|
HC STREPTOCARD STREP A
|
Facility
IP
|
$25.00
|
|
|
Service Code
|
CPT 87880
|
| Hospital Charge Code |
900912483
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$5.00 |
| Max. Negotiated Rate |
$22.50 |
| Rate for Payer: Cash Price |
$11.25
|
| Rate for Payer: Central Health Plan Commercial |
$20.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.00
|
| Rate for Payer: Galaxy Health WC |
$21.25
|
| Rate for Payer: Global Benefits Group Commercial |
$15.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$22.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.00
|
| Rate for Payer: Multiplan Commercial |
$18.75
|
| Rate for Payer: Networks By Design Commercial |
$16.25
|
| Rate for Payer: Prime Health Services Commercial |
$21.25
|
|
|
HC STREPTOCARD STREP A
|
Facility
OP
|
$17.00
|
|
|
Service Code
|
CPT 87880
|
| Hospital Charge Code |
900912483
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$3.40 |
| Max. Negotiated Rate |
$79.75 |
| Rate for Payer: Adventist Health Medi-Cal |
$16.53
|
| Rate for Payer: Aetna of CA HMO/PPO |
$68.17
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$24.80
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$18.18
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$16.53
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$65.38
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$79.75
|
| Rate for Payer: BCBS Transplant Transplant |
$10.20
|
| Rate for Payer: Blue Shield of California Commercial |
$10.51
|
| Rate for Payer: Blue Shield of California EPN |
$8.26
|
| Rate for Payer: Caremore Medicare Advantage |
$16.53
|
| Rate for Payer: Cash Price |
$7.65
|
| Rate for Payer: Cash Price |
$7.65
|
| Rate for Payer: Central Health Plan Commercial |
$13.60
|
| Rate for Payer: Cigna of CA HMO |
$10.88
|
| Rate for Payer: Cigna of CA PPO |
$12.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$24.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$22.32
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$16.53
|
| Rate for Payer: EPIC Health Plan Transplant |
$16.53
|
| Rate for Payer: Galaxy Health WC |
$14.45
|
| Rate for Payer: Global Benefits Group Commercial |
$10.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$15.30
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$12.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$27.11
|
| Rate for Payer: IEHP medi-cal |
$27.27
|
| Rate for Payer: IEHP Medicare Advantage |
$16.53
|
| Rate for Payer: Innovage PACE Commercial |
$24.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$22.15
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$22.15
|
| Rate for Payer: Multiplan Commercial |
$12.75
|
| Rate for Payer: Networks By Design Commercial |
$11.05
|
| Rate for Payer: Prime Health Services Commercial |
$14.45
|
| Rate for Payer: Prime Health Services Medicare |
$17.52
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$10.20
|
| Rate for Payer: Riverside University Health MISP |
$18.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$10.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$13.39
|
| Rate for Payer: United Healthcare All Other HMO |
$13.39
|
| Rate for Payer: United Healthcare HMO Rider |
$13.39
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$13.39
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$24.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$18.18
|
| Rate for Payer: Vantage Medical Group Senior |
$16.53
|
|
|
HC STREPTOCARD STREP B
|
Facility
IP
|
$25.00
|
|
|
Service Code
|
CPT 87147
|
| Hospital Charge Code |
900912484
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$5.00 |
| Max. Negotiated Rate |
$22.50 |
| Rate for Payer: Cash Price |
$11.25
|
| Rate for Payer: Central Health Plan Commercial |
$20.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.00
|
| Rate for Payer: Galaxy Health WC |
$21.25
|
| Rate for Payer: Global Benefits Group Commercial |
$15.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$22.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.00
|
| Rate for Payer: Multiplan Commercial |
$18.75
|
| Rate for Payer: Networks By Design Commercial |
$16.25
|
| Rate for Payer: Prime Health Services Commercial |
$21.25
|
|
|
HC STREPTOCARD STREP B
|
Facility
OP
|
$17.00
|
|
|
Service Code
|
CPT 87147
|
| Hospital Charge Code |
900912484
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$3.40 |
| Max. Negotiated Rate |
$41.52 |
| Rate for Payer: Adventist Health Medi-Cal |
$5.18
|
| Rate for Payer: Aetna of CA HMO/PPO |
$36.02
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$7.77
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$5.70
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$5.18
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$34.04
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$41.52
|
| Rate for Payer: BCBS Transplant Transplant |
$10.20
|
| Rate for Payer: Blue Shield of California Commercial |
$10.51
|
| Rate for Payer: Blue Shield of California EPN |
$8.26
|
| Rate for Payer: Caremore Medicare Advantage |
$5.18
|
| Rate for Payer: Cash Price |
$7.65
|
| Rate for Payer: Cash Price |
$7.65
|
| Rate for Payer: Central Health Plan Commercial |
$13.60
|
| Rate for Payer: Cigna of CA HMO |
$10.88
|
| Rate for Payer: Cigna of CA PPO |
$12.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.99
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$5.18
|
| Rate for Payer: EPIC Health Plan Transplant |
$5.18
|
| Rate for Payer: Galaxy Health WC |
$14.45
|
| Rate for Payer: Global Benefits Group Commercial |
$10.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$15.30
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$12.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$8.50
|
| Rate for Payer: IEHP medi-cal |
$8.55
|
| Rate for Payer: IEHP Medicare Advantage |
$5.18
|
| Rate for Payer: Innovage PACE Commercial |
$7.77
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.94
|
| Rate for Payer: Multiplan Commercial |
$12.75
|
| Rate for Payer: Networks By Design Commercial |
$11.05
|
| Rate for Payer: Prime Health Services Commercial |
$14.45
|
| Rate for Payer: Prime Health Services Medicare |
$5.49
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$10.20
|
| Rate for Payer: Riverside University Health MISP |
$5.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$10.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.19
|
| Rate for Payer: United Healthcare All Other HMO |
$4.19
|
| Rate for Payer: United Healthcare HMO Rider |
$4.19
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.19
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.77
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.70
|
| Rate for Payer: Vantage Medical Group Senior |
$5.18
|
|
|
HC STREPTOCARD STREP C
|
Facility
OP
|
$17.00
|
|
|
Service Code
|
CPT 87147
|
| Hospital Charge Code |
900912485
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$3.40 |
| Max. Negotiated Rate |
$41.52 |
| Rate for Payer: Adventist Health Medi-Cal |
$5.18
|
| Rate for Payer: Aetna of CA HMO/PPO |
$36.02
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$7.77
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$5.70
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$5.18
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$34.04
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$41.52
|
| Rate for Payer: BCBS Transplant Transplant |
$10.20
|
| Rate for Payer: Blue Shield of California Commercial |
$10.51
|
| Rate for Payer: Blue Shield of California EPN |
$8.26
|
| Rate for Payer: Caremore Medicare Advantage |
$5.18
|
| Rate for Payer: Cash Price |
$7.65
|
| Rate for Payer: Cash Price |
$7.65
|
| Rate for Payer: Central Health Plan Commercial |
$13.60
|
| Rate for Payer: Cigna of CA HMO |
$10.88
|
| Rate for Payer: Cigna of CA PPO |
$12.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.99
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$5.18
|
| Rate for Payer: EPIC Health Plan Transplant |
$5.18
|
| Rate for Payer: Galaxy Health WC |
$14.45
|
| Rate for Payer: Global Benefits Group Commercial |
$10.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$15.30
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$12.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$8.50
|
| Rate for Payer: IEHP medi-cal |
$8.55
|
| Rate for Payer: IEHP Medicare Advantage |
$5.18
|
| Rate for Payer: Innovage PACE Commercial |
$7.77
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.94
|
| Rate for Payer: Multiplan Commercial |
$12.75
|
| Rate for Payer: Networks By Design Commercial |
$11.05
|
| Rate for Payer: Prime Health Services Commercial |
$14.45
|
| Rate for Payer: Prime Health Services Medicare |
$5.49
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$10.20
|
| Rate for Payer: Riverside University Health MISP |
$5.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$10.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.19
|
| Rate for Payer: United Healthcare All Other HMO |
$4.19
|
| Rate for Payer: United Healthcare HMO Rider |
$4.19
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.19
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.77
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.70
|
| Rate for Payer: Vantage Medical Group Senior |
$5.18
|
|
|
HC STREPTOCARD STREP C
|
Facility
IP
|
$25.00
|
|
|
Service Code
|
CPT 87147
|
| Hospital Charge Code |
900912485
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$5.00 |
| Max. Negotiated Rate |
$22.50 |
| Rate for Payer: Cash Price |
$11.25
|
| Rate for Payer: Central Health Plan Commercial |
$20.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.00
|
| Rate for Payer: Galaxy Health WC |
$21.25
|
| Rate for Payer: Global Benefits Group Commercial |
$15.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$22.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.00
|
| Rate for Payer: Multiplan Commercial |
$18.75
|
| Rate for Payer: Networks By Design Commercial |
$16.25
|
| Rate for Payer: Prime Health Services Commercial |
$21.25
|
|
|
HC STREPTOCARD STREP D
|
Facility
IP
|
$25.00
|
|
|
Service Code
|
CPT 87147
|
| Hospital Charge Code |
900912486
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$5.00 |
| Max. Negotiated Rate |
$22.50 |
| Rate for Payer: Cash Price |
$11.25
|
| Rate for Payer: Central Health Plan Commercial |
$20.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.00
|
| Rate for Payer: Galaxy Health WC |
$21.25
|
| Rate for Payer: Global Benefits Group Commercial |
$15.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$22.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.00
|
| Rate for Payer: Multiplan Commercial |
$18.75
|
| Rate for Payer: Networks By Design Commercial |
$16.25
|
| Rate for Payer: Prime Health Services Commercial |
$21.25
|
|
|
HC STREPTOCARD STREP D
|
Facility
OP
|
$17.00
|
|
|
Service Code
|
CPT 87147
|
| Hospital Charge Code |
900912486
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$3.40 |
| Max. Negotiated Rate |
$41.52 |
| Rate for Payer: Adventist Health Medi-Cal |
$5.18
|
| Rate for Payer: Aetna of CA HMO/PPO |
$36.02
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$7.77
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$5.70
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$5.18
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$34.04
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$41.52
|
| Rate for Payer: BCBS Transplant Transplant |
$10.20
|
| Rate for Payer: Blue Shield of California Commercial |
$10.51
|
| Rate for Payer: Blue Shield of California EPN |
$8.26
|
| Rate for Payer: Caremore Medicare Advantage |
$5.18
|
| Rate for Payer: Cash Price |
$7.65
|
| Rate for Payer: Cash Price |
$7.65
|
| Rate for Payer: Central Health Plan Commercial |
$13.60
|
| Rate for Payer: Cigna of CA HMO |
$10.88
|
| Rate for Payer: Cigna of CA PPO |
$12.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.99
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$5.18
|
| Rate for Payer: EPIC Health Plan Transplant |
$5.18
|
| Rate for Payer: Galaxy Health WC |
$14.45
|
| Rate for Payer: Global Benefits Group Commercial |
$10.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$15.30
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$12.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$8.50
|
| Rate for Payer: IEHP medi-cal |
$8.55
|
| Rate for Payer: IEHP Medicare Advantage |
$5.18
|
| Rate for Payer: Innovage PACE Commercial |
$7.77
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.94
|
| Rate for Payer: Multiplan Commercial |
$12.75
|
| Rate for Payer: Networks By Design Commercial |
$11.05
|
| Rate for Payer: Prime Health Services Commercial |
$14.45
|
| Rate for Payer: Prime Health Services Medicare |
$5.49
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$10.20
|
| Rate for Payer: Riverside University Health MISP |
$5.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$10.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.19
|
| Rate for Payer: United Healthcare All Other HMO |
$4.19
|
| Rate for Payer: United Healthcare HMO Rider |
$4.19
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.19
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.77
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.70
|
| Rate for Payer: Vantage Medical Group Senior |
$5.18
|
|
|
HC STREPTOCARD STREP F
|
Facility
IP
|
$25.00
|
|
|
Service Code
|
CPT 87147
|
| Hospital Charge Code |
900912487
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$5.00 |
| Max. Negotiated Rate |
$22.50 |
| Rate for Payer: Cash Price |
$11.25
|
| Rate for Payer: Central Health Plan Commercial |
$20.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.00
|
| Rate for Payer: Galaxy Health WC |
$21.25
|
| Rate for Payer: Global Benefits Group Commercial |
$15.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$22.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.00
|
| Rate for Payer: Multiplan Commercial |
$18.75
|
| Rate for Payer: Networks By Design Commercial |
$16.25
|
| Rate for Payer: Prime Health Services Commercial |
$21.25
|
|
|
HC STREPTOCARD STREP F
|
Facility
OP
|
$17.00
|
|
|
Service Code
|
CPT 87147
|
| Hospital Charge Code |
900912487
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$3.40 |
| Max. Negotiated Rate |
$41.52 |
| Rate for Payer: Adventist Health Medi-Cal |
$5.18
|
| Rate for Payer: Aetna of CA HMO/PPO |
$36.02
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$7.77
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$5.70
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$5.18
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$34.04
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$41.52
|
| Rate for Payer: BCBS Transplant Transplant |
$10.20
|
| Rate for Payer: Blue Shield of California Commercial |
$10.51
|
| Rate for Payer: Blue Shield of California EPN |
$8.26
|
| Rate for Payer: Caremore Medicare Advantage |
$5.18
|
| Rate for Payer: Cash Price |
$7.65
|
| Rate for Payer: Cash Price |
$7.65
|
| Rate for Payer: Central Health Plan Commercial |
$13.60
|
| Rate for Payer: Cigna of CA HMO |
$10.88
|
| Rate for Payer: Cigna of CA PPO |
$12.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.99
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$5.18
|
| Rate for Payer: EPIC Health Plan Transplant |
$5.18
|
| Rate for Payer: Galaxy Health WC |
$14.45
|
| Rate for Payer: Global Benefits Group Commercial |
$10.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$15.30
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$12.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$8.50
|
| Rate for Payer: IEHP medi-cal |
$8.55
|
| Rate for Payer: IEHP Medicare Advantage |
$5.18
|
| Rate for Payer: Innovage PACE Commercial |
$7.77
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.94
|
| Rate for Payer: Multiplan Commercial |
$12.75
|
| Rate for Payer: Networks By Design Commercial |
$11.05
|
| Rate for Payer: Prime Health Services Commercial |
$14.45
|
| Rate for Payer: Prime Health Services Medicare |
$5.49
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$10.20
|
| Rate for Payer: Riverside University Health MISP |
$5.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$10.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.19
|
| Rate for Payer: United Healthcare All Other HMO |
$4.19
|
| Rate for Payer: United Healthcare HMO Rider |
$4.19
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.19
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.77
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.70
|
| Rate for Payer: Vantage Medical Group Senior |
$5.18
|
|
|
HC STREPTOCARD STREP G
|
Facility
IP
|
$25.00
|
|
|
Service Code
|
CPT 87147
|
| Hospital Charge Code |
900912488
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$5.00 |
| Max. Negotiated Rate |
$22.50 |
| Rate for Payer: Cash Price |
$11.25
|
| Rate for Payer: Central Health Plan Commercial |
$20.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.00
|
| Rate for Payer: Galaxy Health WC |
$21.25
|
| Rate for Payer: Global Benefits Group Commercial |
$15.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$22.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.00
|
| Rate for Payer: Multiplan Commercial |
$18.75
|
| Rate for Payer: Networks By Design Commercial |
$16.25
|
| Rate for Payer: Prime Health Services Commercial |
$21.25
|
|
|
HC STREPTOCARD STREP G
|
Facility
OP
|
$17.00
|
|
|
Service Code
|
CPT 87147
|
| Hospital Charge Code |
900912488
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$3.40 |
| Max. Negotiated Rate |
$41.52 |
| Rate for Payer: Adventist Health Medi-Cal |
$5.18
|
| Rate for Payer: Aetna of CA HMO/PPO |
$36.02
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$7.77
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$5.70
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$5.18
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$34.04
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$41.52
|
| Rate for Payer: BCBS Transplant Transplant |
$10.20
|
| Rate for Payer: Blue Shield of California Commercial |
$10.51
|
| Rate for Payer: Blue Shield of California EPN |
$8.26
|
| Rate for Payer: Caremore Medicare Advantage |
$5.18
|
| Rate for Payer: Cash Price |
$7.65
|
| Rate for Payer: Cash Price |
$7.65
|
| Rate for Payer: Central Health Plan Commercial |
$13.60
|
| Rate for Payer: Cigna of CA HMO |
$10.88
|
| Rate for Payer: Cigna of CA PPO |
$12.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.99
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$5.18
|
| Rate for Payer: EPIC Health Plan Transplant |
$5.18
|
| Rate for Payer: Galaxy Health WC |
$14.45
|
| Rate for Payer: Global Benefits Group Commercial |
$10.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$15.30
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$12.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$8.50
|
| Rate for Payer: IEHP medi-cal |
$8.55
|
| Rate for Payer: IEHP Medicare Advantage |
$5.18
|
| Rate for Payer: Innovage PACE Commercial |
$7.77
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.94
|
| Rate for Payer: Multiplan Commercial |
$12.75
|
| Rate for Payer: Networks By Design Commercial |
$11.05
|
| Rate for Payer: Prime Health Services Commercial |
$14.45
|
| Rate for Payer: Prime Health Services Medicare |
$5.49
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$10.20
|
| Rate for Payer: Riverside University Health MISP |
$5.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$10.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.19
|
| Rate for Payer: United Healthcare All Other HMO |
$4.19
|
| Rate for Payer: United Healthcare HMO Rider |
$4.19
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.19
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.77
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.70
|
| Rate for Payer: Vantage Medical Group Senior |
$5.18
|
|
|
HC STREPTOZYME TEST
|
Facility
IP
|
$129.00
|
|
|
Service Code
|
CPT 86063
|
| Hospital Charge Code |
900910870
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$25.80 |
| Max. Negotiated Rate |
$116.10 |
| Rate for Payer: Cash Price |
$58.05
|
| Rate for Payer: Central Health Plan Commercial |
$103.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$51.60
|
| Rate for Payer: Galaxy Health WC |
$109.65
|
| Rate for Payer: Global Benefits Group Commercial |
$77.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$116.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$86.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.80
|
| Rate for Payer: Multiplan Commercial |
$96.75
|
| Rate for Payer: Networks By Design Commercial |
$83.85
|
| Rate for Payer: Prime Health Services Commercial |
$109.65
|
|
|
HC STREPTOZYME TEST
|
Facility
OP
|
$17.00
|
|
|
Service Code
|
CPT 86063
|
| Hospital Charge Code |
900910870
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.40 |
| Max. Negotiated Rate |
$51.32 |
| Rate for Payer: Adventist Health Medi-Cal |
$5.77
|
| Rate for Payer: Aetna of CA HMO/PPO |
$42.40
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$8.66
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$6.35
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$5.77
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$42.07
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$51.32
|
| Rate for Payer: BCBS Transplant Transplant |
$10.20
|
| Rate for Payer: Blue Shield of California Commercial |
$10.51
|
| Rate for Payer: Blue Shield of California EPN |
$8.26
|
| Rate for Payer: Caremore Medicare Advantage |
$5.77
|
| Rate for Payer: Cash Price |
$7.65
|
| Rate for Payer: Cash Price |
$7.65
|
| Rate for Payer: Central Health Plan Commercial |
$13.60
|
| Rate for Payer: Cigna of CA HMO |
$10.88
|
| Rate for Payer: Cigna of CA PPO |
$12.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.79
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$5.77
|
| Rate for Payer: EPIC Health Plan Transplant |
$5.77
|
| Rate for Payer: Galaxy Health WC |
$14.45
|
| Rate for Payer: Global Benefits Group Commercial |
$10.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$15.30
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$12.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$9.46
|
| Rate for Payer: IEHP medi-cal |
$9.52
|
| Rate for Payer: IEHP Medicare Advantage |
$5.77
|
| Rate for Payer: Innovage PACE Commercial |
$8.66
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$7.73
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$7.73
|
| Rate for Payer: Multiplan Commercial |
$12.75
|
| Rate for Payer: Networks By Design Commercial |
$11.05
|
| Rate for Payer: Prime Health Services Commercial |
$14.45
|
| Rate for Payer: Prime Health Services Medicare |
$6.12
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$10.20
|
| Rate for Payer: Riverside University Health MISP |
$6.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$10.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.67
|
| Rate for Payer: United Healthcare All Other HMO |
$4.67
|
| Rate for Payer: United Healthcare HMO Rider |
$4.67
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.67
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$8.66
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6.35
|
| Rate for Payer: Vantage Medical Group Senior |
$5.77
|
|
|
HC STR POST TX CD3 ENGRAFTMENT
|
Facility
OP
|
$812.00
|
|
|
Service Code
|
CPT 81268
|
| Hospital Charge Code |
903902026
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$162.40 |
| Max. Negotiated Rate |
$2,284.58 |
| Rate for Payer: Adventist Health Medi-Cal |
$260.79
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,113.32
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$391.18
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$286.87
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$260.79
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,872.98
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,284.58
|
| Rate for Payer: BCBS Transplant Transplant |
$487.20
|
| Rate for Payer: Blue Shield of California Commercial |
$501.82
|
| Rate for Payer: Blue Shield of California EPN |
$394.63
|
| Rate for Payer: Caremore Medicare Advantage |
$260.79
|
| Rate for Payer: Cash Price |
$365.40
|
| Rate for Payer: Cash Price |
$365.40
|
| Rate for Payer: Central Health Plan Commercial |
$649.60
|
| Rate for Payer: Cigna of CA HMO |
$519.68
|
| Rate for Payer: Cigna of CA PPO |
$600.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$391.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$352.07
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$260.79
|
| Rate for Payer: EPIC Health Plan Transplant |
$260.79
|
| Rate for Payer: Galaxy Health WC |
$690.20
|
| Rate for Payer: Global Benefits Group Commercial |
$487.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$730.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$609.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$427.70
|
| Rate for Payer: IEHP medi-cal |
$430.30
|
| Rate for Payer: IEHP Medicare Advantage |
$260.79
|
| Rate for Payer: Innovage PACE Commercial |
$391.18
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$541.60
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$260.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$162.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$349.46
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$349.46
|
| Rate for Payer: Multiplan Commercial |
$609.00
|
| Rate for Payer: Networks By Design Commercial |
$527.80
|
| Rate for Payer: Prime Health Services Commercial |
$690.20
|
| Rate for Payer: Prime Health Services Medicare |
$276.44
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$487.20
|
| Rate for Payer: Riverside University Health MISP |
$286.87
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$487.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$487.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$211.24
|
| Rate for Payer: United Healthcare All Other HMO |
$211.24
|
| Rate for Payer: United Healthcare HMO Rider |
$211.24
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$211.24
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$391.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$286.87
|
| Rate for Payer: Vantage Medical Group Senior |
$260.79
|
|
|
HC STR POST TX CD3 ENGRAFTMENT
|
Facility
IP
|
$812.00
|
|
|
Service Code
|
CPT 81268
|
| Hospital Charge Code |
903902026
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$162.40 |
| Max. Negotiated Rate |
$730.80 |
| Rate for Payer: Cash Price |
$365.40
|
| Rate for Payer: Central Health Plan Commercial |
$649.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$324.80
|
| Rate for Payer: Galaxy Health WC |
$690.20
|
| Rate for Payer: Global Benefits Group Commercial |
$487.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$730.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$541.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$162.40
|
| Rate for Payer: Multiplan Commercial |
$609.00
|
| Rate for Payer: Networks By Design Commercial |
$527.80
|
| Rate for Payer: Prime Health Services Commercial |
$690.20
|
|
|
HC STR POST TX ENGRAFTMENT
|
Facility
OP
|
$1,279.00
|
|
|
Service Code
|
CPT 81267
|
| Hospital Charge Code |
903902025
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$168.04 |
| Max. Negotiated Rate |
$4,862.48 |
| Rate for Payer: Adventist Health Medi-Cal |
$207.46
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,890.53
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$311.19
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$228.21
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$207.46
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,986.43
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,862.48
|
| Rate for Payer: BCBS Transplant Transplant |
$767.40
|
| Rate for Payer: Blue Shield of California Commercial |
$790.42
|
| Rate for Payer: Blue Shield of California EPN |
$621.59
|
| Rate for Payer: Caremore Medicare Advantage |
$207.46
|
| Rate for Payer: Cash Price |
$575.55
|
| Rate for Payer: Cash Price |
$575.55
|
| Rate for Payer: Central Health Plan Commercial |
$1,023.20
|
| Rate for Payer: Cigna of CA HMO |
$818.56
|
| Rate for Payer: Cigna of CA PPO |
$946.46
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$311.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$280.07
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$207.46
|
| Rate for Payer: EPIC Health Plan Transplant |
$207.46
|
| Rate for Payer: Galaxy Health WC |
$1,087.15
|
| Rate for Payer: Global Benefits Group Commercial |
$767.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,151.10
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$959.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$340.23
|
| Rate for Payer: IEHP medi-cal |
$342.31
|
| Rate for Payer: IEHP Medicare Advantage |
$207.46
|
| Rate for Payer: Innovage PACE Commercial |
$311.19
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$853.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$207.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$255.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$278.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$278.00
|
| Rate for Payer: Multiplan Commercial |
$959.25
|
| Rate for Payer: Networks By Design Commercial |
$831.35
|
| Rate for Payer: Prime Health Services Commercial |
$1,087.15
|
| Rate for Payer: Prime Health Services Medicare |
$219.91
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$767.40
|
| Rate for Payer: Riverside University Health MISP |
$228.21
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$767.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$767.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$168.04
|
| Rate for Payer: United Healthcare All Other HMO |
$168.04
|
| Rate for Payer: United Healthcare HMO Rider |
$168.04
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$168.04
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$311.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$228.21
|
| Rate for Payer: Vantage Medical Group Senior |
$207.46
|
|
|
HC STR POST TX ENGRAFTMENT
|
Facility
IP
|
$1,279.00
|
|
|
Service Code
|
CPT 81267
|
| Hospital Charge Code |
903902025
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$255.80 |
| Max. Negotiated Rate |
$1,151.10 |
| Rate for Payer: Cash Price |
$575.55
|
| Rate for Payer: Central Health Plan Commercial |
$1,023.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$511.60
|
| Rate for Payer: Galaxy Health WC |
$1,087.15
|
| Rate for Payer: Global Benefits Group Commercial |
$767.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,151.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$853.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$255.80
|
| Rate for Payer: Multiplan Commercial |
$959.25
|
| Rate for Payer: Networks By Design Commercial |
$831.35
|
| Rate for Payer: Prime Health Services Commercial |
$1,087.15
|
|
|
HC STR POST TX MYELOID ENGRAFTMNT
|
Facility
OP
|
$812.00
|
|
|
Service Code
|
CPT 81268
|
| Hospital Charge Code |
903902027
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$162.40 |
| Max. Negotiated Rate |
$2,284.58 |
| Rate for Payer: Adventist Health Medi-Cal |
$260.79
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,113.32
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$391.18
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$286.87
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$260.79
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,872.98
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,284.58
|
| Rate for Payer: BCBS Transplant Transplant |
$487.20
|
| Rate for Payer: Blue Shield of California Commercial |
$501.82
|
| Rate for Payer: Blue Shield of California EPN |
$394.63
|
| Rate for Payer: Caremore Medicare Advantage |
$260.79
|
| Rate for Payer: Cash Price |
$365.40
|
| Rate for Payer: Cash Price |
$365.40
|
| Rate for Payer: Central Health Plan Commercial |
$649.60
|
| Rate for Payer: Cigna of CA HMO |
$519.68
|
| Rate for Payer: Cigna of CA PPO |
$600.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$391.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$352.07
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$260.79
|
| Rate for Payer: EPIC Health Plan Transplant |
$260.79
|
| Rate for Payer: Galaxy Health WC |
$690.20
|
| Rate for Payer: Global Benefits Group Commercial |
$487.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$730.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$609.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$427.70
|
| Rate for Payer: IEHP medi-cal |
$430.30
|
| Rate for Payer: IEHP Medicare Advantage |
$260.79
|
| Rate for Payer: Innovage PACE Commercial |
$391.18
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$541.60
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$260.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$162.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$349.46
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$349.46
|
| Rate for Payer: Multiplan Commercial |
$609.00
|
| Rate for Payer: Networks By Design Commercial |
$527.80
|
| Rate for Payer: Prime Health Services Commercial |
$690.20
|
| Rate for Payer: Prime Health Services Medicare |
$276.44
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$487.20
|
| Rate for Payer: Riverside University Health MISP |
$286.87
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$487.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$487.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$211.24
|
| Rate for Payer: United Healthcare All Other HMO |
$211.24
|
| Rate for Payer: United Healthcare HMO Rider |
$211.24
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$211.24
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$391.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$286.87
|
| Rate for Payer: Vantage Medical Group Senior |
$260.79
|
|
|
HC STR POST TX MYELOID ENGRAFTMNT
|
Facility
IP
|
$812.00
|
|
|
Service Code
|
CPT 81268
|
| Hospital Charge Code |
903902027
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$162.40 |
| Max. Negotiated Rate |
$730.80 |
| Rate for Payer: Cash Price |
$365.40
|
| Rate for Payer: Central Health Plan Commercial |
$649.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$324.80
|
| Rate for Payer: Galaxy Health WC |
$690.20
|
| Rate for Payer: Global Benefits Group Commercial |
$487.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$730.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$541.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$162.40
|
| Rate for Payer: Multiplan Commercial |
$609.00
|
| Rate for Payer: Networks By Design Commercial |
$527.80
|
| Rate for Payer: Prime Health Services Commercial |
$690.20
|
|
|
HC STR PRE TX ENGRAFTMENT
|
Facility
IP
|
$762.00
|
|
|
Service Code
|
CPT 81265
|
| Hospital Charge Code |
903902024
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$152.40 |
| Max. Negotiated Rate |
$685.80 |
| Rate for Payer: Cash Price |
$342.90
|
| Rate for Payer: Central Health Plan Commercial |
$609.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$304.80
|
| Rate for Payer: Galaxy Health WC |
$647.70
|
| Rate for Payer: Global Benefits Group Commercial |
$457.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$685.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$508.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$152.40
|
| Rate for Payer: Multiplan Commercial |
$571.50
|
| Rate for Payer: Networks By Design Commercial |
$495.30
|
| Rate for Payer: Prime Health Services Commercial |
$647.70
|
|
|
HC STR PRE TX ENGRAFTMENT
|
Facility
OP
|
$762.00
|
|
|
Service Code
|
CPT 81265
|
| Hospital Charge Code |
903902024
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$152.40 |
| Max. Negotiated Rate |
$2,116.59 |
| Rate for Payer: Adventist Health Medi-Cal |
$233.07
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,656.64
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$349.60
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$256.38
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$233.07
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,735.26
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,116.59
|
| Rate for Payer: BCBS Transplant Transplant |
$457.20
|
| Rate for Payer: Blue Shield of California Commercial |
$470.92
|
| Rate for Payer: Blue Shield of California EPN |
$370.33
|
| Rate for Payer: Caremore Medicare Advantage |
$233.07
|
| Rate for Payer: Cash Price |
$342.90
|
| Rate for Payer: Cash Price |
$342.90
|
| Rate for Payer: Central Health Plan Commercial |
$609.60
|
| Rate for Payer: Cigna of CA HMO |
$487.68
|
| Rate for Payer: Cigna of CA PPO |
$563.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$349.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$314.64
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$233.07
|
| Rate for Payer: EPIC Health Plan Transplant |
$233.07
|
| Rate for Payer: Galaxy Health WC |
$647.70
|
| Rate for Payer: Global Benefits Group Commercial |
$457.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$685.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$571.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$382.23
|
| Rate for Payer: IEHP medi-cal |
$384.57
|
| Rate for Payer: IEHP Medicare Advantage |
$233.07
|
| Rate for Payer: Innovage PACE Commercial |
$349.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$508.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$233.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$152.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$312.31
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$312.31
|
| Rate for Payer: Multiplan Commercial |
$571.50
|
| Rate for Payer: Networks By Design Commercial |
$495.30
|
| Rate for Payer: Prime Health Services Commercial |
$647.70
|
| Rate for Payer: Prime Health Services Medicare |
$247.05
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$457.20
|
| Rate for Payer: Riverside University Health MISP |
$256.38
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$457.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$457.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$188.78
|
| Rate for Payer: United Healthcare All Other HMO |
$188.78
|
| Rate for Payer: United Healthcare HMO Rider |
$188.78
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$188.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$349.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$256.38
|
| Rate for Payer: Vantage Medical Group Senior |
$233.07
|
|
|
HC STUMP SOCK SINGLE PLY AK EACH
|
Facility
OP
|
$35.00
|
|
|
Service Code
|
CPT L8480
|
| Hospital Charge Code |
905358480
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$12.25 |
| Max. Negotiated Rate |
$40.68 |
| Rate for Payer: Aetna of CA HMO/PPO |
$40.68
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$29.75
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$19.25
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$19.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$16.95
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$20.68
|
| Rate for Payer: BCBS Transplant Transplant |
$21.00
|
| Rate for Payer: Blue Shield of California Commercial |
$26.25
|
| Rate for Payer: Blue Shield of California EPN |
$19.04
|
| Rate for Payer: Cash Price |
$15.75
|
| Rate for Payer: Cash Price |
$15.75
|
| Rate for Payer: Central Health Plan Commercial |
$28.00
|
| Rate for Payer: Cigna of CA HMO |
$24.50
|
| Rate for Payer: Cigna of CA PPO |
$24.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$29.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$14.00
|
| Rate for Payer: Galaxy Health WC |
$29.75
|
| Rate for Payer: Global Benefits Group Commercial |
$21.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$31.50
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$26.25
|
| Rate for Payer: IEHP medi-cal |
$12.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$23.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.35
|
| Rate for Payer: Multiplan Commercial |
$26.25
|
| Rate for Payer: Networks By Design Commercial |
$17.50
|
| Rate for Payer: Prime Health Services Commercial |
$29.75
|
| Rate for Payer: Riverside University Health MISP |
$14.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$21.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$21.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$17.50
|
| Rate for Payer: United Healthcare All Other HMO |
$17.50
|
| Rate for Payer: United Healthcare HMO Rider |
$17.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$17.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$29.75
|
| Rate for Payer: Vantage Medical Group Senior |
$29.75
|
|
|
HC STUMP SOCK SINGLE PLY AK EACH
|
Facility
IP
|
$35.00
|
|
|
Service Code
|
CPT L8480
|
| Hospital Charge Code |
905358480
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$7.00 |
| Max. Negotiated Rate |
$31.50 |
| Rate for Payer: Blue Shield of California EPN |
$18.69
|
| Rate for Payer: Cash Price |
$15.75
|
| Rate for Payer: Central Health Plan Commercial |
$28.00
|
| Rate for Payer: Cigna of CA HMO |
$24.50
|
| Rate for Payer: Cigna of CA PPO |
$24.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$14.00
|
| Rate for Payer: Galaxy Health WC |
$29.75
|
| Rate for Payer: Global Benefits Group Commercial |
$21.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$31.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$23.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.00
|
| Rate for Payer: Multiplan Commercial |
$26.25
|
| Rate for Payer: Networks By Design Commercial |
$17.50
|
| Rate for Payer: Prime Health Services Commercial |
$29.75
|
|
|
HC STUMP SOCK SINGLE PLY BK EACH
|
Facility
OP
|
$32.00
|
|
|
Service Code
|
CPT L8470
|
| Hospital Charge Code |
905358470
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$11.20 |
| Max. Negotiated Rate |
$29.51 |
| Rate for Payer: Aetna of CA HMO/PPO |
$29.51
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$27.20
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$17.60
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$17.60
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$15.49
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$18.91
|
| Rate for Payer: BCBS Transplant Transplant |
$19.20
|
| Rate for Payer: Blue Shield of California Commercial |
$24.00
|
| Rate for Payer: Blue Shield of California EPN |
$17.41
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Central Health Plan Commercial |
$25.60
|
| Rate for Payer: Cigna of CA HMO |
$22.40
|
| Rate for Payer: Cigna of CA PPO |
$22.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$27.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$12.80
|
| Rate for Payer: Galaxy Health WC |
$27.20
|
| Rate for Payer: Global Benefits Group Commercial |
$19.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$28.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$24.00
|
| Rate for Payer: IEHP medi-cal |
$11.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$21.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.12
|
| Rate for Payer: Multiplan Commercial |
$24.00
|
| Rate for Payer: Networks By Design Commercial |
$16.00
|
| Rate for Payer: Prime Health Services Commercial |
$27.20
|
| Rate for Payer: Riverside University Health MISP |
$12.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$19.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$19.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$16.00
|
| Rate for Payer: United Healthcare All Other HMO |
$16.00
|
| Rate for Payer: United Healthcare HMO Rider |
$16.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$27.20
|
| Rate for Payer: Vantage Medical Group Senior |
$27.20
|
|
