: Vantage Medical Group Senior |
$7.11
|
|
|
HC TRACH CARE TRAY
|
Facility
|
IP
|
$8.36
|
|
| Hospital Charge Code |
901698275
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.67 |
| Max. Negotiated Rate |
$7.52 |
| Rate for Payer: Adventist Health Commercial |
$1.67
|
| Rate for Payer: Cash Price |
$3.76
|
| Rate for Payer: Central Health Plan Commercial |
$6.69
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.34
|
| Rate for Payer: EPIC Health Plan Senior |
$3.34
|
| Rate for Payer: Galaxy Health WC |
$7.11
|
| Rate for Payer: Global Benefits Group Commercial |
$5.02
|
| Rate for Payer: Health Management Network EPO/PPO |
$7.52
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.67
|
| Rate for Payer: Multiplan Commercial |
$6.27
|
| Rate for Payer: Networks By Design Commercial |
$5.43
|
| Rate for Payer: Prime Health Services Commercial |
$7.11
|
|
|
HC TRACH CHANGE
|
Facility
|
OP
|
$1,570.00
|
|
|
Service Code
|
CPT 94799
|
| Hospital Charge Code |
900801125
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$165.49 |
| Max. Negotiated Rate |
$1,413.00 |
| Rate for Payer: Adventist Health Commercial |
$314.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$165.49
|
| Rate for Payer: Aetna of CA HMO/PPO |
$953.46
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$248.24
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$182.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$165.49
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$760.19
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$913.27
|
| Rate for Payer: Blue Shield of California Commercial |
$989.10
|
| Rate for Payer: Blue Shield of California EPN |
$623.29
|
| Rate for Payer: Cash Price |
$706.50
|
| Rate for Payer: Cash Price |
$706.50
|
| Rate for Payer: Cash Price |
$706.50
|
| Rate for Payer: Central Health Plan Commercial |
$1,256.00
|
| Rate for Payer: Cigna of CA HMO |
$1,004.80
|
| Rate for Payer: Cigna of CA PPO |
$1,161.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$248.24
|
| Rate for Payer: Dignity Health Medi-Cal |
$182.04
|
| Rate for Payer: Dignity Health Medicare Advantage |
$165.49
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,099.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$273.06
|
| Rate for Payer: EPIC Health Plan Senior |
$182.04
|
| Rate for Payer: Galaxy Health WC |
$1,334.50
|
| Rate for Payer: Global Benefits Group Commercial |
$942.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,413.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$271.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$165.49
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$996.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$231.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$314.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$221.76
|
| Rate for Payer: Multiplan Commercial |
$1,177.50
|
| Rate for Payer: Networks By Design Commercial |
$1,020.50
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$165.49
|
| Rate for Payer: Prime Health Services Commercial |
$1,334.50
|
| Rate for Payer: Prime Health Services Medicare |
$175.42
|
| Rate for Payer: Riverside University Health System MISP |
$182.04
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$942.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$942.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$764.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$731.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$669.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$165.49
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$248.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$182.04
|
| Rate for Payer: Vantage Medical Group Senior |
$165.49
|
|
|
HC TRACH CHANGE
|
Facility
|
IP
|
$1,570.00
|
|
|
Service Code
|
CPT 94799
|
| Hospital Charge Code |
900801125
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$314.00 |
| Max. Negotiated Rate |
$1,413.00 |
| Rate for Payer: Adventist Health Commercial |
$314.00
|
| Rate for Payer: Cash Price |
$706.50
|
| Rate for Payer: Central Health Plan Commercial |
$1,256.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,099.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$628.00
|
| Rate for Payer: EPIC Health Plan Senior |
$628.00
|
| Rate for Payer: Galaxy Health WC |
$1,334.50
|
| Rate for Payer: Global Benefits Group Commercial |
$942.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,413.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$996.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$926.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$314.00
|
| Rate for Payer: Multiplan Commercial |
$1,177.50
|
| Rate for Payer: Networks By Design Commercial |
$1,020.50
|
| Rate for Payer: Prime Health Services Commercial |
$1,334.50
|
|
|
HC TRACH CLSD SUCTION CATH 12FR
|
Facility
|
OP
|
$57.56
|
|
|
Service Code
|
CPT A4605
|
| Hospital Charge Code |
901698183
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$11.51 |
| Max. Negotiated Rate |
$51.80 |
| Rate for Payer: Adventist Health Commercial |
$11.51
|
| Rate for Payer: Aetna of CA HMO/PPO |
$41.29
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$48.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$31.66
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$43.17
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$27.87
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$33.48
|
| Rate for Payer: Blue Shield of California Commercial |
$36.49
|
| Rate for Payer: Blue Shield of California EPN |
$22.97
|
| Rate for Payer: Cash Price |
$25.90
|
| Rate for Payer: Cash Price |
$25.90
|
| Rate for Payer: Central Health Plan Commercial |
$46.05
|
| Rate for Payer: Cigna of CA HMO |
$36.84
|
| Rate for Payer: Cigna of CA PPO |
$42.59
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$48.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$48.93
|
| Rate for Payer: Dignity Health Medicare Advantage |
$48.93
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$40.29
|
| Rate for Payer: EPIC Health Plan Commercial |
$23.02
|
| Rate for Payer: EPIC Health Plan Senior |
$23.02
|
| Rate for Payer: Galaxy Health WC |
$48.93
|
| Rate for Payer: Global Benefits Group Commercial |
$34.54
|
| Rate for Payer: Health Management Network EPO/PPO |
$51.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$36.55
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$20.89
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$33.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.51
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$40.29
|
| Rate for Payer: Multiplan Commercial |
$43.17
|
| Rate for Payer: Networks By Design Commercial |
$37.41
|
| Rate for Payer: Prime Health Services Commercial |
$48.93
|
| Rate for Payer: Riverside University Health System MISP |
$23.02
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$34.54
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$34.54
|
| Rate for Payer: United Healthcare All Other Commercial |
$28.78
|
| Rate for Payer: United Healthcare All Other HMO |
$28.78
|
| Rate for Payer: United Healthcare HMO Rider |
$28.78
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$28.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$48.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$48.93
|
| Rate for Payer: Vantage Medical Group Senior |
$48.93
|
|
|
HC TRACH CLSD SUCTION CATH 12FR
|
Facility
|
IP
|
$57.56
|
|
|
Service Code
|
CPT A4605
|
| Hospital Charge Code |
901698183
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$11.51 |
| Max. Negotiated Rate |
$51.80 |
| Rate for Payer: Adventist Health Commercial |
$11.51
|
| Rate for Payer: Cash Price |
$25.90
|
| Rate for Payer: Central Health Plan Commercial |
$46.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$40.29
|
| Rate for Payer: EPIC Health Plan Commercial |
$23.02
|
| Rate for Payer: EPIC Health Plan Senior |
$23.02
|
| Rate for Payer: Galaxy Health WC |
$48.93
|
| Rate for Payer: Global Benefits Group Commercial |
$34.54
|
| Rate for Payer: Health Management Network EPO/PPO |
$51.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$36.55
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$33.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.51
|
| Rate for Payer: Multiplan Commercial |
$43.17
|
| Rate for Payer: Networks By Design Commercial |
$37.41
|
| Rate for Payer: Prime Health Services Commercial |
$48.93
|
|
|
HC TRACHEOBRONCH VIA TRACHESOTOMY
|
Facility
|
OP
|
$3,520.00
|
|
|
Service Code
|
CPT 31615
|
| Hospital Charge Code |
900501297
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$292.00 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$704.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$693.67
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,040.51
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$763.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$693.67
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$1,030.97
|
| Rate for Payer: Blue Shield of California Commercial |
$3,293.23
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$1,584.00
|
| Rate for Payer: Cash Price |
$1,584.00
|
| Rate for Payer: Cash Price |
$1,584.00
|
| Rate for Payer: Central Health Plan Commercial |
$2,816.00
|
| Rate for Payer: Cigna of CA HMO |
$2,252.80
|
| Rate for Payer: Cigna of CA PPO |
$2,604.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,040.51
|
| Rate for Payer: Dignity Health Medi-Cal |
$763.04
|
| Rate for Payer: Dignity Health Medicare Advantage |
$693.67
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,464.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,144.56
|
| Rate for Payer: EPIC Health Plan Senior |
$763.04
|
| Rate for Payer: Galaxy Health WC |
$2,992.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,112.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,168.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,137.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$292.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$693.67
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,235.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$322.56
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$971.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$704.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$929.52
|
| Rate for Payer: Multiplan Commercial |
$2,640.00
|
| Rate for Payer: Multiplan WC |
$1,030.97
|
| Rate for Payer: Networks By Design Commercial |
$2,288.00
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$693.67
|
| Rate for Payer: Preferred Health Network WC |
$1,052.01
|
| Rate for Payer: Prime Health Services Commercial |
$2,992.00
|
| Rate for Payer: Prime Health Services Medicare |
$735.29
|
| Rate for Payer: Prime Health Services WC |
$1,020.45
|
| Rate for Payer: Riverside University Health System MISP |
$763.04
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,112.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,760.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$693.67
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,040.51
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$763.04
|
| Rate for Payer: Vantage Medical Group Senior |
$693.67
|
|
|
HC TRACHEOBRONCH VIA TRACHESOTOMY
|
Facility
|
IP
|
$3,520.00
|
|
|
Service Code
|
CPT 31615
|
| Hospital Charge Code |
900501297
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$704.00 |
| Max. Negotiated Rate |
$3,168.00 |
| Rate for Payer: Adventist Health Commercial |
$704.00
|
| Rate for Payer: Cash Price |
$1,584.00
|
| Rate for Payer: Central Health Plan Commercial |
$2,816.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,464.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,408.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,408.00
|
| Rate for Payer: Galaxy Health WC |
$2,992.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,112.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,168.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,235.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,076.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$704.00
|
| Rate for Payer: Multiplan Commercial |
$2,640.00
|
| Rate for Payer: Networks By Design Commercial |
$2,288.00
|
| Rate for Payer: Prime Health Services Commercial |
$2,992.00
|
|
|
HC TRACHEOSTOMY CRICOTHYROID MEMB
|
Facility
|
IP
|
$4,438.00
|
|
|
Service Code
|
CPT 31605
|
| Hospital Charge Code |
900501344
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$887.60 |
| Max. Negotiated Rate |
$3,994.20 |
| Rate for Payer: Adventist Health Commercial |
$887.60
|
| Rate for Payer: Cash Price |
$1,997.10
|
| Rate for Payer: Central Health Plan Commercial |
$3,550.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,106.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,775.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,775.20
|
| Rate for Payer: Galaxy Health WC |
$3,772.30
|
| Rate for Payer: Global Benefits Group Commercial |
$2,662.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,994.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,818.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,618.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$887.60
|
| Rate for Payer: Multiplan Commercial |
$3,328.50
|
| Rate for Payer: Networks By Design Commercial |
$2,884.70
|
| Rate for Payer: Prime Health Services Commercial |
$3,772.30
|
|
|
HC TRACHEOSTOMY CRICOTHYROID MEMB
|
Facility
|
OP
|
$4,438.00
|
|
|
Service Code
|
CPT 31605
|
| Hospital Charge Code |
900501344
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$304.63 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$887.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$304.63
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$456.94
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$335.09
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$304.63
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$470.13
|
| Rate for Payer: Blue Shield of California Commercial |
$4,407.11
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Cash Price |
$1,997.10
|
| Rate for Payer: Cash Price |
$1,997.10
|
| Rate for Payer: Cash Price |
$1,997.10
|
| Rate for Payer: Central Health Plan Commercial |
$3,550.40
|
| Rate for Payer: Cigna of CA HMO |
$2,840.32
|
| Rate for Payer: Cigna of CA PPO |
$3,284.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$456.94
|
| Rate for Payer: Dignity Health Medi-Cal |
$335.09
|
| Rate for Payer: Dignity Health Medicare Advantage |
$304.63
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,106.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$502.64
|
| Rate for Payer: EPIC Health Plan Senior |
$335.09
|
| Rate for Payer: Galaxy Health WC |
$3,772.30
|
| Rate for Payer: Global Benefits Group Commercial |
$2,662.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,994.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$499.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$345.79
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$304.63
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,818.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$381.98
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$426.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$887.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$408.20
|
| Rate for Payer: Multiplan Commercial |
$3,328.50
|
| Rate for Payer: Multiplan WC |
$470.13
|
| Rate for Payer: Networks By Design Commercial |
$2,884.70
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$304.63
|
| Rate for Payer: Preferred Health Network WC |
$479.72
|
| Rate for Payer: Prime Health Services Commercial |
$3,772.30
|
| Rate for Payer: Prime Health Services Medicare |
$322.91
|
| Rate for Payer: Prime Health Services WC |
$465.33
|
| Rate for Payer: Riverside University Health System MISP |
$335.09
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,662.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,219.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$304.63
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$456.94
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$335.09
|
| Rate for Payer: Vantage Medical Group Senior |
$304.63
|
|
