|
HC TORSION CONTROL KNEE JOINT ADDITION LE
|
Facility
IP
|
$200.00
|
|
|
Service Code
|
CPT L2380
|
| Hospital Charge Code |
905352380
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$40.00 |
| Max. Negotiated Rate |
$180.00 |
| Rate for Payer: Blue Shield of California EPN |
$106.80
|
| Rate for Payer: Cash Price |
$90.00
|
| Rate for Payer: Central Health Plan Commercial |
$160.00
|
| Rate for Payer: Cigna of CA HMO |
$140.00
|
| Rate for Payer: Cigna of CA PPO |
$140.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$80.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$80.00
|
| Rate for Payer: Galaxy Health WC |
$170.00
|
| Rate for Payer: Global Benefits Group Commercial |
$120.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$180.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$133.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$40.00
|
| Rate for Payer: Multiplan Commercial |
$150.00
|
| Rate for Payer: Networks By Design Commercial |
$100.00
|
| Rate for Payer: Prime Health Services Commercial |
$170.00
|
|
|
HC TORSION MECHANISM KNEE/ANKLE
|
Facility
OP
|
$400.00
|
|
|
Service Code
|
CPT L2861
|
| Hospital Charge Code |
905352861
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$140.00 |
| Max. Negotiated Rate |
$950.60 |
| Rate for Payer: Aetna of CA HMO/PPO |
$950.60
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$340.00
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$220.00
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$220.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$193.68
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$236.32
|
| Rate for Payer: BCBS Transplant Transplant |
$240.00
|
| Rate for Payer: Blue Shield of California Commercial |
$300.00
|
| Rate for Payer: Blue Shield of California EPN |
$217.60
|
| Rate for Payer: Cash Price |
$180.00
|
| Rate for Payer: Cash Price |
$180.00
|
| Rate for Payer: Central Health Plan Commercial |
$320.00
|
| Rate for Payer: Cigna of CA HMO |
$280.00
|
| Rate for Payer: Cigna of CA PPO |
$280.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$340.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$160.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$160.00
|
| Rate for Payer: Galaxy Health WC |
$340.00
|
| Rate for Payer: Global Benefits Group Commercial |
$240.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$360.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$300.00
|
| Rate for Payer: IEHP medi-cal |
$140.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$266.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$164.00
|
| Rate for Payer: Multiplan Commercial |
$300.00
|
| Rate for Payer: Networks By Design Commercial |
$200.00
|
| Rate for Payer: Prime Health Services Commercial |
$340.00
|
| Rate for Payer: Riverside University Health MISP |
$160.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$240.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$240.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$200.00
|
| Rate for Payer: United Healthcare All Other HMO |
$200.00
|
| Rate for Payer: United Healthcare HMO Rider |
$200.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$200.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$340.00
|
| Rate for Payer: Vantage Medical Group Senior |
$340.00
|
|
|
HC TORSION MECHANISM KNEE/ANKLE
|
Facility
IP
|
$400.00
|
|
|
Service Code
|
CPT L2861
|
| Hospital Charge Code |
905352861
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$80.00 |
| Max. Negotiated Rate |
$360.00 |
| Rate for Payer: Blue Shield of California EPN |
$213.60
|
| Rate for Payer: Cash Price |
$180.00
|
| Rate for Payer: Central Health Plan Commercial |
$320.00
|
| Rate for Payer: Cigna of CA HMO |
$280.00
|
| Rate for Payer: Cigna of CA PPO |
$280.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$160.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$160.00
|
| Rate for Payer: Galaxy Health WC |
$340.00
|
| Rate for Payer: Global Benefits Group Commercial |
$240.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$360.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$266.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$80.00
|
| Rate for Payer: Multiplan Commercial |
$300.00
|
| Rate for Payer: Networks By Design Commercial |
$200.00
|
| Rate for Payer: Prime Health Services Commercial |
$340.00
|
|
|
HC TORSION MECHANISM WRIST ELBOW
|
Facility
IP
|
$400.00
|
|
|
Service Code
|
CPT L3891
|
| Hospital Charge Code |
905353891
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$80.00 |
| Max. Negotiated Rate |
$360.00 |
| Rate for Payer: Blue Shield of California EPN |
$213.60
|
| Rate for Payer: Cash Price |
$180.00
|
| Rate for Payer: Central Health Plan Commercial |
$320.00
|
| Rate for Payer: Cigna of CA HMO |
$280.00
|
| Rate for Payer: Cigna of CA PPO |
$280.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$160.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$160.00
|
| Rate for Payer: Galaxy Health WC |
$340.00
|
| Rate for Payer: Global Benefits Group Commercial |
$240.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$360.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$266.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$80.00
|
| Rate for Payer: Multiplan Commercial |
$300.00
|
| Rate for Payer: Networks By Design Commercial |
$200.00
|
| Rate for Payer: Prime Health Services Commercial |
$340.00
|
|
|
HC TORSION MECHANISM WRIST ELBOW
|
Facility
OP
|
$400.00
|
|
|
Service Code
|
CPT L3891
|
| Hospital Charge Code |
905353891
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$140.00 |
| Max. Negotiated Rate |
$1,265.18 |
| Rate for Payer: Aetna of CA HMO/PPO |
$1,265.18
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$340.00
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$220.00
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$220.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$193.68
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$236.32
|
| Rate for Payer: BCBS Transplant Transplant |
$240.00
|
| Rate for Payer: Blue Shield of California Commercial |
$300.00
|
| Rate for Payer: Blue Shield of California EPN |
$217.60
|
| Rate for Payer: Cash Price |
$180.00
|
| Rate for Payer: Cash Price |
$180.00
|
| Rate for Payer: Central Health Plan Commercial |
$320.00
|
| Rate for Payer: Cigna of CA HMO |
$280.00
|
| Rate for Payer: Cigna of CA PPO |
$280.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$340.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$160.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$160.00
|
| Rate for Payer: Galaxy Health WC |
$340.00
|
| Rate for Payer: Global Benefits Group Commercial |
$240.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$360.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$300.00
|
| Rate for Payer: IEHP medi-cal |
$140.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$266.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$164.00
|
| Rate for Payer: Multiplan Commercial |
$300.00
|
| Rate for Payer: Networks By Design Commercial |
$200.00
|
| Rate for Payer: Prime Health Services Commercial |
$340.00
|
| Rate for Payer: Riverside University Health MISP |
$160.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$240.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$240.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$200.00
|
| Rate for Payer: United Healthcare All Other HMO |
$200.00
|
| Rate for Payer: United Healthcare HMO Rider |
$200.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$200.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$340.00
|
| Rate for Payer: Vantage Medical Group Senior |
$340.00
|
|
|
HC TOTAL BODY THYROID SCAN
|
Facility
OP
|
$4,679.00
|
|
|
Service Code
|
CPT 78018
|
| Hospital Charge Code |
909301317
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$675.33 |
| Max. Negotiated Rate |
$4,211.10 |
| Rate for Payer: Adventist Health Medi-Cal |
$675.33
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,553.99
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,013.00
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$742.86
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$675.33
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$985.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,764.35
|
| Rate for Payer: BCBS Transplant Transplant |
$2,807.40
|
| Rate for Payer: Blue Shield of California Commercial |
$2,891.62
|
| Rate for Payer: Blue Shield of California EPN |
$2,273.99
|
| Rate for Payer: Caremore Medicare Advantage |
$675.33
|
| Rate for Payer: Cash Price |
$2,105.55
|
| Rate for Payer: Cash Price |
$2,105.55
|
| Rate for Payer: Central Health Plan Commercial |
$3,743.20
|
| Rate for Payer: Cigna of CA HMO |
$2,994.56
|
| Rate for Payer: Cigna of CA PPO |
$3,462.46
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,013.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$911.70
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$675.33
|
| Rate for Payer: EPIC Health Plan Transplant |
$675.33
|
| Rate for Payer: Galaxy Health WC |
$3,977.15
|
| Rate for Payer: Global Benefits Group Commercial |
$2,807.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,211.10
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$3,509.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,107.54
|
| Rate for Payer: IEHP medi-cal |
$1,114.29
|
| Rate for Payer: IEHP Medicare Advantage |
$675.33
|
| Rate for Payer: Innovage PACE Commercial |
$1,013.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,120.89
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$675.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$935.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$904.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$904.94
|
| Rate for Payer: Multiplan Commercial |
$3,509.25
|
| Rate for Payer: Networks By Design Commercial |
$3,041.35
|
| Rate for Payer: Prime Health Services Commercial |
$3,977.15
|
| Rate for Payer: Prime Health Services Medicare |
$715.85
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$2,807.40
|
| Rate for Payer: Riverside University Health MISP |
$742.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,807.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,807.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$717.15
|
| Rate for Payer: United Healthcare All Other HMO |
$717.15
|
| Rate for Payer: United Healthcare HMO Rider |
$717.15
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$717.15
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,013.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$742.86
|
| Rate for Payer: Vantage Medical Group Senior |
$675.33
|
|
|
HC TOTAL BODY THYROID SCAN
|
Facility
IP
|
$4,679.00
|
|
|
Service Code
|
CPT 78018
|
| Hospital Charge Code |
909301317
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$935.80 |
| Max. Negotiated Rate |
$4,211.10 |
| Rate for Payer: Cash Price |
$2,105.55
|
| Rate for Payer: Central Health Plan Commercial |
$3,743.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,871.60
|
| Rate for Payer: Galaxy Health WC |
$3,977.15
|
| Rate for Payer: Global Benefits Group Commercial |
$2,807.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,211.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,120.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$935.80
|
| Rate for Payer: Multiplan Commercial |
$3,509.25
|
| Rate for Payer: Networks By Design Commercial |
$3,041.35
|
| Rate for Payer: Prime Health Services Commercial |
$3,977.15
|
|
|
HC TOTAL CONTACT CAST LEG
|
Facility
OP
|
$766.00
|
|
|
Service Code
|
CPT 29445
|
| Hospital Charge Code |
900101505
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$153.20 |
| Max. Negotiated Rate |
$397,400.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$335.55
|
| Rate for Payer: Aetna of CA HMO/PPO |
$563.38
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$503.32
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$369.10
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$335.55
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$397,400.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: BCBS Transplant Transplant |
$459.60
|
| Rate for Payer: Blue Shield of California Commercial |
$481.81
|
| Rate for Payer: Blue Shield of California EPN |
$374.57
|
| Rate for Payer: Caremore Medicare Advantage |
$335.55
|
| Rate for Payer: Cash Price |
$344.70
|
| Rate for Payer: Cash Price |
$344.70
|
| Rate for Payer: Cash Price |
$344.70
|
| Rate for Payer: Central Health Plan Commercial |
$612.80
|
| Rate for Payer: Cigna of CA HMO |
$490.24
|
| Rate for Payer: Cigna of CA PPO |
$566.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$503.32
|
| Rate for Payer: EPIC Health Plan Commercial |
$452.99
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$335.55
|
| Rate for Payer: EPIC Health Plan Transplant |
$335.55
|
| Rate for Payer: Galaxy Health WC |
$651.10
|
| Rate for Payer: Global Benefits Group Commercial |
$459.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$689.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$574.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$550.30
|
| Rate for Payer: IEHP medi-cal |
$553.66
|
| Rate for Payer: IEHP Medicare Advantage |
$335.55
|
| Rate for Payer: Innovage PACE Commercial |
$503.32
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$510.92
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$335.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$153.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$449.64
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$449.64
|
| Rate for Payer: Multiplan Commercial |
$574.50
|
| Rate for Payer: Networks By Design Commercial |
$497.90
|
| Rate for Payer: Prime Health Services Commercial |
$651.10
|
| Rate for Payer: Prime Health Services Medicare |
$355.68
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$459.60
|
| Rate for Payer: Riverside University Health MISP |
$369.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$459.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$459.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$383.00
|
| Rate for Payer: United Healthcare All Other HMO |
$383.00
|
| Rate for Payer: United Healthcare HMO Rider |
$383.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$383.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$503.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$369.10
|
| Rate for Payer: Vantage Medical Group Senior |
$335.55
|
|
|
HC TOTAL CONTACT CAST LEG
|
Facility
IP
|
$766.00
|
|
|
Service Code
|
CPT 29445
|
| Hospital Charge Code |
900101505
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$153.20 |
| Max. Negotiated Rate |
$689.40 |
| Rate for Payer: Cash Price |
$344.70
|
| Rate for Payer: Central Health Plan Commercial |
$612.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$306.40
|
| Rate for Payer: Galaxy Health WC |
$651.10
|
| Rate for Payer: Global Benefits Group Commercial |
$459.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$689.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$510.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$153.20
|
| Rate for Payer: Multiplan Commercial |
$574.50
|
| Rate for Payer: Networks By Design Commercial |
$497.90
|
| Rate for Payer: Prime Health Services Commercial |
$651.10
|
|
|
HC TOTAL ELBOW STATIC POLYFORM
|
Facility
IP
|
$243.00
|
|
|
Service Code
|
CPT L3700
|
| Hospital Charge Code |
901301051
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$48.60 |
| Max. Negotiated Rate |
$218.70 |
| Rate for Payer: Blue Shield of California EPN |
$129.76
|
| Rate for Payer: Cash Price |
$109.35
|
| Rate for Payer: Central Health Plan Commercial |
$194.40
|
| Rate for Payer: Cigna of CA HMO |
$170.10
|
| Rate for Payer: Cigna of CA PPO |
$170.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$97.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$97.20
|
| Rate for Payer: Galaxy Health WC |
$206.55
|
| Rate for Payer: Global Benefits Group Commercial |
$145.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$218.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$162.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$48.60
|
| Rate for Payer: Multiplan Commercial |
$182.25
|
| Rate for Payer: Networks By Design Commercial |
$121.50
|
| Rate for Payer: Prime Health Services Commercial |
$206.55
|
|
|
HC TOTAL ELBOW STATIC POLYFORM
|
Facility
OP
|
$243.00
|
|
|
Service Code
|
CPT L3700
|
| Hospital Charge Code |
901301051
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$85.05 |
| Max. Negotiated Rate |
$218.70 |
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$206.55
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$133.65
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$133.65
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$117.66
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$143.56
|
| Rate for Payer: BCBS Transplant Transplant |
$145.80
|
| Rate for Payer: Blue Shield of California Commercial |
$182.25
|
| Rate for Payer: Blue Shield of California EPN |
$132.19
|
| Rate for Payer: Cash Price |
$109.35
|
| Rate for Payer: Cash Price |
$109.35
|
| Rate for Payer: Central Health Plan Commercial |
$194.40
|
| Rate for Payer: Cigna of CA HMO |
$170.10
|
| Rate for Payer: Cigna of CA PPO |
$170.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$206.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$97.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$97.20
|
| Rate for Payer: Galaxy Health WC |
$206.55
|
| Rate for Payer: Global Benefits Group Commercial |
$145.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$218.70
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$182.25
|
| Rate for Payer: IEHP medi-cal |
$85.05
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$162.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$99.63
|
| Rate for Payer: Multiplan Commercial |
$182.25
|
| Rate for Payer: Networks By Design Commercial |
$121.50
|
| Rate for Payer: Prime Health Services Commercial |
$206.55
|
| Rate for Payer: Riverside University Health MISP |
$97.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$145.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$145.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$121.50
|
| Rate for Payer: United Healthcare All Other HMO |
$121.50
|
| Rate for Payer: United Healthcare HMO Rider |
$121.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$121.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$206.55
|
| Rate for Payer: Vantage Medical Group Senior |
$206.55
|
|
|
HC TOTAL HEMOGLOBIN
|
Facility
OP
|
$11.00
|
|
|
Service Code
|
CPT 85018
|
| Hospital Charge Code |
900912031
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$1.92 |
| Max. Negotiated Rate |
$20.97 |
| Rate for Payer: Adventist Health Medi-Cal |
$2.37
|
| Rate for Payer: Aetna of CA HMO/PPO |
$17.36
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$3.56
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2.61
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$2.37
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$17.19
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$20.97
|
| Rate for Payer: BCBS Transplant Transplant |
$6.60
|
| Rate for Payer: Blue Shield of California Commercial |
$6.80
|
| Rate for Payer: Blue Shield of California EPN |
$5.35
|
| Rate for Payer: Caremore Medicare Advantage |
$2.37
|
| Rate for Payer: Cash Price |
$4.95
|
| Rate for Payer: Cash Price |
$4.95
|
| Rate for Payer: Central Health Plan Commercial |
$8.80
|
| Rate for Payer: Cigna of CA HMO |
$7.04
|
| Rate for Payer: Cigna of CA PPO |
$8.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.20
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2.37
|
| Rate for Payer: EPIC Health Plan Transplant |
$2.37
|
| Rate for Payer: Galaxy Health WC |
$9.35
|
| Rate for Payer: Global Benefits Group Commercial |
$6.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$9.90
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$8.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3.89
|
| Rate for Payer: IEHP medi-cal |
$3.91
|
| Rate for Payer: IEHP Medicare Advantage |
$2.37
|
| Rate for Payer: Innovage PACE Commercial |
$3.56
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3.18
|
| Rate for Payer: Multiplan Commercial |
$8.25
|
| Rate for Payer: Networks By Design Commercial |
$7.15
|
| Rate for Payer: Prime Health Services Commercial |
$9.35
|
| Rate for Payer: Prime Health Services Medicare |
$2.51
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$6.60
|
| Rate for Payer: Riverside University Health MISP |
$2.61
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.92
|
| Rate for Payer: United Healthcare All Other HMO |
$1.92
|
| Rate for Payer: United Healthcare HMO Rider |
$1.92
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.92
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3.56
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2.61
|
| Rate for Payer: Vantage Medical Group Senior |
$2.37
|
|
|
HC TOTAL HEMOGLOBIN
|
Facility
IP
|
$20.00
|
|
|
Service Code
|
CPT 85018
|
| Hospital Charge Code |
900912031
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$4.00 |
| Max. Negotiated Rate |
$18.00 |
| Rate for Payer: Cash Price |
$9.00
|
| Rate for Payer: Central Health Plan Commercial |
$16.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.00
|
| Rate for Payer: Galaxy Health WC |
$17.00
|
| Rate for Payer: Global Benefits Group Commercial |
$12.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$18.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$13.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.00
|
| Rate for Payer: Multiplan Commercial |
$15.00
|
| Rate for Payer: Networks By Design Commercial |
$13.00
|
| Rate for Payer: Prime Health Services Commercial |
$17.00
|
|
|
HC TOTAL LUNG LAVAGE UNILATERAL
|
Facility
IP
|
$1,968.00
|
|
|
Service Code
|
CPT 32997
|
| Hospital Charge Code |
900803550
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$393.60 |
| Max. Negotiated Rate |
$1,771.20 |
| Rate for Payer: Cash Price |
$885.60
|
| Rate for Payer: Central Health Plan Commercial |
$1,574.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$787.20
|
| Rate for Payer: Galaxy Health WC |
$1,672.80
|
| Rate for Payer: Global Benefits Group Commercial |
$1,180.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,771.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,312.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$393.60
|
| Rate for Payer: Multiplan Commercial |
$1,476.00
|
| Rate for Payer: Networks By Design Commercial |
$1,279.20
|
| Rate for Payer: Prime Health Services Commercial |
$1,672.80
|
|
|
HC TOTAL LUNG LAVAGE UNILATERAL
|
Facility
OP
|
$1,968.00
|
|
|
Service Code
|
CPT 32997
|
| Hospital Charge Code |
900803550
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$393.60 |
| Max. Negotiated Rate |
$397,400.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$1,809.42
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,672.80
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1,082.40
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1,082.40
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$397,400.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: BCBS Transplant Transplant |
$1,180.80
|
| Rate for Payer: Blue Shield of California Commercial |
$1,237.87
|
| Rate for Payer: Blue Shield of California EPN |
$962.35
|
| Rate for Payer: Cash Price |
$885.60
|
| Rate for Payer: Cash Price |
$885.60
|
| Rate for Payer: Cash Price |
$885.60
|
| Rate for Payer: Central Health Plan Commercial |
$1,574.40
|
| Rate for Payer: Cigna of CA HMO |
$1,259.52
|
| Rate for Payer: Cigna of CA PPO |
$1,456.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,672.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$787.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$787.20
|
| Rate for Payer: Galaxy Health WC |
$1,672.80
|
| Rate for Payer: Global Benefits Group Commercial |
$1,180.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,771.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,476.00
|
| Rate for Payer: IEHP medi-cal |
$688.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,312.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$393.60
|
| Rate for Payer: Multiplan Commercial |
$1,476.00
|
| Rate for Payer: Networks By Design Commercial |
$1,279.20
|
| Rate for Payer: Prime Health Services Commercial |
$1,672.80
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,180.80
|
| Rate for Payer: Riverside University Health MISP |
$787.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,180.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,180.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$984.00
|
| Rate for Payer: United Healthcare All Other HMO |
$984.00
|
| Rate for Payer: United Healthcare HMO Rider |
$984.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$984.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,672.80
|
| Rate for Payer: Vantage Medical Group Senior |
$1,672.80
|
|
|
HC TOXOPLASMA AB IGG
|
Facility
OP
|
$55.00
|
|
|
Service Code
|
CPT 86777
|
| Hospital Charge Code |
900910989
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.00 |
| Max. Negotiated Rate |
$127.31 |
| Rate for Payer: Adventist Health Medi-Cal |
$14.39
|
| Rate for Payer: Aetna of CA HMO/PPO |
$105.60
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$21.58
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$15.83
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$14.39
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$104.37
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$127.31
|
| Rate for Payer: BCBS Transplant Transplant |
$33.00
|
| Rate for Payer: Blue Shield of California Commercial |
$33.99
|
| Rate for Payer: Blue Shield of California EPN |
$26.73
|
| Rate for Payer: Caremore Medicare Advantage |
$14.39
|
| Rate for Payer: Cash Price |
$24.75
|
| Rate for Payer: Cash Price |
$24.75
|
| Rate for Payer: Central Health Plan Commercial |
$44.00
|
| Rate for Payer: Cigna of CA HMO |
$35.20
|
| Rate for Payer: Cigna of CA PPO |
$40.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.43
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$14.39
|
| Rate for Payer: EPIC Health Plan Transplant |
$14.39
|
| Rate for Payer: Galaxy Health WC |
$46.75
|
| Rate for Payer: Global Benefits Group Commercial |
$33.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$49.50
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$41.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$23.60
|
| Rate for Payer: IEHP medi-cal |
$23.74
|
| Rate for Payer: IEHP Medicare Advantage |
$14.39
|
| Rate for Payer: Innovage PACE Commercial |
$21.58
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$36.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$19.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$19.28
|
| Rate for Payer: Multiplan Commercial |
$41.25
|
| Rate for Payer: Networks By Design Commercial |
$35.75
|
| Rate for Payer: Prime Health Services Commercial |
$46.75
|
| Rate for Payer: Prime Health Services Medicare |
$15.25
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$33.00
|
| Rate for Payer: Riverside University Health MISP |
$15.83
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$33.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$33.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$11.66
|
| Rate for Payer: United Healthcare All Other HMO |
$11.66
|
| Rate for Payer: United Healthcare HMO Rider |
$11.66
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.66
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21.58
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15.83
|
| Rate for Payer: Vantage Medical Group Senior |
$14.39
|
|
|
HC TOXOPLASMA AB IGG
|
Facility
IP
|
$210.00
|
|
|
Service Code
|
CPT 86777
|
| Hospital Charge Code |
900910989
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$42.00 |
| Max. Negotiated Rate |
$189.00 |
| Rate for Payer: Cash Price |
$94.50
|
| Rate for Payer: Central Health Plan Commercial |
$168.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$84.00
|
| Rate for Payer: Galaxy Health WC |
$178.50
|
| Rate for Payer: Global Benefits Group Commercial |
$126.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$189.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$140.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$42.00
|
| Rate for Payer: Multiplan Commercial |
$157.50
|
| Rate for Payer: Networks By Design Commercial |
$136.50
|
| Rate for Payer: Prime Health Services Commercial |
$178.50
|
|
|
HC TOXOPLASMA AB IGM
|
Facility
OP
|
$55.00
|
|
|
Service Code
|
CPT 86778
|
| Hospital Charge Code |
900912320
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$11.00 |
| Max. Negotiated Rate |
$132.14 |
| Rate for Payer: Adventist Health Medi-Cal |
$14.41
|
| Rate for Payer: Aetna of CA HMO/PPO |
$105.72
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$21.62
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$15.85
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$14.41
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$108.34
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$132.14
|
| Rate for Payer: BCBS Transplant Transplant |
$33.00
|
| Rate for Payer: Blue Shield of California Commercial |
$33.99
|
| Rate for Payer: Blue Shield of California EPN |
$26.73
|
| Rate for Payer: Caremore Medicare Advantage |
$14.41
|
| Rate for Payer: Cash Price |
$24.75
|
| Rate for Payer: Cash Price |
$24.75
|
| Rate for Payer: Central Health Plan Commercial |
$44.00
|
| Rate for Payer: Cigna of CA HMO |
$35.20
|
| Rate for Payer: Cigna of CA PPO |
$40.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.45
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$14.41
|
| Rate for Payer: EPIC Health Plan Transplant |
$14.41
|
| Rate for Payer: Galaxy Health WC |
$46.75
|
| Rate for Payer: Global Benefits Group Commercial |
$33.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$49.50
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$41.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$23.63
|
| Rate for Payer: IEHP medi-cal |
$23.78
|
| Rate for Payer: IEHP Medicare Advantage |
$14.41
|
| Rate for Payer: Innovage PACE Commercial |
$21.62
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$36.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$19.31
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$19.31
|
| Rate for Payer: Multiplan Commercial |
$41.25
|
| Rate for Payer: Networks By Design Commercial |
$35.75
|
| Rate for Payer: Prime Health Services Commercial |
$46.75
|
| Rate for Payer: Prime Health Services Medicare |
$15.27
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$33.00
|
| Rate for Payer: Riverside University Health MISP |
$15.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$33.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$33.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$11.67
|
| Rate for Payer: United Healthcare All Other HMO |
$11.67
|
| Rate for Payer: United Healthcare HMO Rider |
$11.67
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.67
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15.85
|
| Rate for Payer: Vantage Medical Group Senior |
$14.41
|
|
|
HC TOXOPLASMA AB IGM
|
Facility
IP
|
$210.00
|
|
|
Service Code
|
CPT 86778
|
| Hospital Charge Code |
900912320
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$42.00 |
| Max. Negotiated Rate |
$189.00 |
| Rate for Payer: Cash Price |
$94.50
|
| Rate for Payer: Central Health Plan Commercial |
$168.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$84.00
|
| Rate for Payer: Galaxy Health WC |
$178.50
|
| Rate for Payer: Global Benefits Group Commercial |
$126.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$189.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$140.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$42.00
|
| Rate for Payer: Multiplan Commercial |
$157.50
|
| Rate for Payer: Networks By Design Commercial |
$136.50
|
| Rate for Payer: Prime Health Services Commercial |
$178.50
|
|
|
HC TOXOPLASMA ANTIBODY IGG
|
Facility
IP
|
$58.00
|
|
|
Service Code
|
CPT 86777
|
| Hospital Charge Code |
900913667
|
|
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 TOXOPLASMA ANTIBODY IGG
|
Facility
OP
|
$39.00
|
|
|
Service Code
|
CPT 86777
|
| Hospital Charge Code |
900913667
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.80 |
| Max. Negotiated Rate |
$127.31 |
| Rate for Payer: Adventist Health Medi-Cal |
$14.39
|
| Rate for Payer: Aetna of CA HMO/PPO |
$105.60
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$21.58
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$15.83
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$14.39
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$104.37
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$127.31
|
| 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 |
$14.39
|
| 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 |
$21.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.43
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$14.39
|
| Rate for Payer: EPIC Health Plan Transplant |
$14.39
|
| 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 |
$23.60
|
| Rate for Payer: IEHP medi-cal |
$23.74
|
| Rate for Payer: IEHP Medicare Advantage |
$14.39
|
| Rate for Payer: Innovage PACE Commercial |
$21.58
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$26.01
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$19.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$19.28
|
| 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 |
$15.25
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$23.40
|
| Rate for Payer: Riverside University Health MISP |
$15.83
|
| 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 |
$11.66
|
| Rate for Payer: United Healthcare All Other HMO |
$11.66
|
| Rate for Payer: United Healthcare HMO Rider |
$11.66
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.66
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21.58
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15.83
|
| Rate for Payer: Vantage Medical Group Senior |
$14.39
|
|
|
HC TOXOPLASMA ANTIBODY IGM
|
Facility
IP
|
$58.00
|
|
|
Service Code
|
CPT 86778
|
| Hospital Charge Code |
900913668
|
|
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 TOXOPLASMA ANTIBODY IGM
|
Facility
OP
|
$39.00
|
|
|
Service Code
|
CPT 86778
|
| Hospital Charge Code |
900913668
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.80 |
| Max. Negotiated Rate |
$132.14 |
| Rate for Payer: Adventist Health Medi-Cal |
$14.41
|
| Rate for Payer: Aetna of CA HMO/PPO |
$105.72
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$21.62
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$15.85
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$14.41
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$108.34
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$132.14
|
| 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 |
$14.41
|
| 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 |
$21.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.45
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$14.41
|
| Rate for Payer: EPIC Health Plan Transplant |
$14.41
|
| 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 |
$23.63
|
| Rate for Payer: IEHP medi-cal |
$23.78
|
| Rate for Payer: IEHP Medicare Advantage |
$14.41
|
| Rate for Payer: Innovage PACE Commercial |
$21.62
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$26.01
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$19.31
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$19.31
|
| 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 |
$15.27
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$23.40
|
| Rate for Payer: Riverside University Health MISP |
$15.85
|
| 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 |
$11.67
|
| Rate for Payer: United Healthcare All Other HMO |
$11.67
|
| Rate for Payer: United Healthcare HMO Rider |
$11.67
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.67
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15.85
|
| Rate for Payer: Vantage Medical Group Senior |
$14.41
|
|
|
HC TPN/QUINTON CATH DUAL
|
Facility
OP
|
$414.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
909081727
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$82.80 |
| Max. Negotiated Rate |
$1,019.88 |
| Rate for Payer: Aetna of CA HMO/PPO |
$1,019.88
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$351.90
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$227.70
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$227.70
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$189.03
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$230.60
|
| Rate for Payer: BCBS Transplant Transplant |
$248.40
|
| Rate for Payer: Blue Shield of California Commercial |
$310.50
|
| Rate for Payer: Blue Shield of California EPN |
$225.22
|
| Rate for Payer: Cash Price |
$186.30
|
| Rate for Payer: Cash Price |
$186.30
|
| Rate for Payer: Central Health Plan Commercial |
$331.20
|
| Rate for Payer: Cigna of CA HMO |
$289.80
|
| Rate for Payer: Cigna of CA PPO |
$289.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$351.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$165.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$165.60
|
| Rate for Payer: Galaxy Health WC |
$351.90
|
| Rate for Payer: Global Benefits Group Commercial |
$248.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$372.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$310.50
|
| Rate for Payer: IEHP medi-cal |
$144.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$276.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$82.80
|
| Rate for Payer: Multiplan Commercial |
$310.50
|
| Rate for Payer: Networks By Design Commercial |
$207.00
|
| Rate for Payer: Prime Health Services Commercial |
$351.90
|
| Rate for Payer: Riverside University Health MISP |
$165.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$248.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$248.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$207.00
|
| Rate for Payer: United Healthcare All Other HMO |
$207.00
|
| Rate for Payer: United Healthcare HMO Rider |
$207.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$207.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$351.90
|
| Rate for Payer: Vantage Medical Group Senior |
$351.90
|
|
|
HC TPN/QUINTON CATH DUAL
|
Facility
IP
|
$414.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
909081727
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$82.80 |
| Max. Negotiated Rate |
$372.60 |
| Rate for Payer: Blue Shield of California EPN |
$221.08
|
| Rate for Payer: Cash Price |
$186.30
|
| Rate for Payer: Central Health Plan Commercial |
$331.20
|
| Rate for Payer: Cigna of CA HMO |
$289.80
|
| Rate for Payer: Cigna of CA PPO |
$289.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$165.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$165.60
|
| Rate for Payer: Galaxy Health WC |
$351.90
|
| Rate for Payer: Global Benefits Group Commercial |
$248.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$372.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$276.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$82.80
|
| Rate for Payer: Multiplan Commercial |
$310.50
|
| Rate for Payer: Prime Health Services Commercial |
$351.90
|
|
