|
HC TORSION CONTROL KNEE JOINT ADDITION LE
|
Facility
|
OP
|
$200.00
|
|
|
Service Code
|
CPT L2380
|
| Hospital Charge Code |
915352380
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$65.50 |
| Max. Negotiated Rate |
$180.00 |
| Rate for Payer: Adventist Health Commercial |
$82.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$170.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$110.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$150.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$117.46
|
| Rate for Payer: Blue Shield of California Commercial |
$154.60
|
| Rate for Payer: Blue Shield of California EPN |
$100.80
|
| Rate for Payer: Cash Price |
$110.00
|
| Rate for Payer: Cash Price |
$110.00
|
| 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: Dignity Health Commercial/Exchange |
$170.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$170.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$170.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$80.00
|
| Rate for Payer: EPIC Health Plan Senior |
$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: Inland Empire Health Plan (IEHP) medi-cal |
$142.52
|
| Rate for Payer: InnovAge PACE Commercial |
$100.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$133.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$157.43
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$123.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$82.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$140.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$140.00
|
| 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
|
| Rate for Payer: Riverside University Health System MISP |
$80.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$120.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$120.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$75.06
|
| Rate for Payer: United Healthcare All Other HMO |
$73.06
|
| Rate for Payer: United Healthcare HMO Rider |
$71.48
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$65.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$170.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$170.00
|
| Rate for Payer: Vantage Medical Group Senior |
$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 |
$131.00 |
| Max. Negotiated Rate |
$360.00 |
| Rate for Payer: Adventist Health Commercial |
$164.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$340.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$220.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$300.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$234.92
|
| Rate for Payer: Blue Shield of California Commercial |
$309.20
|
| Rate for Payer: Blue Shield of California EPN |
$201.60
|
| Rate for Payer: Cash Price |
$220.00
|
| 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: Dignity Health Medi-Cal |
$340.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$340.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$160.00
|
| Rate for Payer: EPIC Health Plan Senior |
$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: InnovAge PACE Commercial |
$200.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$266.80
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$247.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$164.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$280.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$280.00
|
| 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 System 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 |
$150.12
|
| Rate for Payer: United Healthcare All Other HMO |
$146.12
|
| Rate for Payer: United Healthcare HMO Rider |
$142.96
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$131.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$340.00
|
| 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: Adventist Health Commercial |
$80.00
|
| Rate for Payer: Blue Shield of California Commercial |
$309.20
|
| Rate for Payer: Blue Shield of California EPN |
$201.60
|
| Rate for Payer: Cash Price |
$220.00
|
| 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 Senior |
$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: Kaiser Permanente of CA Medi-Cal |
$152.40
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$247.60
|
| 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 |
$260.00
|
| Rate for Payer: Prime Health Services Commercial |
$340.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$150.12
|
| Rate for Payer: United Healthcare All Other HMO |
$146.12
|
| Rate for Payer: United Healthcare HMO Rider |
$142.96
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$131.00
|
|
|
HC TORSION MECHANISM WRIST ELBOW
|
Facility
|
OP
|
$400.00
|
|
|
Service Code
|
CPT L3891
|
| Hospital Charge Code |
905353891
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$131.00 |
| Max. Negotiated Rate |
$360.00 |
| Rate for Payer: Adventist Health Commercial |
$164.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$340.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$220.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$300.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$234.92
|
| Rate for Payer: Blue Shield of California Commercial |
$309.20
|
| Rate for Payer: Blue Shield of California EPN |
$201.60
|
| Rate for Payer: Cash Price |
$220.00
|
| 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: Dignity Health Medi-Cal |
$340.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$340.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$160.00
|
| Rate for Payer: EPIC Health Plan Senior |
$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: InnovAge PACE Commercial |
$200.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$266.80
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$247.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$164.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$280.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$280.00
|
| 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 System 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 |
$150.12
|
| Rate for Payer: United Healthcare All Other HMO |
$146.12
|
| Rate for Payer: United Healthcare HMO Rider |
$142.96
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$131.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$340.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$340.00
|
| Rate for Payer: Vantage Medical Group Senior |
$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: Adventist Health Commercial |
$80.00
|
| Rate for Payer: Blue Shield of California Commercial |
$309.20
|
| Rate for Payer: Blue Shield of California EPN |
$201.60
|
| Rate for Payer: Cash Price |
$220.00
|
| 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 Senior |
$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: Kaiser Permanente of CA Medi-Cal |
$152.40
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$247.60
|
| 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 |
$260.00
|
| Rate for Payer: Prime Health Services Commercial |
$340.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$150.12
|
| Rate for Payer: United Healthcare All Other HMO |
$146.12
|
| Rate for Payer: United Healthcare HMO Rider |
$142.96
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$131.00
|
|
|
HC TOTAL BODY THYROID SCAN
|
Facility
|
IP
|
$3,778.00
|
|
|
Service Code
|
CPT 78018
|
| Hospital Charge Code |
909301317
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$755.60 |
| Max. Negotiated Rate |
$3,400.20 |
| Rate for Payer: Adventist Health Commercial |
$755.60
|
| Rate for Payer: Cash Price |
$2,077.90
|
| Rate for Payer: Central Health Plan Commercial |
$3,022.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,511.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,511.20
|
| Rate for Payer: Galaxy Health WC |
$3,211.30
|
| Rate for Payer: Global Benefits Group Commercial |
$2,266.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,400.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,519.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,439.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,338.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$755.60
|
| Rate for Payer: Multiplan Commercial |
$2,833.50
|
| Rate for Payer: Networks By Design Commercial |
$2,455.70
|
| Rate for Payer: Prime Health Services Commercial |
$3,211.30
|
|
|
HC TOTAL BODY THYROID SCAN
|
Facility
|
OP
|
$3,778.00
|
|
|
Service Code
|
CPT 78018
|
| Hospital Charge Code |
909301317
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$223.26 |
| Max. Negotiated Rate |
$3,400.20 |
| Rate for Payer: Adventist Health Commercial |
$755.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$683.93
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,294.38
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,025.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$752.32
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$683.93
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$985.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,218.82
|
| Rate for Payer: Blue Shield of California Commercial |
$2,293.25
|
| Rate for Payer: Blue Shield of California EPN |
$1,499.87
|
| Rate for Payer: Cash Price |
$2,077.90
|
| Rate for Payer: Cash Price |
$2,077.90
|
| Rate for Payer: Central Health Plan Commercial |
$3,022.40
|
| Rate for Payer: Cigna of CA HMO |
$2,417.92
|
| Rate for Payer: Cigna of CA PPO |
$2,795.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,025.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$752.32
|
| Rate for Payer: Dignity Health Medicare Advantage |
$683.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$923.31
|
| Rate for Payer: EPIC Health Plan Senior |
$683.93
|
| Rate for Payer: Galaxy Health WC |
$3,211.30
|
| Rate for Payer: Global Benefits Group Commercial |
$2,266.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,400.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,121.65
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$223.26
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$683.93
|
| Rate for Payer: InnovAge PACE Commercial |
$1,025.89
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,519.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$246.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$683.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$755.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$916.47
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$916.47
|
| Rate for Payer: Multiplan Commercial |
$2,833.50
|
| Rate for Payer: Networks By Design Commercial |
$2,455.70
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$683.93
|
| Rate for Payer: Prime Health Services Commercial |
$3,211.30
|
| Rate for Payer: Prime Health Services Medicare |
$724.97
|
| Rate for Payer: Riverside University Health System MISP |
$752.32
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,266.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,266.80
|
| 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: Upland Medical Group Pediatric |
$683.93
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,025.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$752.32
|
| Rate for Payer: Vantage Medical Group Senior |
$683.93
|
|
|
HC TOTAL CONTACT CAST LEG
|
Facility
|
IP
|
$1,013.00
|
|
|
Service Code
|
CPT 29445
|
| Hospital Charge Code |
900101505
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$202.60 |
| Max. Negotiated Rate |
$911.70 |
| Rate for Payer: Adventist Health Commercial |
$202.60
|
| Rate for Payer: Cash Price |
$557.15
|
| Rate for Payer: Central Health Plan Commercial |
$810.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$405.20
|
| Rate for Payer: EPIC Health Plan Senior |
$405.20
|
| Rate for Payer: Galaxy Health WC |
$861.05
|
| Rate for Payer: Global Benefits Group Commercial |
$607.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$911.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$675.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$385.95
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$627.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$202.60
|
| Rate for Payer: Multiplan Commercial |
$759.75
|
| Rate for Payer: Networks By Design Commercial |
$658.45
|
| Rate for Payer: Prime Health Services Commercial |
$861.05
|
|
|
HC TOTAL CONTACT CAST LEG
|
Facility
|
OP
|
$1,013.00
|
|
|
Service Code
|
CPT 29445
|
| Hospital Charge Code |
900101505
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$202.60 |
| Max. Negotiated Rate |
$911.70 |
| Rate for Payer: Adventist Health Commercial |
$202.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$337.45
|
| Rate for Payer: Aetna of CA HMO/PPO |
$615.19
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$506.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$371.19
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$337.45
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$490.49
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$594.93
|
| Rate for Payer: Blue Shield of California Commercial |
$618.94
|
| Rate for Payer: Blue Shield of California EPN |
$404.19
|
| Rate for Payer: Cash Price |
$557.15
|
| Rate for Payer: Cash Price |
$557.15
|
| Rate for Payer: Central Health Plan Commercial |
$810.40
|
| Rate for Payer: Cigna of CA HMO |
$648.32
|
| Rate for Payer: Cigna of CA PPO |
$749.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$506.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$371.19
|
| Rate for Payer: Dignity Health Medicare Advantage |
$337.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$455.56
|
| Rate for Payer: EPIC Health Plan Senior |
$337.45
|
| Rate for Payer: Galaxy Health WC |
$861.05
|
| Rate for Payer: Global Benefits Group Commercial |
$607.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$911.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$553.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$235.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$337.45
|
| Rate for Payer: InnovAge PACE Commercial |
$506.18
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$675.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$259.60
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$337.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$202.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$452.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$452.18
|
| Rate for Payer: Multiplan Commercial |
$759.75
|
| Rate for Payer: Networks By Design Commercial |
$658.45
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$337.45
|
| Rate for Payer: Prime Health Services Commercial |
$861.05
|
| Rate for Payer: Prime Health Services Medicare |
$357.70
|
| Rate for Payer: Riverside University Health System MISP |
$371.19
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$607.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$607.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$506.50
|
| Rate for Payer: United Healthcare All Other HMO |
$506.50
|
| Rate for Payer: United Healthcare HMO Rider |
$506.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$506.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$337.45
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$506.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$371.19
|
| Rate for Payer: Vantage Medical Group Senior |
$337.45
|
|
|
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: Adventist Health Commercial |
$48.60
|
| Rate for Payer: Blue Shield of California Commercial |
$187.84
|
| Rate for Payer: Blue Shield of California EPN |
$122.47
|
| Rate for Payer: Cash Price |
$133.65
|
| 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 Senior |
$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: Kaiser Permanente of CA Medi-Cal |
$92.58
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$150.42
|
| 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 |
$157.95
|
| Rate for Payer: Prime Health Services Commercial |
$206.55
|
| Rate for Payer: United Healthcare All Other Commercial |
$91.20
|
| Rate for Payer: United Healthcare All Other HMO |
$88.77
|
| Rate for Payer: United Healthcare HMO Rider |
$86.85
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$79.58
|
|
|
HC TOTAL ELBOW STATIC POLYFORM
|
Facility
|
OP
|
$243.00
|
|
|
Service Code
|
CPT L3700
|
| Hospital Charge Code |
901301051
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$79.58 |
| Max. Negotiated Rate |
$218.70 |
| Rate for Payer: Adventist Health Commercial |
$99.63
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$206.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$133.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$182.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$142.71
|
| Rate for Payer: Blue Shield of California Commercial |
$187.84
|
| Rate for Payer: Blue Shield of California EPN |
$122.47
|
| Rate for Payer: Cash Price |
$133.65
|
| 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: Dignity Health Medi-Cal |
$206.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$206.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$97.20
|
| Rate for Payer: EPIC Health Plan Senior |
$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: InnovAge PACE Commercial |
$121.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$162.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$92.58
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$150.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$99.63
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$170.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$170.10
|
| 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 System 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 |
$91.20
|
| Rate for Payer: United Healthcare All Other HMO |
$88.77
|
| Rate for Payer: United Healthcare HMO Rider |
$86.85
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$79.58
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$206.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$206.55
|
| Rate for Payer: Vantage Medical Group Senior |
$206.55
|
|
|
HC TOTAL HEMOGLOBIN
|
Facility
|
OP
|
$10.00
|
|
|
Service Code
|
CPT 85018
|
| Hospital Charge Code |
900912031
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$1.92 |
| Max. Negotiated Rate |
$17.19 |
| Rate for Payer: Adventist Health Commercial |
$2.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$2.37
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6.07
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3.56
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2.61
|
| Rate for Payer: Alpha Care 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 |
$3.49
|
| Rate for Payer: Blue Shield of California Commercial |
$6.07
|
| Rate for Payer: Blue Shield of California EPN |
$3.97
|
| Rate for Payer: Cash Price |
$5.50
|
| Rate for Payer: Cash Price |
$5.50
|
| Rate for Payer: Central Health Plan Commercial |
$8.00
|
| Rate for Payer: Cigna of CA HMO |
$6.40
|
| Rate for Payer: Cigna of CA PPO |
$7.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3.56
|
| Rate for Payer: Dignity Health Medi-Cal |
$2.61
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2.37
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.20
|
| Rate for Payer: EPIC Health Plan Senior |
$2.37
|
| Rate for Payer: Galaxy Health WC |
$8.50
|
| Rate for Payer: Global Benefits Group Commercial |
$6.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$9.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3.89
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3.56
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2.37
|
| Rate for Payer: InnovAge PACE Commercial |
$3.56
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.00
|
| 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 |
$7.50
|
| Rate for Payer: Networks By Design Commercial |
$6.50
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2.37
|
| Rate for Payer: Prime Health Services Commercial |
$8.50
|
| Rate for Payer: Prime Health Services Medicare |
$2.51
|
| Rate for Payer: Riverside University Health System MISP |
$2.61
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6.00
|
| 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: Upland Medical Group Pediatric |
$2.37
|
| 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
|
$10.00
|
|
|
Service Code
|
CPT 85018
|
| Hospital Charge Code |
900912031
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$2.00 |
| Max. Negotiated Rate |
$9.00 |
| Rate for Payer: Adventist Health Commercial |
$2.00
|
| Rate for Payer: Cash Price |
$5.50
|
| Rate for Payer: Central Health Plan Commercial |
$8.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.00
|
| Rate for Payer: EPIC Health Plan Senior |
$4.00
|
| Rate for Payer: Galaxy Health WC |
$8.50
|
| Rate for Payer: Global Benefits Group Commercial |
$6.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$9.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.00
|
| Rate for Payer: Multiplan Commercial |
$7.50
|
| Rate for Payer: Networks By Design Commercial |
$6.50
|
| Rate for Payer: Prime Health Services Commercial |
$8.50
|
|
|
HC TOTAL LUNG LAVAGE UNILATERAL
|
Facility
|
IP
|
$2,263.00
|
|
|
Service Code
|
CPT 32997
|
| Hospital Charge Code |
900803550
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$452.60 |
| Max. Negotiated Rate |
$2,036.70 |
| Rate for Payer: Adventist Health Commercial |
$452.60
|
| Rate for Payer: Cash Price |
$1,244.65
|
| Rate for Payer: Central Health Plan Commercial |
$1,810.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$905.20
|
| Rate for Payer: EPIC Health Plan Senior |
$905.20
|
| Rate for Payer: Galaxy Health WC |
$1,923.55
|
| Rate for Payer: Global Benefits Group Commercial |
$1,357.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,036.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,509.42
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$862.20
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,400.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$452.60
|
| Rate for Payer: Multiplan Commercial |
$1,697.25
|
| Rate for Payer: Networks By Design Commercial |
$1,470.95
|
| Rate for Payer: Prime Health Services Commercial |
$1,923.55
|
|
|
HC TOTAL LUNG LAVAGE UNILATERAL
|
Facility
|
OP
|
$2,263.00
|
|
|
Service Code
|
CPT 32997
|
| Hospital Charge Code |
900803550
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$452.60 |
| Max. Negotiated Rate |
$5,311.00 |
| Rate for Payer: Adventist Health Commercial |
$452.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,374.32
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,923.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,244.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,697.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,311.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,382.69
|
| Rate for Payer: Blue Shield of California EPN |
$902.94
|
| Rate for Payer: Cash Price |
$1,244.65
|
| Rate for Payer: Cash Price |
$1,244.65
|
| Rate for Payer: Central Health Plan Commercial |
$1,810.40
|
| Rate for Payer: Cigna of CA HMO |
$1,448.32
|
| Rate for Payer: Cigna of CA PPO |
$1,674.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,923.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,923.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,923.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$905.20
|
| Rate for Payer: EPIC Health Plan Senior |
$905.20
|
| Rate for Payer: Galaxy Health WC |
$1,923.55
|
| Rate for Payer: Global Benefits Group Commercial |
$1,357.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,036.70
|
| Rate for Payer: InnovAge PACE Commercial |
$1,131.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,509.42
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$862.20
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,400.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$452.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,584.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,584.10
|
| Rate for Payer: Multiplan Commercial |
$1,697.25
|
| Rate for Payer: Networks By Design Commercial |
$1,470.95
|
| Rate for Payer: Prime Health Services Commercial |
$1,923.55
|
| Rate for Payer: Riverside University Health System MISP |
$905.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,357.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,357.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,131.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,131.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,131.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,131.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,923.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,923.55
|
| Rate for Payer: Vantage Medical Group Senior |
$1,923.55
|
|
|
HC TOXOPLASMA AB IGG
|
Facility
|
OP
|
$130.00
|
|
|
Service Code
|
CPT 86777
|
| Hospital Charge Code |
900910989
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.65 |
| Max. Negotiated Rate |
$117.00 |
| Rate for Payer: Adventist Health Commercial |
$26.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$14.39
|
| Rate for Payer: Aetna of CA HMO/PPO |
$78.95
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21.59
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15.83
|
| Rate for Payer: Alpha Care Medical Group 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 |
$21.18
|
| Rate for Payer: Blue Shield of California Commercial |
$78.91
|
| Rate for Payer: Blue Shield of California EPN |
$51.61
|
| Rate for Payer: Cash Price |
$71.50
|
| Rate for Payer: Cash Price |
$71.50
|
| Rate for Payer: Central Health Plan Commercial |
$104.00
|
| Rate for Payer: Cigna of CA HMO |
$83.20
|
| Rate for Payer: Cigna of CA PPO |
$96.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21.59
|
| Rate for Payer: Dignity Health Medi-Cal |
$15.83
|
| Rate for Payer: Dignity Health Medicare Advantage |
$14.39
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.43
|
| Rate for Payer: EPIC Health Plan Senior |
$14.39
|
| Rate for Payer: Galaxy Health WC |
$110.50
|
| Rate for Payer: Global Benefits Group Commercial |
$78.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$117.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$23.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$22.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$14.39
|
| Rate for Payer: InnovAge PACE Commercial |
$21.59
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$86.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$24.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$26.00
|
| 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 |
$97.50
|
| Rate for Payer: Networks By Design Commercial |
$84.50
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$14.39
|
| Rate for Payer: Prime Health Services Commercial |
$110.50
|
| Rate for Payer: Prime Health Services Medicare |
$15.25
|
| Rate for Payer: Riverside University Health System MISP |
$15.83
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$78.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$78.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$11.65
|
| Rate for Payer: United Healthcare All Other HMO |
$11.65
|
| Rate for Payer: United Healthcare HMO Rider |
$11.65
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.65
|
| Rate for Payer: Upland Medical Group Pediatric |
$14.39
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21.59
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15.83
|
| Rate for Payer: Vantage Medical Group Senior |
$14.39
|
|
|
HC TOXOPLASMA AB IGG
|
Facility
|
IP
|
$130.00
|
|
|
Service Code
|
CPT 86777
|
| Hospital Charge Code |
900910989
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$26.00 |
| Max. Negotiated Rate |
$117.00 |
| Rate for Payer: Adventist Health Commercial |
$26.00
|
| Rate for Payer: Cash Price |
$71.50
|
| Rate for Payer: Central Health Plan Commercial |
$104.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$52.00
|
| Rate for Payer: EPIC Health Plan Senior |
$52.00
|
| Rate for Payer: Galaxy Health WC |
$110.50
|
| Rate for Payer: Global Benefits Group Commercial |
$78.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$117.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$86.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$49.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$80.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$26.00
|
| Rate for Payer: Multiplan Commercial |
$97.50
|
| Rate for Payer: Networks By Design Commercial |
$84.50
|
| Rate for Payer: Prime Health Services Commercial |
$110.50
|
|
|
HC TOXOPLASMA AB IGM
|
Facility
|
IP
|
$130.00
|
|
|
Service Code
|
CPT 86778
|
| Hospital Charge Code |
900912320
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$26.00 |
| Max. Negotiated Rate |
$117.00 |
| Rate for Payer: Adventist Health Commercial |
$26.00
|
| Rate for Payer: Cash Price |
$71.50
|
| Rate for Payer: Central Health Plan Commercial |
$104.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$52.00
|
| Rate for Payer: EPIC Health Plan Senior |
$52.00
|
| Rate for Payer: Galaxy Health WC |
$110.50
|
| Rate for Payer: Global Benefits Group Commercial |
$78.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$117.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$86.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$49.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$80.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$26.00
|
| Rate for Payer: Multiplan Commercial |
$97.50
|
| Rate for Payer: Networks By Design Commercial |
$84.50
|
| Rate for Payer: Prime Health Services Commercial |
$110.50
|
|
|
HC TOXOPLASMA AB IGM
|
Facility
|
OP
|
$130.00
|
|
|
Service Code
|
CPT 86778
|
| Hospital Charge Code |
900912320
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$11.67 |
| Max. Negotiated Rate |
$117.00 |
| Rate for Payer: Adventist Health Commercial |
$26.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$14.41
|
| Rate for Payer: Aetna of CA HMO/PPO |
$78.95
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21.61
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15.85
|
| Rate for Payer: Alpha Care Medical Group 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 |
$21.99
|
| Rate for Payer: Blue Shield of California Commercial |
$78.91
|
| Rate for Payer: Blue Shield of California EPN |
$51.61
|
| Rate for Payer: Cash Price |
$71.50
|
| Rate for Payer: Cash Price |
$71.50
|
| Rate for Payer: Central Health Plan Commercial |
$104.00
|
| Rate for Payer: Cigna of CA HMO |
$83.20
|
| Rate for Payer: Cigna of CA PPO |
$96.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21.61
|
| Rate for Payer: Dignity Health Medi-Cal |
$15.85
|
| Rate for Payer: Dignity Health Medicare Advantage |
$14.41
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.45
|
| Rate for Payer: EPIC Health Plan Senior |
$14.41
|
| Rate for Payer: Galaxy Health WC |
$110.50
|
| Rate for Payer: Global Benefits Group Commercial |
$78.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$117.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$23.63
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$22.02
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$14.41
|
| Rate for Payer: InnovAge PACE Commercial |
$21.61
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$86.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$24.32
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$26.00
|
| 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 |
$97.50
|
| Rate for Payer: Networks By Design Commercial |
$84.50
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$14.41
|
| Rate for Payer: Prime Health Services Commercial |
$110.50
|
| Rate for Payer: Prime Health Services Medicare |
$15.27
|
| Rate for Payer: Riverside University Health System MISP |
$15.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$78.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$78.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$11.67
|
| Rate for Payer: United Healthcare All Other 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: Upland Medical Group Pediatric |
$14.41
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21.61
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15.85
|
| Rate for Payer: Vantage Medical Group Senior |
$14.41
|
|
|
HC TOXOPLASMA ANTIBODY IGG
|
Facility
|
OP
|
$98.00
|
|
|
Service Code
|
CPT 86777
|
| Hospital Charge Code |
900913667
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.65 |
| Max. Negotiated Rate |
$104.37 |
| Rate for Payer: Adventist Health Commercial |
$19.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$14.39
|
| Rate for Payer: Aetna of CA HMO/PPO |
$59.52
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21.59
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15.83
|
| Rate for Payer: Alpha Care Medical Group 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 |
$21.18
|
| Rate for Payer: Blue Shield of California Commercial |
$59.49
|
| Rate for Payer: Blue Shield of California EPN |
$38.91
|
| Rate for Payer: Cash Price |
$53.90
|
| Rate for Payer: Cash Price |
$53.90
|
| Rate for Payer: Central Health Plan Commercial |
$78.40
|
| Rate for Payer: Cigna of CA HMO |
$62.72
|
| Rate for Payer: Cigna of CA PPO |
$72.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21.59
|
| Rate for Payer: Dignity Health Medi-Cal |
$15.83
|
| Rate for Payer: Dignity Health Medicare Advantage |
$14.39
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.43
|
| Rate for Payer: EPIC Health Plan Senior |
$14.39
|
| Rate for Payer: Galaxy Health WC |
$83.30
|
| Rate for Payer: Global Benefits Group Commercial |
$58.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$88.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$23.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$22.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$14.39
|
| Rate for Payer: InnovAge PACE Commercial |
$21.59
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$65.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$24.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.60
|
| 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 |
$73.50
|
| Rate for Payer: Networks By Design Commercial |
$63.70
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$14.39
|
| Rate for Payer: Prime Health Services Commercial |
$83.30
|
| Rate for Payer: Prime Health Services Medicare |
$15.25
|
| Rate for Payer: Riverside University Health System MISP |
$15.83
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$58.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$58.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$11.65
|
| Rate for Payer: United Healthcare All Other HMO |
$11.65
|
| Rate for Payer: United Healthcare HMO Rider |
$11.65
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.65
|
| Rate for Payer: Upland Medical Group Pediatric |
$14.39
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21.59
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15.83
|
| Rate for Payer: Vantage Medical Group Senior |
$14.39
|
|
|
HC TOXOPLASMA ANTIBODY IGG
|
Facility
|
IP
|
$98.00
|
|
|
Service Code
|
CPT 86777
|
| Hospital Charge Code |
900913667
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$19.60 |
| Max. Negotiated Rate |
$88.20 |
| Rate for Payer: Adventist Health Commercial |
$19.60
|
| Rate for Payer: Cash Price |
$53.90
|
| Rate for Payer: Central Health Plan Commercial |
$78.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$39.20
|
| Rate for Payer: EPIC Health Plan Senior |
$39.20
|
| Rate for Payer: Galaxy Health WC |
$83.30
|
| Rate for Payer: Global Benefits Group Commercial |
$58.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$88.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$65.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$37.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$60.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.60
|
| Rate for Payer: Multiplan Commercial |
$73.50
|
| Rate for Payer: Networks By Design Commercial |
$63.70
|
| Rate for Payer: Prime Health Services Commercial |
$83.30
|
|
|
HC TOXOPLASMA ANTIBODY IGM
|
Facility
|
OP
|
$98.00
|
|
|
Service Code
|
CPT 86778
|
| Hospital Charge Code |
900913668
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.67 |
| Max. Negotiated Rate |
$108.34 |
| Rate for Payer: Adventist Health Commercial |
$19.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$14.41
|
| Rate for Payer: Aetna of CA HMO/PPO |
$59.52
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21.61
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15.85
|
| Rate for Payer: Alpha Care Medical Group 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 |
$21.99
|
| Rate for Payer: Blue Shield of California Commercial |
$59.49
|
| Rate for Payer: Blue Shield of California EPN |
$38.91
|
| Rate for Payer: Cash Price |
$53.90
|
| Rate for Payer: Cash Price |
$53.90
|
| Rate for Payer: Central Health Plan Commercial |
$78.40
|
| Rate for Payer: Cigna of CA HMO |
$62.72
|
| Rate for Payer: Cigna of CA PPO |
$72.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21.61
|
| Rate for Payer: Dignity Health Medi-Cal |
$15.85
|
| Rate for Payer: Dignity Health Medicare Advantage |
$14.41
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.45
|
| Rate for Payer: EPIC Health Plan Senior |
$14.41
|
| Rate for Payer: Galaxy Health WC |
$83.30
|
| Rate for Payer: Global Benefits Group Commercial |
$58.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$88.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$23.63
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$22.02
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$14.41
|
| Rate for Payer: InnovAge PACE Commercial |
$21.61
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$65.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$24.32
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.60
|
| 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 |
$73.50
|
| Rate for Payer: Networks By Design Commercial |
$63.70
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$14.41
|
| Rate for Payer: Prime Health Services Commercial |
$83.30
|
| Rate for Payer: Prime Health Services Medicare |
$15.27
|
| Rate for Payer: Riverside University Health System MISP |
$15.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$58.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$58.80
|
| 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: Upland Medical Group Pediatric |
$14.41
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21.61
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15.85
|
| Rate for Payer: Vantage Medical Group Senior |
$14.41
|
|
|
HC TOXOPLASMA ANTIBODY IGM
|
Facility
|
IP
|
$98.00
|
|
|
Service Code
|
CPT 86778
|
| Hospital Charge Code |
900913668
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$19.60 |
| Max. Negotiated Rate |
$88.20 |
| Rate for Payer: Adventist Health Commercial |
$19.60
|
| Rate for Payer: Cash Price |
$53.90
|
| Rate for Payer: Central Health Plan Commercial |
$78.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$39.20
|
| Rate for Payer: EPIC Health Plan Senior |
$39.20
|
| Rate for Payer: Galaxy Health WC |
$83.30
|
| Rate for Payer: Global Benefits Group Commercial |
$58.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$88.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$65.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$37.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$60.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.60
|
| Rate for Payer: Multiplan Commercial |
$73.50
|
| Rate for Payer: Networks By Design Commercial |
$63.70
|
| Rate for Payer: Prime Health Services Commercial |
$83.30
|
|
|
HC TPN/QUINTON CATH DUAL
|
Facility
|
IP
|
$414.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
909081727
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$82.80 |
| Max. Negotiated Rate |
$372.60 |
| Rate for Payer: Adventist Health Commercial |
$82.80
|
| Rate for Payer: Blue Shield of California Commercial |
$320.02
|
| Rate for Payer: Blue Shield of California EPN |
$208.66
|
| Rate for Payer: Cash Price |
$227.70
|
| 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 Senior |
$165.60
|
| Rate for Payer: Galaxy Health WC |
$351.90
|
| Rate for Payer: Global Benefits Group Commercial |
$248.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$372.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$276.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$157.73
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$256.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$82.80
|
| Rate for Payer: Multiplan Commercial |
$310.50
|
| Rate for Payer: Networks By Design Commercial |
$207.00
|
| Rate for Payer: Prime Health Services Commercial |
$351.90
|
| Rate for Payer: United Healthcare All Other Commercial |
$155.37
|
| Rate for Payer: United Healthcare All Other HMO |
$151.23
|
| Rate for Payer: United Healthcare HMO Rider |
$147.96
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$135.59
|
|
|
HC TPN/QUINTON CATH DUAL
|
Facility
|
OP
|
$414.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
909081727
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$82.80 |
| Max. Negotiated Rate |
$372.60 |
| Rate for Payer: Adventist Health Commercial |
$82.80
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$351.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$227.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$310.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$189.03
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$229.23
|
| Rate for Payer: Blue Shield of California Commercial |
$320.02
|
| Rate for Payer: Blue Shield of California EPN |
$208.66
|
| Rate for Payer: Cash Price |
$227.70
|
| Rate for Payer: Central Health Plan Commercial |
$331.20
|
| Rate for Payer: Cigna of CA HMO |
$289.80
|
| Rate for Payer: Cigna of CA PPO |
$289.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$351.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$351.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$351.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$165.60
|
| Rate for Payer: EPIC Health Plan Senior |
$165.60
|
| Rate for Payer: Galaxy Health WC |
$351.90
|
| Rate for Payer: Global Benefits Group Commercial |
$248.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$372.60
|
| Rate for Payer: InnovAge PACE Commercial |
$207.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$276.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$157.73
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$256.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$82.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$289.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$289.80
|
| Rate for Payer: Multiplan Commercial |
$310.50
|
| Rate for Payer: Networks By Design Commercial |
$207.00
|
| Rate for Payer: Prime Health Services Commercial |
$351.90
|
| Rate for Payer: Riverside University Health System MISP |
$165.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$248.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$248.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$155.37
|
| Rate for Payer: United Healthcare All Other HMO |
$151.23
|
| Rate for Payer: United Healthcare HMO Rider |
$147.96
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$135.59
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$351.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$351.90
|
| Rate for Payer: Vantage Medical Group Senior |
$351.90
|
|
