|
HC SYPHILIS NON TREP QUANT
|
Facility
IP
|
$58.00
|
|
|
Service Code
|
CPT 86593
|
| Hospital Charge Code |
900913672
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.60 |
| Max. Negotiated Rate |
$52.20 |
| Rate for Payer: Cash Price |
$26.10
|
| Rate for Payer: Central Health Plan Commercial |
$46.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$23.20
|
| Rate for Payer: Galaxy Health WC |
$49.30
|
| Rate for Payer: Global Benefits Group Commercial |
$34.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$52.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$38.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.60
|
| Rate for Payer: Multiplan Commercial |
$43.50
|
| Rate for Payer: Networks By Design Commercial |
$37.70
|
| Rate for Payer: Prime Health Services Commercial |
$49.30
|
|
|
HC SYPHILIS NON TREP QUANT
|
Facility
OP
|
$39.00
|
|
|
Service Code
|
CPT 86593
|
| Hospital Charge Code |
900913672
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.56 |
| Max. Negotiated Rate |
$39.07 |
| Rate for Payer: Adventist Health Medi-Cal |
$4.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32.27
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$6.60
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4.84
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$4.40
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$32.03
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$39.07
|
| Rate for Payer: BCBS Transplant Transplant |
$23.40
|
| Rate for Payer: Blue Shield of California Commercial |
$24.10
|
| Rate for Payer: Blue Shield of California EPN |
$18.95
|
| Rate for Payer: Caremore Medicare Advantage |
$4.40
|
| Rate for Payer: Cash Price |
$17.55
|
| Rate for Payer: Cash Price |
$17.55
|
| Rate for Payer: Central Health Plan Commercial |
$31.20
|
| Rate for Payer: Cigna of CA HMO |
$24.96
|
| Rate for Payer: Cigna of CA PPO |
$28.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.94
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$4.40
|
| Rate for Payer: Galaxy Health WC |
$33.15
|
| Rate for Payer: Global Benefits Group Commercial |
$23.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$35.10
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$29.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7.22
|
| Rate for Payer: IEHP medi-cal |
$7.26
|
| Rate for Payer: IEHP Medicare Advantage |
$4.40
|
| Rate for Payer: Innovage PACE Commercial |
$6.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$26.01
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5.90
|
| Rate for Payer: Multiplan Commercial |
$29.25
|
| Rate for Payer: Networks By Design Commercial |
$25.35
|
| Rate for Payer: Prime Health Services Commercial |
$33.15
|
| Rate for Payer: Prime Health Services Medicare |
$4.66
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$23.40
|
| Rate for Payer: Riverside University Health MISP |
$4.84
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$23.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$23.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.56
|
| Rate for Payer: United Healthcare All Other HMO |
$3.56
|
| Rate for Payer: United Healthcare HMO Rider |
$3.56
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.56
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4.84
|
| Rate for Payer: Vantage Medical Group Senior |
$4.40
|
|
|
HC SYPHILIS TOTAL
|
Facility
IP
|
$58.00
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
900913674
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.60 |
| Max. Negotiated Rate |
$52.20 |
| Rate for Payer: Cash Price |
$26.10
|
| Rate for Payer: Central Health Plan Commercial |
$46.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$23.20
|
| Rate for Payer: Galaxy Health WC |
$49.30
|
| Rate for Payer: Global Benefits Group Commercial |
$34.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$52.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$38.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.60
|
| Rate for Payer: Multiplan Commercial |
$43.50
|
| Rate for Payer: Networks By Design Commercial |
$37.70
|
| Rate for Payer: Prime Health Services Commercial |
$49.30
|
|
|
HC SYPHILIS TOTAL
|
Facility
OP
|
$39.00
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
900913674
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.80 |
| Max. Negotiated Rate |
$207.60 |
| Rate for Payer: Adventist Health Medi-Cal |
$11.53
|
| Rate for Payer: Aetna of CA HMO/PPO |
$68.17
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$17.30
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$12.68
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$11.53
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$170.20
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$207.60
|
| Rate for Payer: BCBS Transplant Transplant |
$23.40
|
| Rate for Payer: Blue Shield of California Commercial |
$24.10
|
| Rate for Payer: Blue Shield of California EPN |
$18.95
|
| Rate for Payer: Caremore Medicare Advantage |
$11.53
|
| Rate for Payer: Cash Price |
$17.55
|
| Rate for Payer: Cash Price |
$17.55
|
| Rate for Payer: Central Health Plan Commercial |
$31.20
|
| Rate for Payer: Cigna of CA HMO |
$24.96
|
| Rate for Payer: Cigna of CA PPO |
$28.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$17.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.57
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$11.53
|
| Rate for Payer: EPIC Health Plan Transplant |
$11.53
|
| Rate for Payer: Galaxy Health WC |
$33.15
|
| Rate for Payer: Global Benefits Group Commercial |
$23.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$35.10
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$29.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$18.91
|
| Rate for Payer: IEHP medi-cal |
$19.02
|
| Rate for Payer: IEHP Medicare Advantage |
$11.53
|
| Rate for Payer: Innovage PACE Commercial |
$17.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$26.01
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$11.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$15.45
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$15.45
|
| Rate for Payer: Multiplan Commercial |
$29.25
|
| Rate for Payer: Networks By Design Commercial |
$25.35
|
| Rate for Payer: Prime Health Services Commercial |
$33.15
|
| Rate for Payer: Prime Health Services Medicare |
$12.22
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$23.40
|
| Rate for Payer: Riverside University Health MISP |
$12.68
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$23.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$23.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.34
|
| Rate for Payer: United Healthcare All Other HMO |
$9.34
|
| Rate for Payer: United Healthcare HMO Rider |
$9.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.34
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$17.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$12.68
|
| Rate for Payer: Vantage Medical Group Senior |
$11.53
|
|
|
HC SYPHILLIS IGG
|
Facility
OP
|
$26.00
|
|
|
Service Code
|
CPT 86780
|
| Hospital Charge Code |
900913561
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.20 |
| Max. Negotiated Rate |
$153.95 |
| Rate for Payer: Adventist Health Medi-Cal |
$13.24
|
| Rate for Payer: Aetna of CA HMO/PPO |
$97.19
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$19.86
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$14.56
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$13.24
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$126.21
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$153.95
|
| Rate for Payer: BCBS Transplant Transplant |
$15.60
|
| Rate for Payer: Blue Shield of California Commercial |
$16.07
|
| Rate for Payer: Blue Shield of California EPN |
$12.64
|
| Rate for Payer: Caremore Medicare Advantage |
$13.24
|
| Rate for Payer: Cash Price |
$11.70
|
| Rate for Payer: Cash Price |
$11.70
|
| Rate for Payer: Central Health Plan Commercial |
$20.80
|
| Rate for Payer: Cigna of CA HMO |
$16.64
|
| Rate for Payer: Cigna of CA PPO |
$19.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$17.87
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$13.24
|
| Rate for Payer: EPIC Health Plan Transplant |
$13.24
|
| Rate for Payer: Galaxy Health WC |
$22.10
|
| Rate for Payer: Global Benefits Group Commercial |
$15.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$23.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$19.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$21.71
|
| Rate for Payer: IEHP medi-cal |
$21.85
|
| Rate for Payer: IEHP Medicare Advantage |
$13.24
|
| Rate for Payer: Innovage PACE Commercial |
$19.86
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17.74
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17.74
|
| Rate for Payer: Multiplan Commercial |
$19.50
|
| Rate for Payer: Networks By Design Commercial |
$16.90
|
| Rate for Payer: Prime Health Services Commercial |
$22.10
|
| Rate for Payer: Prime Health Services Medicare |
$14.03
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$15.60
|
| Rate for Payer: Riverside University Health MISP |
$14.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$15.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.73
|
| Rate for Payer: United Healthcare All Other HMO |
$10.73
|
| Rate for Payer: United Healthcare HMO Rider |
$10.73
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.73
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.86
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.56
|
| Rate for Payer: Vantage Medical Group Senior |
$13.24
|
|
|
HC SYPHILLIS IGG
|
Facility
IP
|
$137.00
|
|
|
Service Code
|
CPT 86780
|
| Hospital Charge Code |
900913561
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$27.40 |
| Max. Negotiated Rate |
$123.30 |
| Rate for Payer: Cash Price |
$61.65
|
| Rate for Payer: Central Health Plan Commercial |
$109.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$54.80
|
| Rate for Payer: Galaxy Health WC |
$116.45
|
| Rate for Payer: Global Benefits Group Commercial |
$82.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$123.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$91.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27.40
|
| Rate for Payer: Multiplan Commercial |
$102.75
|
| Rate for Payer: Networks By Design Commercial |
$89.05
|
| Rate for Payer: Prime Health Services Commercial |
$116.45
|
|
|
HC SYPHILLIS IGG INDIVIDUAL
|
Facility
OP
|
$137.00
|
|
|
Service Code
|
CPT 86780
|
| Hospital Charge Code |
900913563
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.73 |
| Max. Negotiated Rate |
$153.95 |
| Rate for Payer: Adventist Health Medi-Cal |
$13.24
|
| Rate for Payer: Aetna of CA HMO/PPO |
$97.19
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$19.86
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$14.56
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$13.24
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$126.21
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$153.95
|
| Rate for Payer: BCBS Transplant Transplant |
$82.20
|
| Rate for Payer: Blue Shield of California Commercial |
$84.67
|
| Rate for Payer: Blue Shield of California EPN |
$66.58
|
| Rate for Payer: Caremore Medicare Advantage |
$13.24
|
| Rate for Payer: Cash Price |
$61.65
|
| Rate for Payer: Cash Price |
$61.65
|
| Rate for Payer: Central Health Plan Commercial |
$109.60
|
| Rate for Payer: Cigna of CA HMO |
$87.68
|
| Rate for Payer: Cigna of CA PPO |
$101.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$17.87
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$13.24
|
| Rate for Payer: EPIC Health Plan Transplant |
$13.24
|
| Rate for Payer: Galaxy Health WC |
$116.45
|
| Rate for Payer: Global Benefits Group Commercial |
$82.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$123.30
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$102.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$21.71
|
| Rate for Payer: IEHP medi-cal |
$21.85
|
| Rate for Payer: IEHP Medicare Advantage |
$13.24
|
| Rate for Payer: Innovage PACE Commercial |
$19.86
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$91.38
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17.74
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17.74
|
| Rate for Payer: Multiplan Commercial |
$102.75
|
| Rate for Payer: Networks By Design Commercial |
$89.05
|
| Rate for Payer: Prime Health Services Commercial |
$116.45
|
| Rate for Payer: Prime Health Services Medicare |
$14.03
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$82.20
|
| Rate for Payer: Riverside University Health MISP |
$14.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$82.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$82.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.73
|
| Rate for Payer: United Healthcare All Other HMO |
$10.73
|
| Rate for Payer: United Healthcare HMO Rider |
$10.73
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.73
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.86
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.56
|
| Rate for Payer: Vantage Medical Group Senior |
$13.24
|
|
|
HC SYPHILLIS IGG INDIVIDUAL
|
Facility
IP
|
$137.00
|
|
|
Service Code
|
CPT 86780
|
| Hospital Charge Code |
900913563
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$27.40 |
| Max. Negotiated Rate |
$123.30 |
| Rate for Payer: Cash Price |
$61.65
|
| Rate for Payer: Central Health Plan Commercial |
$109.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$54.80
|
| Rate for Payer: Galaxy Health WC |
$116.45
|
| Rate for Payer: Global Benefits Group Commercial |
$82.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$123.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$91.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27.40
|
| Rate for Payer: Multiplan Commercial |
$102.75
|
| Rate for Payer: Networks By Design Commercial |
$89.05
|
| Rate for Payer: Prime Health Services Commercial |
$116.45
|
|
|
HC SYPHILLIS TEST RPR
|
Facility
OP
|
$12.00
|
|
|
Service Code
|
CPT 86592
|
| Hospital Charge Code |
900910892
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.40 |
| Max. Negotiated Rate |
$37.88 |
| Rate for Payer: Adventist Health Medi-Cal |
$4.27
|
| Rate for Payer: Aetna of CA HMO/PPO |
$31.35
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$6.40
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4.70
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$4.27
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$31.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$37.88
|
| Rate for Payer: BCBS Transplant Transplant |
$7.20
|
| Rate for Payer: Blue Shield of California Commercial |
$7.42
|
| Rate for Payer: Blue Shield of California EPN |
$5.83
|
| Rate for Payer: Caremore Medicare Advantage |
$4.27
|
| Rate for Payer: Cash Price |
$5.40
|
| Rate for Payer: Cash Price |
$5.40
|
| Rate for Payer: Central Health Plan Commercial |
$9.60
|
| Rate for Payer: Cigna of CA HMO |
$7.68
|
| Rate for Payer: Cigna of CA PPO |
$8.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.76
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4.27
|
| Rate for Payer: EPIC Health Plan Transplant |
$4.27
|
| Rate for Payer: Galaxy Health WC |
$10.20
|
| Rate for Payer: Global Benefits Group Commercial |
$7.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$10.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$9.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7.00
|
| Rate for Payer: IEHP medi-cal |
$7.05
|
| Rate for Payer: IEHP Medicare Advantage |
$4.27
|
| Rate for Payer: Innovage PACE Commercial |
$6.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5.72
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5.72
|
| Rate for Payer: Multiplan Commercial |
$9.00
|
| Rate for Payer: Networks By Design Commercial |
$7.80
|
| Rate for Payer: Prime Health Services Commercial |
$10.20
|
| Rate for Payer: Prime Health Services Medicare |
$4.53
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$7.20
|
| Rate for Payer: Riverside University Health MISP |
$4.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.46
|
| Rate for Payer: United Healthcare All Other HMO |
$3.46
|
| Rate for Payer: United Healthcare HMO Rider |
$3.46
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4.70
|
| Rate for Payer: Vantage Medical Group Senior |
$4.27
|
|
|
HC SYPHILLIS TEST RPR
|
Facility
IP
|
$137.00
|
|
|
Service Code
|
CPT 86592
|
| Hospital Charge Code |
900910892
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$27.40 |
| Max. Negotiated Rate |
$123.30 |
| Rate for Payer: Cash Price |
$61.65
|
| Rate for Payer: Central Health Plan Commercial |
$109.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$54.80
|
| Rate for Payer: Galaxy Health WC |
$116.45
|
| Rate for Payer: Global Benefits Group Commercial |
$82.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$123.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$91.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27.40
|
| Rate for Payer: Multiplan Commercial |
$102.75
|
| Rate for Payer: Networks By Design Commercial |
$89.05
|
| Rate for Payer: Prime Health Services Commercial |
$116.45
|
|
|
HC SYPHILLIS TEST RPR INDIVIDUAL
|
Facility
OP
|
$12.00
|
|
|
Service Code
|
CPT 86592
|
| Hospital Charge Code |
900912331
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.40 |
| Max. Negotiated Rate |
$37.88 |
| Rate for Payer: Adventist Health Medi-Cal |
$4.27
|
| Rate for Payer: Aetna of CA HMO/PPO |
$31.35
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$6.40
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4.70
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$4.27
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$31.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$37.88
|
| Rate for Payer: BCBS Transplant Transplant |
$7.20
|
| Rate for Payer: Blue Shield of California Commercial |
$7.42
|
| Rate for Payer: Blue Shield of California EPN |
$5.83
|
| Rate for Payer: Caremore Medicare Advantage |
$4.27
|
| Rate for Payer: Cash Price |
$5.40
|
| Rate for Payer: Cash Price |
$5.40
|
| Rate for Payer: Central Health Plan Commercial |
$9.60
|
| Rate for Payer: Cigna of CA HMO |
$7.68
|
| Rate for Payer: Cigna of CA PPO |
$8.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.76
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4.27
|
| Rate for Payer: EPIC Health Plan Transplant |
$4.27
|
| Rate for Payer: Galaxy Health WC |
$10.20
|
| Rate for Payer: Global Benefits Group Commercial |
$7.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$10.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$9.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7.00
|
| Rate for Payer: IEHP medi-cal |
$7.05
|
| Rate for Payer: IEHP Medicare Advantage |
$4.27
|
| Rate for Payer: Innovage PACE Commercial |
$6.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5.72
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5.72
|
| Rate for Payer: Multiplan Commercial |
$9.00
|
| Rate for Payer: Networks By Design Commercial |
$7.80
|
| Rate for Payer: Prime Health Services Commercial |
$10.20
|
| Rate for Payer: Prime Health Services Medicare |
$4.53
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$7.20
|
| Rate for Payer: Riverside University Health MISP |
$4.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.46
|
| Rate for Payer: United Healthcare All Other HMO |
$3.46
|
| Rate for Payer: United Healthcare HMO Rider |
$3.46
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4.70
|
| Rate for Payer: Vantage Medical Group Senior |
$4.27
|
|
|
HC SYPHILLIS TEST RPR INDIVIDUAL
|
Facility
IP
|
$137.00
|
|
|
Service Code
|
CPT 86592
|
| Hospital Charge Code |
900912331
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$27.40 |
| Max. Negotiated Rate |
$123.30 |
| Rate for Payer: Cash Price |
$61.65
|
| Rate for Payer: Central Health Plan Commercial |
$109.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$54.80
|
| Rate for Payer: Galaxy Health WC |
$116.45
|
| Rate for Payer: Global Benefits Group Commercial |
$82.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$123.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$91.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27.40
|
| Rate for Payer: Multiplan Commercial |
$102.75
|
| Rate for Payer: Networks By Design Commercial |
$89.05
|
| Rate for Payer: Prime Health Services Commercial |
$116.45
|
|
|
HC SYPHILLIS TEST VDRL/ CSF
|
Facility
IP
|
$137.00
|
|
|
Service Code
|
CPT 86592
|
| Hospital Charge Code |
900910861
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$27.40 |
| Max. Negotiated Rate |
$123.30 |
| Rate for Payer: Cash Price |
$61.65
|
| Rate for Payer: Central Health Plan Commercial |
$109.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$54.80
|
| Rate for Payer: Galaxy Health WC |
$116.45
|
| Rate for Payer: Global Benefits Group Commercial |
$82.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$123.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$91.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27.40
|
| Rate for Payer: Multiplan Commercial |
$102.75
|
| Rate for Payer: Networks By Design Commercial |
$89.05
|
| Rate for Payer: Prime Health Services Commercial |
$116.45
|
|
|
HC SYPHILLIS TEST VDRL/ CSF
|
Facility
OP
|
$17.00
|
|
|
Service Code
|
CPT 86592
|
| Hospital Charge Code |
900910861
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.40 |
| Max. Negotiated Rate |
$37.88 |
| Rate for Payer: Adventist Health Medi-Cal |
$4.27
|
| Rate for Payer: Aetna of CA HMO/PPO |
$31.35
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$6.40
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4.70
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$4.27
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$31.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$37.88
|
| 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 |
$4.27
|
| 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 |
$6.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.76
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4.27
|
| Rate for Payer: EPIC Health Plan Transplant |
$4.27
|
| 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 |
$7.00
|
| Rate for Payer: IEHP medi-cal |
$7.05
|
| Rate for Payer: IEHP Medicare Advantage |
$4.27
|
| Rate for Payer: Innovage PACE Commercial |
$6.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5.72
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5.72
|
| 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 |
$4.53
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$10.20
|
| Rate for Payer: Riverside University Health MISP |
$4.70
|
| 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 |
$3.46
|
| Rate for Payer: United Healthcare All Other HMO |
$3.46
|
| Rate for Payer: United Healthcare HMO Rider |
$3.46
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4.70
|
| Rate for Payer: Vantage Medical Group Senior |
$4.27
|
|
|
HC SYSTEM NASAL TUBE RTNR 12-14FR
|
Facility
IP
|
$580.00
|
|
| Hospital Charge Code |
901698433
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$522.00 |
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Central Health Plan Commercial |
$464.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: Galaxy Health WC |
$493.00
|
| Rate for Payer: Global Benefits Group Commercial |
$348.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$522.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$386.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$116.00
|
| Rate for Payer: Multiplan Commercial |
$435.00
|
| Rate for Payer: Networks By Design Commercial |
$377.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
|
|
HC SYSTEM NASAL TUBE RTNR 12-14FR
|
Facility
OP
|
$580.00
|
|
| Hospital Charge Code |
901698433
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$522.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$352.23
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$493.00
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$319.00
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$319.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$280.84
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$342.66
|
| Rate for Payer: BCBS Transplant Transplant |
$348.00
|
| Rate for Payer: Blue Shield of California Commercial |
$364.82
|
| Rate for Payer: Blue Shield of California EPN |
$283.62
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Central Health Plan Commercial |
$464.00
|
| Rate for Payer: Cigna of CA HMO |
$371.20
|
| Rate for Payer: Cigna of CA PPO |
$429.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$493.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$232.00
|
| Rate for Payer: Galaxy Health WC |
$493.00
|
| Rate for Payer: Global Benefits Group Commercial |
$348.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$522.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$435.00
|
| Rate for Payer: IEHP medi-cal |
$203.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$386.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$116.00
|
| Rate for Payer: Multiplan Commercial |
$435.00
|
| Rate for Payer: Networks By Design Commercial |
$377.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$348.00
|
| Rate for Payer: Riverside University Health MISP |
$232.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$348.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$348.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$290.00
|
| Rate for Payer: United Healthcare All Other HMO |
$290.00
|
| Rate for Payer: United Healthcare HMO Rider |
$290.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$290.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$493.00
|
| Rate for Payer: Vantage Medical Group Senior |
$493.00
|
|
|
HC SYSTEM NASAL TUBE RTNR 16-18FR
|
Facility
IP
|
$624.77
|
|
| Hospital Charge Code |
901698599
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$124.95 |
| Max. Negotiated Rate |
$562.29 |
| Rate for Payer: Cash Price |
$281.15
|
| Rate for Payer: Central Health Plan Commercial |
$499.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$249.91
|
| Rate for Payer: Galaxy Health WC |
$531.05
|
| Rate for Payer: Global Benefits Group Commercial |
$374.86
|
| Rate for Payer: Health Management Network EPO/PPO |
$562.29
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$416.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$124.95
|
| Rate for Payer: Multiplan Commercial |
$468.58
|
| Rate for Payer: Networks By Design Commercial |
$406.10
|
| Rate for Payer: Prime Health Services Commercial |
$531.05
|
|
|
HC SYSTEM NASAL TUBE RTNR 16-18FR
|
Facility
OP
|
$624.77
|
|
| Hospital Charge Code |
901698599
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$124.95 |
| Max. Negotiated Rate |
$562.29 |
| Rate for Payer: Aetna of CA HMO/PPO |
$379.42
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$531.05
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$343.62
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$343.62
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$302.51
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$369.11
|
| Rate for Payer: BCBS Transplant Transplant |
$374.86
|
| Rate for Payer: Blue Shield of California Commercial |
$392.98
|
| Rate for Payer: Blue Shield of California EPN |
$305.51
|
| Rate for Payer: Cash Price |
$281.15
|
| Rate for Payer: Central Health Plan Commercial |
$499.82
|
| Rate for Payer: Cigna of CA HMO |
$399.85
|
| Rate for Payer: Cigna of CA PPO |
$462.33
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$531.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$249.91
|
| Rate for Payer: EPIC Health Plan Transplant |
$249.91
|
| Rate for Payer: Galaxy Health WC |
$531.05
|
| Rate for Payer: Global Benefits Group Commercial |
$374.86
|
| Rate for Payer: Health Management Network EPO/PPO |
$562.29
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$468.58
|
| Rate for Payer: IEHP medi-cal |
$218.67
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$416.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$124.95
|
| Rate for Payer: Multiplan Commercial |
$468.58
|
| Rate for Payer: Networks By Design Commercial |
$406.10
|
| Rate for Payer: Prime Health Services Commercial |
$531.05
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$374.86
|
| Rate for Payer: Riverside University Health MISP |
$249.91
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$374.86
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$374.86
|
| Rate for Payer: United Healthcare All Other Commercial |
$312.38
|
| Rate for Payer: United Healthcare All Other HMO |
$312.38
|
| Rate for Payer: United Healthcare HMO Rider |
$312.38
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$312.38
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$531.05
|
| Rate for Payer: Vantage Medical Group Senior |
$531.05
|
|
|
HC SYSTEM NASAL TUBE RTNR 8-10FR
|
Facility
IP
|
$588.34
|
|
| Hospital Charge Code |
901698432
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$117.67 |
| Max. Negotiated Rate |
$529.51 |
| Rate for Payer: Cash Price |
$264.75
|
| Rate for Payer: Central Health Plan Commercial |
$470.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$235.34
|
| Rate for Payer: Galaxy Health WC |
$500.09
|
| Rate for Payer: Global Benefits Group Commercial |
$353.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$529.51
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$392.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$117.67
|
| Rate for Payer: Multiplan Commercial |
$441.26
|
| Rate for Payer: Networks By Design Commercial |
$382.42
|
| Rate for Payer: Prime Health Services Commercial |
$500.09
|
|
|
HC SYSTEM NASAL TUBE RTNR 8-10FR
|
Facility
OP
|
$588.34
|
|
| Hospital Charge Code |
901698432
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$117.67 |
| Max. Negotiated Rate |
$529.51 |
| Rate for Payer: Aetna of CA HMO/PPO |
$357.30
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$500.09
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$323.59
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$323.59
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$284.87
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$347.59
|
| Rate for Payer: BCBS Transplant Transplant |
$353.00
|
| Rate for Payer: Blue Shield of California Commercial |
$370.07
|
| Rate for Payer: Blue Shield of California EPN |
$287.70
|
| Rate for Payer: Cash Price |
$264.75
|
| Rate for Payer: Central Health Plan Commercial |
$470.67
|
| Rate for Payer: Cigna of CA HMO |
$376.54
|
| Rate for Payer: Cigna of CA PPO |
$435.37
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$500.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$235.34
|
| Rate for Payer: EPIC Health Plan Transplant |
$235.34
|
| Rate for Payer: Galaxy Health WC |
$500.09
|
| Rate for Payer: Global Benefits Group Commercial |
$353.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$529.51
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$441.26
|
| Rate for Payer: IEHP medi-cal |
$205.92
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$392.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$117.67
|
| Rate for Payer: Multiplan Commercial |
$441.26
|
| Rate for Payer: Networks By Design Commercial |
$382.42
|
| Rate for Payer: Prime Health Services Commercial |
$500.09
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$353.00
|
| Rate for Payer: Riverside University Health MISP |
$235.34
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$353.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$353.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$294.17
|
| Rate for Payer: United Healthcare All Other HMO |
$294.17
|
| Rate for Payer: United Healthcare HMO Rider |
$294.17
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$294.17
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$500.09
|
| Rate for Payer: Vantage Medical Group Senior |
$500.09
|
|
|
HC SYTM TORTLEAIR HEAD REPOSITIONING LRG 41-46CM
|
Facility
OP
|
$176.75
|
|
| Hospital Charge Code |
901607217
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$35.35 |
| Max. Negotiated Rate |
$159.08 |
| Rate for Payer: Aetna of CA HMO/PPO |
$107.34
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$150.24
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$97.21
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$97.21
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$85.58
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$104.42
|
| Rate for Payer: BCBS Transplant Transplant |
$106.05
|
| Rate for Payer: Blue Shield of California Commercial |
$111.18
|
| Rate for Payer: Blue Shield of California EPN |
$86.43
|
| Rate for Payer: Cash Price |
$79.54
|
| Rate for Payer: Central Health Plan Commercial |
$141.40
|
| Rate for Payer: Cigna of CA HMO |
$113.12
|
| Rate for Payer: Cigna of CA PPO |
$130.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$150.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$70.70
|
| Rate for Payer: EPIC Health Plan Transplant |
$70.70
|
| Rate for Payer: Galaxy Health WC |
$150.24
|
| Rate for Payer: Global Benefits Group Commercial |
$106.05
|
| Rate for Payer: Health Management Network EPO/PPO |
$159.08
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$132.56
|
| Rate for Payer: IEHP medi-cal |
$61.86
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$117.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$35.35
|
| Rate for Payer: Multiplan Commercial |
$132.56
|
| Rate for Payer: Networks By Design Commercial |
$114.89
|
| Rate for Payer: Prime Health Services Commercial |
$150.24
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$106.05
|
| Rate for Payer: Riverside University Health MISP |
$70.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$106.05
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$106.05
|
| Rate for Payer: United Healthcare All Other Commercial |
$88.38
|
| Rate for Payer: United Healthcare All Other HMO |
$88.38
|
| Rate for Payer: United Healthcare HMO Rider |
$88.38
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$88.38
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$150.24
|
| Rate for Payer: Vantage Medical Group Senior |
$150.24
|
|
|
HC SYTM TORTLEAIR HEAD REPOSITIONING LRG 41-46CM
|
Facility
IP
|
$176.75
|
|
| Hospital Charge Code |
901607217
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$35.35 |
| Max. Negotiated Rate |
$159.08 |
| Rate for Payer: Cash Price |
$79.54
|
| Rate for Payer: Central Health Plan Commercial |
$141.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$70.70
|
| Rate for Payer: Galaxy Health WC |
$150.24
|
| Rate for Payer: Global Benefits Group Commercial |
$106.05
|
| Rate for Payer: Health Management Network EPO/PPO |
$159.08
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$117.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$35.35
|
| Rate for Payer: Multiplan Commercial |
$132.56
|
| Rate for Payer: Networks By Design Commercial |
$114.89
|
| Rate for Payer: Prime Health Services Commercial |
$150.24
|
|
|
HC SYTM TORTLEAIR HEAD REPOSITIONING MED 38-41CM
|
Facility
OP
|
$183.75
|
|
| Hospital Charge Code |
901607216
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$36.75 |
| Max. Negotiated Rate |
$165.38 |
| Rate for Payer: Aetna of CA HMO/PPO |
$111.59
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$156.19
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$101.06
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$101.06
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$88.97
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$108.56
|
| Rate for Payer: BCBS Transplant Transplant |
$110.25
|
| Rate for Payer: Blue Shield of California Commercial |
$115.58
|
| Rate for Payer: Blue Shield of California EPN |
$89.85
|
| Rate for Payer: Cash Price |
$82.69
|
| Rate for Payer: Central Health Plan Commercial |
$147.00
|
| Rate for Payer: Cigna of CA HMO |
$117.60
|
| Rate for Payer: Cigna of CA PPO |
$135.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$156.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$73.50
|
| Rate for Payer: EPIC Health Plan Transplant |
$73.50
|
| Rate for Payer: Galaxy Health WC |
$156.19
|
| Rate for Payer: Global Benefits Group Commercial |
$110.25
|
| Rate for Payer: Health Management Network EPO/PPO |
$165.38
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$137.81
|
| Rate for Payer: IEHP medi-cal |
$64.31
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$122.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$36.75
|
| Rate for Payer: Multiplan Commercial |
$137.81
|
| Rate for Payer: Networks By Design Commercial |
$119.44
|
| Rate for Payer: Prime Health Services Commercial |
$156.19
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$110.25
|
| Rate for Payer: Riverside University Health MISP |
$73.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$110.25
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$110.25
|
| Rate for Payer: United Healthcare All Other Commercial |
$91.88
|
| Rate for Payer: United Healthcare All Other HMO |
$91.88
|
| Rate for Payer: United Healthcare HMO Rider |
$91.88
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$91.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$156.19
|
| Rate for Payer: Vantage Medical Group Senior |
$156.19
|
|
|
HC SYTM TORTLEAIR HEAD REPOSITIONING MED 38-41CM
|
Facility
IP
|
$183.75
|
|
| Hospital Charge Code |
901607216
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$36.75 |
| Max. Negotiated Rate |
$165.38 |
| Rate for Payer: Cash Price |
$82.69
|
| Rate for Payer: Central Health Plan Commercial |
$147.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$73.50
|
| Rate for Payer: Galaxy Health WC |
$156.19
|
| Rate for Payer: Global Benefits Group Commercial |
$110.25
|
| Rate for Payer: Health Management Network EPO/PPO |
$165.38
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$122.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$36.75
|
| Rate for Payer: Multiplan Commercial |
$137.81
|
| Rate for Payer: Networks By Design Commercial |
$119.44
|
| Rate for Payer: Prime Health Services Commercial |
$156.19
|
|
|
HC SYTM TORTLEAIR HEAD REPOSITIONING SM 33-38CM
|
Facility
OP
|
$183.75
|
|
| Hospital Charge Code |
901607215
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$36.75 |
| Max. Negotiated Rate |
$165.38 |
| Rate for Payer: Aetna of CA HMO/PPO |
$111.59
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$156.19
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$101.06
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$101.06
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$88.97
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$108.56
|
| Rate for Payer: BCBS Transplant Transplant |
$110.25
|
| Rate for Payer: Blue Shield of California Commercial |
$115.58
|
| Rate for Payer: Blue Shield of California EPN |
$89.85
|
| Rate for Payer: Cash Price |
$82.69
|
| Rate for Payer: Central Health Plan Commercial |
$147.00
|
| Rate for Payer: Cigna of CA HMO |
$117.60
|
| Rate for Payer: Cigna of CA PPO |
$135.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$156.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$73.50
|
| Rate for Payer: EPIC Health Plan Transplant |
$73.50
|
| Rate for Payer: Galaxy Health WC |
$156.19
|
| Rate for Payer: Global Benefits Group Commercial |
$110.25
|
| Rate for Payer: Health Management Network EPO/PPO |
$165.38
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$137.81
|
| Rate for Payer: IEHP medi-cal |
$64.31
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$122.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$36.75
|
| Rate for Payer: Multiplan Commercial |
$137.81
|
| Rate for Payer: Networks By Design Commercial |
$119.44
|
| Rate for Payer: Prime Health Services Commercial |
$156.19
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$110.25
|
| Rate for Payer: Riverside University Health MISP |
$73.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$110.25
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$110.25
|
| Rate for Payer: United Healthcare All Other Commercial |
$91.88
|
| Rate for Payer: United Healthcare All Other HMO |
$91.88
|
| Rate for Payer: United Healthcare HMO Rider |
$91.88
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$91.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$156.19
|
| Rate for Payer: Vantage Medical Group Senior |
$156.19
|
|
