|
HC URINALYSIS NON AUTOMATED WO MICROSCOPY
|
Facility
|
OP
|
$134.00
|
|
|
Service Code
|
CPT 81002
|
| Hospital Charge Code |
906581002
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$2.82 |
| Max. Negotiated Rate |
$120.60 |
| Rate for Payer: Adventist Health Commercial |
$26.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$3.48
|
| Rate for Payer: Aetna of CA HMO/PPO |
$81.38
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3.83
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3.48
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$17.29
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3.51
|
| Rate for Payer: Blue Shield of California Commercial |
$81.34
|
| Rate for Payer: Blue Shield of California EPN |
$53.20
|
| Rate for Payer: Cash Price |
$73.70
|
| Rate for Payer: Cash Price |
$73.70
|
| Rate for Payer: Central Health Plan Commercial |
$107.20
|
| Rate for Payer: Cigna of CA HMO |
$85.76
|
| Rate for Payer: Cigna of CA PPO |
$99.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$3.83
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.70
|
| Rate for Payer: EPIC Health Plan Senior |
$3.48
|
| Rate for Payer: Galaxy Health WC |
$113.90
|
| Rate for Payer: Global Benefits Group Commercial |
$80.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$120.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$5.71
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3.48
|
| Rate for Payer: InnovAge PACE Commercial |
$5.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$89.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.08
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$26.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4.66
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4.66
|
| Rate for Payer: Multiplan Commercial |
$100.50
|
| Rate for Payer: Networks By Design Commercial |
$87.10
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$3.48
|
| Rate for Payer: Prime Health Services Commercial |
$113.90
|
| Rate for Payer: Prime Health Services Medicare |
$3.69
|
| Rate for Payer: Riverside University Health System MISP |
$3.83
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$80.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$80.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.82
|
| Rate for Payer: United Healthcare All Other HMO |
$2.82
|
| Rate for Payer: United Healthcare HMO Rider |
$2.82
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.82
|
| Rate for Payer: Upland Medical Group Pediatric |
$3.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3.83
|
| Rate for Payer: Vantage Medical Group Senior |
$3.48
|
|
|
HC URINALYSIS NON AUTOMATED WO MICROSCOPY
|
Facility
|
OP
|
$134.00
|
|
|
Service Code
|
CPT 81002
|
| Hospital Charge Code |
900510277
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.82 |
| Max. Negotiated Rate |
$120.60 |
| Rate for Payer: Adventist Health Commercial |
$26.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$3.48
|
| Rate for Payer: Aetna of CA HMO/PPO |
$81.38
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3.83
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3.48
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$17.29
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3.51
|
| Rate for Payer: Blue Shield of California Commercial |
$81.34
|
| Rate for Payer: Blue Shield of California EPN |
$53.20
|
| Rate for Payer: Cash Price |
$73.70
|
| Rate for Payer: Cash Price |
$73.70
|
| Rate for Payer: Central Health Plan Commercial |
$107.20
|
| Rate for Payer: Cigna of CA HMO |
$85.76
|
| Rate for Payer: Cigna of CA PPO |
$99.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$3.83
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.70
|
| Rate for Payer: EPIC Health Plan Senior |
$3.48
|
| Rate for Payer: Galaxy Health WC |
$113.90
|
| Rate for Payer: Global Benefits Group Commercial |
$80.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$120.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$5.71
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3.48
|
| Rate for Payer: InnovAge PACE Commercial |
$5.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$89.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.08
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$26.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4.66
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4.66
|
| Rate for Payer: Multiplan Commercial |
$100.50
|
| Rate for Payer: Networks By Design Commercial |
$87.10
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$3.48
|
| Rate for Payer: Prime Health Services Commercial |
$113.90
|
| Rate for Payer: Prime Health Services Medicare |
$3.69
|
| Rate for Payer: Riverside University Health System MISP |
$3.83
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$80.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$80.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.82
|
| Rate for Payer: United Healthcare All Other HMO |
$2.82
|
| Rate for Payer: United Healthcare HMO Rider |
$2.82
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.82
|
| Rate for Payer: Upland Medical Group Pediatric |
$3.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3.83
|
| Rate for Payer: Vantage Medical Group Senior |
$3.48
|
|
|
HC URINALYSIS NON AUTOMATED WO MICROSCOPY
|
Facility
|
IP
|
$134.00
|
|
|
Service Code
|
CPT 81002
|
| Hospital Charge Code |
900510277
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$26.80 |
| Max. Negotiated Rate |
$120.60 |
| Rate for Payer: Adventist Health Commercial |
$26.80
|
| Rate for Payer: Cash Price |
$73.70
|
| Rate for Payer: Central Health Plan Commercial |
$107.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$53.60
|
| Rate for Payer: EPIC Health Plan Senior |
$53.60
|
| Rate for Payer: Galaxy Health WC |
$113.90
|
| Rate for Payer: Global Benefits Group Commercial |
$80.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$120.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$89.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$51.05
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$82.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$26.80
|
| Rate for Payer: Multiplan Commercial |
$100.50
|
| Rate for Payer: Networks By Design Commercial |
$87.10
|
| Rate for Payer: Prime Health Services Commercial |
$113.90
|
|
|
HC URINALYSIS NON AUTOMATED WO MICROSCOPY
|
Facility
|
OP
|
$134.00
|
|
|
Service Code
|
CPT 81002
|
| Hospital Charge Code |
900510277
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$2.82 |
| Max. Negotiated Rate |
$120.60 |
| Rate for Payer: Adventist Health Commercial |
$26.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$3.48
|
| Rate for Payer: Aetna of CA HMO/PPO |
$81.38
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3.83
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3.48
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$17.29
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3.51
|
| Rate for Payer: Blue Shield of California Commercial |
$81.34
|
| Rate for Payer: Blue Shield of California EPN |
$53.20
|
| Rate for Payer: Cash Price |
$73.70
|
| Rate for Payer: Cash Price |
$73.70
|
| Rate for Payer: Central Health Plan Commercial |
$107.20
|
| Rate for Payer: Cigna of CA HMO |
$85.76
|
| Rate for Payer: Cigna of CA PPO |
$99.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$3.83
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.70
|
| Rate for Payer: EPIC Health Plan Senior |
$3.48
|
| Rate for Payer: Galaxy Health WC |
$113.90
|
| Rate for Payer: Global Benefits Group Commercial |
$80.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$120.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$5.71
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3.48
|
| Rate for Payer: InnovAge PACE Commercial |
$5.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$89.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.08
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$26.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4.66
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4.66
|
| Rate for Payer: Multiplan Commercial |
$100.50
|
| Rate for Payer: Networks By Design Commercial |
$87.10
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$3.48
|
| Rate for Payer: Prime Health Services Commercial |
$113.90
|
| Rate for Payer: Prime Health Services Medicare |
$3.69
|
| Rate for Payer: Riverside University Health System MISP |
$3.83
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$80.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$80.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.82
|
| Rate for Payer: United Healthcare All Other HMO |
$2.82
|
| Rate for Payer: United Healthcare HMO Rider |
$2.82
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.82
|
| Rate for Payer: Upland Medical Group Pediatric |
$3.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3.83
|
| Rate for Payer: Vantage Medical Group Senior |
$3.48
|
|
|
HC URINARY CATH 3.5FR SILICONE
|
Facility
|
OP
|
$137.71
|
|
| Hospital Charge Code |
901698493
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$27.54 |
| Max. Negotiated Rate |
$123.94 |
| Rate for Payer: Adventist Health Commercial |
$27.54
|
| Rate for Payer: Aetna of CA HMO/PPO |
$83.63
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$117.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$75.74
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$103.28
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$66.68
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$80.88
|
| Rate for Payer: Blue Shield of California Commercial |
$84.14
|
| Rate for Payer: Blue Shield of California EPN |
$54.95
|
| Rate for Payer: Cash Price |
$75.74
|
| Rate for Payer: Central Health Plan Commercial |
$110.17
|
| Rate for Payer: Cigna of CA HMO |
$88.13
|
| Rate for Payer: Cigna of CA PPO |
$101.91
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$117.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$117.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$117.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$55.08
|
| Rate for Payer: EPIC Health Plan Senior |
$55.08
|
| Rate for Payer: Galaxy Health WC |
$117.05
|
| Rate for Payer: Global Benefits Group Commercial |
$82.63
|
| Rate for Payer: Health Management Network EPO/PPO |
$123.94
|
| Rate for Payer: InnovAge PACE Commercial |
$68.86
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$91.85
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$52.47
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$85.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27.54
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$96.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$96.40
|
| Rate for Payer: Multiplan Commercial |
$103.28
|
| Rate for Payer: Networks By Design Commercial |
$89.51
|
| Rate for Payer: Prime Health Services Commercial |
$117.05
|
| Rate for Payer: Riverside University Health System MISP |
$55.08
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$82.63
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$82.63
|
| Rate for Payer: United Healthcare All Other Commercial |
$68.86
|
| Rate for Payer: United Healthcare All Other HMO |
$68.86
|
| Rate for Payer: United Healthcare HMO Rider |
$68.86
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$68.86
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$117.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$117.05
|
| Rate for Payer: Vantage Medical Group Senior |
$117.05
|
|
|
HC URINARY CATH 3.5FR SILICONE
|
Facility
|
IP
|
$137.71
|
|
| Hospital Charge Code |
901698493
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$27.54 |
| Max. Negotiated Rate |
$123.94 |
| Rate for Payer: Adventist Health Commercial |
$27.54
|
| Rate for Payer: Cash Price |
$75.74
|
| Rate for Payer: Central Health Plan Commercial |
$110.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$55.08
|
| Rate for Payer: EPIC Health Plan Senior |
$55.08
|
| Rate for Payer: Galaxy Health WC |
$117.05
|
| Rate for Payer: Global Benefits Group Commercial |
$82.63
|
| Rate for Payer: Health Management Network EPO/PPO |
$123.94
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$91.85
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$52.47
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$85.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27.54
|
| Rate for Payer: Multiplan Commercial |
$103.28
|
| Rate for Payer: Networks By Design Commercial |
$89.51
|
| Rate for Payer: Prime Health Services Commercial |
$117.05
|
|
|
HC URINARY CATH 5.0 SILICONE
|
Facility
|
IP
|
$83.60
|
|
| Hospital Charge Code |
901698568
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$16.72 |
| Max. Negotiated Rate |
$75.24 |
| Rate for Payer: Adventist Health Commercial |
$16.72
|
| Rate for Payer: Cash Price |
$45.98
|
| Rate for Payer: Central Health Plan Commercial |
$66.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$33.44
|
| Rate for Payer: EPIC Health Plan Senior |
$33.44
|
| Rate for Payer: Galaxy Health WC |
$71.06
|
| Rate for Payer: Global Benefits Group Commercial |
$50.16
|
| Rate for Payer: Health Management Network EPO/PPO |
$75.24
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$55.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$31.85
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$51.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.72
|
| Rate for Payer: Multiplan Commercial |
$62.70
|
| Rate for Payer: Networks By Design Commercial |
$54.34
|
| Rate for Payer: Prime Health Services Commercial |
$71.06
|
|
|
HC URINARY CATH 5.0 SILICONE
|
Facility
|
OP
|
$83.60
|
|
| Hospital Charge Code |
901698568
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$16.72 |
| Max. Negotiated Rate |
$75.24 |
| Rate for Payer: Adventist Health Commercial |
$16.72
|
| Rate for Payer: Aetna of CA HMO/PPO |
$50.77
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$71.06
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$45.98
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$62.70
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$40.48
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$49.10
|
| Rate for Payer: Blue Shield of California Commercial |
$51.08
|
| Rate for Payer: Blue Shield of California EPN |
$33.36
|
| Rate for Payer: Cash Price |
$45.98
|
| Rate for Payer: Central Health Plan Commercial |
$66.88
|
| Rate for Payer: Cigna of CA HMO |
$53.50
|
| Rate for Payer: Cigna of CA PPO |
$61.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$71.06
|
| Rate for Payer: Dignity Health Medi-Cal |
$71.06
|
| Rate for Payer: Dignity Health Medicare Advantage |
$71.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$33.44
|
| Rate for Payer: EPIC Health Plan Senior |
$33.44
|
| Rate for Payer: Galaxy Health WC |
$71.06
|
| Rate for Payer: Global Benefits Group Commercial |
$50.16
|
| Rate for Payer: Health Management Network EPO/PPO |
$75.24
|
| Rate for Payer: InnovAge PACE Commercial |
$41.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$55.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$31.85
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$51.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.72
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$58.52
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$58.52
|
| Rate for Payer: Multiplan Commercial |
$62.70
|
| Rate for Payer: Networks By Design Commercial |
$54.34
|
| Rate for Payer: Prime Health Services Commercial |
$71.06
|
| Rate for Payer: Riverside University Health System MISP |
$33.44
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$50.16
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$50.16
|
| Rate for Payer: United Healthcare All Other Commercial |
$41.80
|
| Rate for Payer: United Healthcare All Other HMO |
$41.80
|
| Rate for Payer: United Healthcare HMO Rider |
$41.80
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$41.80
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$71.06
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$71.06
|
| Rate for Payer: Vantage Medical Group Senior |
$71.06
|
|
|
HC URINARY DRAIN CATH KIT 8FR
|
Facility
|
IP
|
$196.00
|
|
| Hospital Charge Code |
901698629
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$39.20 |
| Max. Negotiated Rate |
$176.40 |
| Rate for Payer: Adventist Health Commercial |
$39.20
|
| Rate for Payer: Cash Price |
$107.80
|
| Rate for Payer: Central Health Plan Commercial |
$156.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$78.40
|
| Rate for Payer: EPIC Health Plan Senior |
$78.40
|
| Rate for Payer: Galaxy Health WC |
$166.60
|
| Rate for Payer: Global Benefits Group Commercial |
$117.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$176.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$130.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$74.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$121.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$39.20
|
| Rate for Payer: Multiplan Commercial |
$147.00
|
| Rate for Payer: Networks By Design Commercial |
$127.40
|
| Rate for Payer: Prime Health Services Commercial |
$166.60
|
|
|
HC URINARY DRAIN CATH KIT 8FR
|
Facility
|
OP
|
$196.00
|
|
| Hospital Charge Code |
901698629
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$39.20 |
| Max. Negotiated Rate |
$176.40 |
| Rate for Payer: Adventist Health Commercial |
$39.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$119.03
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$166.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$107.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$147.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$94.90
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$115.11
|
| Rate for Payer: Blue Shield of California Commercial |
$119.76
|
| Rate for Payer: Blue Shield of California EPN |
$78.20
|
| Rate for Payer: Cash Price |
$107.80
|
| Rate for Payer: Central Health Plan Commercial |
$156.80
|
| Rate for Payer: Cigna of CA HMO |
$125.44
|
| Rate for Payer: Cigna of CA PPO |
$145.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$166.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$166.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$166.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$78.40
|
| Rate for Payer: EPIC Health Plan Senior |
$78.40
|
| Rate for Payer: Galaxy Health WC |
$166.60
|
| Rate for Payer: Global Benefits Group Commercial |
$117.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$176.40
|
| Rate for Payer: InnovAge PACE Commercial |
$98.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$130.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$74.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$121.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$39.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$137.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$137.20
|
| Rate for Payer: Multiplan Commercial |
$147.00
|
| Rate for Payer: Networks By Design Commercial |
$127.40
|
| Rate for Payer: Prime Health Services Commercial |
$166.60
|
| Rate for Payer: Riverside University Health System MISP |
$78.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$117.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$117.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$98.00
|
| Rate for Payer: United Healthcare All Other HMO |
$98.00
|
| Rate for Payer: United Healthcare HMO Rider |
$98.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$98.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$166.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$166.60
|
| Rate for Payer: Vantage Medical Group Senior |
$166.60
|
|
|
HC URINARY DRAIN KIT W/5FR CATH
|
Facility
|
IP
|
$248.36
|
|
| Hospital Charge Code |
901698447
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$49.67 |
| Max. Negotiated Rate |
$223.52 |
| Rate for Payer: Adventist Health Commercial |
$49.67
|
| Rate for Payer: Cash Price |
$136.60
|
| Rate for Payer: Central Health Plan Commercial |
$198.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$99.34
|
| Rate for Payer: EPIC Health Plan Senior |
$99.34
|
| Rate for Payer: Galaxy Health WC |
$211.11
|
| Rate for Payer: Global Benefits Group Commercial |
$149.02
|
| Rate for Payer: Health Management Network EPO/PPO |
$223.52
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$165.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$94.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$153.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$49.67
|
| Rate for Payer: Multiplan Commercial |
$186.27
|
| Rate for Payer: Networks By Design Commercial |
$161.43
|
| Rate for Payer: Prime Health Services Commercial |
$211.11
|
|
|
HC URINARY DRAIN KIT W/5FR CATH
|
Facility
|
OP
|
$248.36
|
|
| Hospital Charge Code |
901698447
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$49.67 |
| Max. Negotiated Rate |
$223.52 |
| Rate for Payer: Adventist Health Commercial |
$49.67
|
| Rate for Payer: Aetna of CA HMO/PPO |
$150.83
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$211.11
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$136.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$186.27
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$120.26
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$145.86
|
| Rate for Payer: Blue Shield of California Commercial |
$151.75
|
| Rate for Payer: Blue Shield of California EPN |
$99.10
|
| Rate for Payer: Cash Price |
$136.60
|
| Rate for Payer: Central Health Plan Commercial |
$198.69
|
| Rate for Payer: Cigna of CA HMO |
$158.95
|
| Rate for Payer: Cigna of CA PPO |
$183.79
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$211.11
|
| Rate for Payer: Dignity Health Medi-Cal |
$211.11
|
| Rate for Payer: Dignity Health Medicare Advantage |
$211.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$99.34
|
| Rate for Payer: EPIC Health Plan Senior |
$99.34
|
| Rate for Payer: Galaxy Health WC |
$211.11
|
| Rate for Payer: Global Benefits Group Commercial |
$149.02
|
| Rate for Payer: Health Management Network EPO/PPO |
$223.52
|
| Rate for Payer: InnovAge PACE Commercial |
$124.18
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$165.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$94.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$153.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$49.67
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$173.85
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$173.85
|
| Rate for Payer: Multiplan Commercial |
$186.27
|
| Rate for Payer: Networks By Design Commercial |
$161.43
|
| Rate for Payer: Prime Health Services Commercial |
$211.11
|
| Rate for Payer: Riverside University Health System MISP |
$99.34
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$149.02
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$149.02
|
| Rate for Payer: United Healthcare All Other Commercial |
$124.18
|
| Rate for Payer: United Healthcare All Other HMO |
$124.18
|
| Rate for Payer: United Healthcare HMO Rider |
$124.18
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$124.18
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$211.11
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$211.11
|
| Rate for Payer: Vantage Medical Group Senior |
$211.11
|
|
|
HC URINARY DRAIN KIT W/CATH 5.0
|
Facility
|
OP
|
$196.00
|
|
| Hospital Charge Code |
901698567
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$39.20 |
| Max. Negotiated Rate |
$176.40 |
| Rate for Payer: Adventist Health Commercial |
$39.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$119.03
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$166.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$107.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$147.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$94.90
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$115.11
|
| Rate for Payer: Blue Shield of California Commercial |
$119.76
|
| Rate for Payer: Blue Shield of California EPN |
$78.20
|
| Rate for Payer: Cash Price |
$107.80
|
| Rate for Payer: Central Health Plan Commercial |
$156.80
|
| Rate for Payer: Cigna of CA HMO |
$125.44
|
| Rate for Payer: Cigna of CA PPO |
$145.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$166.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$166.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$166.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$78.40
|
| Rate for Payer: EPIC Health Plan Senior |
$78.40
|
| Rate for Payer: Galaxy Health WC |
$166.60
|
| Rate for Payer: Global Benefits Group Commercial |
$117.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$176.40
|
| Rate for Payer: InnovAge PACE Commercial |
$98.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$130.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$74.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$121.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$39.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$137.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$137.20
|
| Rate for Payer: Multiplan Commercial |
$147.00
|
| Rate for Payer: Networks By Design Commercial |
$127.40
|
| Rate for Payer: Prime Health Services Commercial |
$166.60
|
| Rate for Payer: Riverside University Health System MISP |
$78.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$117.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$117.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$98.00
|
| Rate for Payer: United Healthcare All Other HMO |
$98.00
|
| Rate for Payer: United Healthcare HMO Rider |
$98.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$98.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$166.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$166.60
|
| Rate for Payer: Vantage Medical Group Senior |
$166.60
|
|
|
HC URINARY DRAIN KIT W/CATH 5.0
|
Facility
|
IP
|
$196.00
|
|
| Hospital Charge Code |
901698567
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$39.20 |
| Max. Negotiated Rate |
$176.40 |
| Rate for Payer: Adventist Health Commercial |
$39.20
|
| Rate for Payer: Cash Price |
$107.80
|
| Rate for Payer: Central Health Plan Commercial |
$156.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$78.40
|
| Rate for Payer: EPIC Health Plan Senior |
$78.40
|
| Rate for Payer: Galaxy Health WC |
$166.60
|
| Rate for Payer: Global Benefits Group Commercial |
$117.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$176.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$130.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$74.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$121.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$39.20
|
| Rate for Payer: Multiplan Commercial |
$147.00
|
| Rate for Payer: Networks By Design Commercial |
$127.40
|
| Rate for Payer: Prime Health Services Commercial |
$166.60
|
|
|
HC URINARY DRAIN SET CATH 3.5FR
|
Facility
|
OP
|
$248.36
|
|
| Hospital Charge Code |
901698491
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$49.67 |
| Max. Negotiated Rate |
$223.52 |
| Rate for Payer: Adventist Health Commercial |
$49.67
|
| Rate for Payer: Aetna of CA HMO/PPO |
$150.83
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$211.11
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$136.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$186.27
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$120.26
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$145.86
|
| Rate for Payer: Blue Shield of California Commercial |
$151.75
|
| Rate for Payer: Blue Shield of California EPN |
$99.10
|
| Rate for Payer: Cash Price |
$136.60
|
| Rate for Payer: Central Health Plan Commercial |
$198.69
|
| Rate for Payer: Cigna of CA HMO |
$158.95
|
| Rate for Payer: Cigna of CA PPO |
$183.79
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$211.11
|
| Rate for Payer: Dignity Health Medi-Cal |
$211.11
|
| Rate for Payer: Dignity Health Medicare Advantage |
$211.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$99.34
|
| Rate for Payer: EPIC Health Plan Senior |
$99.34
|
| Rate for Payer: Galaxy Health WC |
$211.11
|
| Rate for Payer: Global Benefits Group Commercial |
$149.02
|
| Rate for Payer: Health Management Network EPO/PPO |
$223.52
|
| Rate for Payer: InnovAge PACE Commercial |
$124.18
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$165.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$94.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$153.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$49.67
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$173.85
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$173.85
|
| Rate for Payer: Multiplan Commercial |
$186.27
|
| Rate for Payer: Networks By Design Commercial |
$161.43
|
| Rate for Payer: Prime Health Services Commercial |
$211.11
|
| Rate for Payer: Riverside University Health System MISP |
$99.34
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$149.02
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$149.02
|
| Rate for Payer: United Healthcare All Other Commercial |
$124.18
|
| Rate for Payer: United Healthcare All Other HMO |
$124.18
|
| Rate for Payer: United Healthcare HMO Rider |
$124.18
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$124.18
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$211.11
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$211.11
|
| Rate for Payer: Vantage Medical Group Senior |
$211.11
|
|
|
HC URINARY DRAIN SET CATH 3.5FR
|
Facility
|
IP
|
$248.36
|
|
| Hospital Charge Code |
901698491
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$49.67 |
| Max. Negotiated Rate |
$223.52 |
| Rate for Payer: Adventist Health Commercial |
$49.67
|
| Rate for Payer: Cash Price |
$136.60
|
| Rate for Payer: Central Health Plan Commercial |
$198.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$99.34
|
| Rate for Payer: EPIC Health Plan Senior |
$99.34
|
| Rate for Payer: Galaxy Health WC |
$211.11
|
| Rate for Payer: Global Benefits Group Commercial |
$149.02
|
| Rate for Payer: Health Management Network EPO/PPO |
$223.52
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$165.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$94.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$153.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$49.67
|
| Rate for Payer: Multiplan Commercial |
$186.27
|
| Rate for Payer: Networks By Design Commercial |
$161.43
|
| Rate for Payer: Prime Health Services Commercial |
$211.11
|
|
|
HC URINARY DRAIN SET CATH 8FR
|
Facility
|
IP
|
$248.36
|
|
| Hospital Charge Code |
901698512
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$49.67 |
| Max. Negotiated Rate |
$223.52 |
| Rate for Payer: Adventist Health Commercial |
$49.67
|
| Rate for Payer: Cash Price |
$136.60
|
| Rate for Payer: Central Health Plan Commercial |
$198.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$99.34
|
| Rate for Payer: EPIC Health Plan Senior |
$99.34
|
| Rate for Payer: Galaxy Health WC |
$211.11
|
| Rate for Payer: Global Benefits Group Commercial |
$149.02
|
| Rate for Payer: Health Management Network EPO/PPO |
$223.52
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$165.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$94.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$153.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$49.67
|
| Rate for Payer: Multiplan Commercial |
$186.27
|
| Rate for Payer: Networks By Design Commercial |
$161.43
|
| Rate for Payer: Prime Health Services Commercial |
$211.11
|
|
|
HC URINARY DRAIN SET CATH 8FR
|
Facility
|
OP
|
$248.36
|
|
| Hospital Charge Code |
901698512
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$49.67 |
| Max. Negotiated Rate |
$223.52 |
| Rate for Payer: Adventist Health Commercial |
$49.67
|
| Rate for Payer: Aetna of CA HMO/PPO |
$150.83
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$211.11
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$136.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$186.27
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$120.26
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$145.86
|
| Rate for Payer: Blue Shield of California Commercial |
$151.75
|
| Rate for Payer: Blue Shield of California EPN |
$99.10
|
| Rate for Payer: Cash Price |
$136.60
|
| Rate for Payer: Central Health Plan Commercial |
$198.69
|
| Rate for Payer: Cigna of CA HMO |
$158.95
|
| Rate for Payer: Cigna of CA PPO |
$183.79
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$211.11
|
| Rate for Payer: Dignity Health Medi-Cal |
$211.11
|
| Rate for Payer: Dignity Health Medicare Advantage |
$211.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$99.34
|
| Rate for Payer: EPIC Health Plan Senior |
$99.34
|
| Rate for Payer: Galaxy Health WC |
$211.11
|
| Rate for Payer: Global Benefits Group Commercial |
$149.02
|
| Rate for Payer: Health Management Network EPO/PPO |
$223.52
|
| Rate for Payer: InnovAge PACE Commercial |
$124.18
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$165.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$94.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$153.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$49.67
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$173.85
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$173.85
|
| Rate for Payer: Multiplan Commercial |
$186.27
|
| Rate for Payer: Networks By Design Commercial |
$161.43
|
| Rate for Payer: Prime Health Services Commercial |
$211.11
|
| Rate for Payer: Riverside University Health System MISP |
$99.34
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$149.02
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$149.02
|
| Rate for Payer: United Healthcare All Other Commercial |
$124.18
|
| Rate for Payer: United Healthcare All Other HMO |
$124.18
|
| Rate for Payer: United Healthcare HMO Rider |
$124.18
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$124.18
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$211.11
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$211.11
|
| Rate for Payer: Vantage Medical Group Senior |
$211.11
|
|
|
HC URINE CHEMISTRY SCREEN
|
Facility
|
OP
|
$87.00
|
|
|
Service Code
|
CPT 81003
|
| Hospital Charge Code |
900910180
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$1.83 |
| Max. Negotiated Rate |
$78.30 |
| Rate for Payer: Adventist Health Commercial |
$17.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$2.25
|
| Rate for Payer: Aetna of CA HMO/PPO |
$52.84
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3.38
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2.48
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$16.36
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3.32
|
| Rate for Payer: Blue Shield of California Commercial |
$52.81
|
| Rate for Payer: Blue Shield of California EPN |
$34.54
|
| Rate for Payer: Cash Price |
$47.85
|
| Rate for Payer: Cash Price |
$47.85
|
| Rate for Payer: Central Health Plan Commercial |
$69.60
|
| Rate for Payer: Cigna of CA HMO |
$55.68
|
| Rate for Payer: Cigna of CA PPO |
$64.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3.38
|
| Rate for Payer: Dignity Health Medi-Cal |
$2.48
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.04
|
| Rate for Payer: EPIC Health Plan Senior |
$2.25
|
| Rate for Payer: Galaxy Health WC |
$73.95
|
| Rate for Payer: Global Benefits Group Commercial |
$52.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$78.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3.37
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2.25
|
| Rate for Payer: InnovAge PACE Commercial |
$3.38
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$58.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.72
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$17.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3.02
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3.02
|
| Rate for Payer: Multiplan Commercial |
$65.25
|
| Rate for Payer: Networks By Design Commercial |
$56.55
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2.25
|
| Rate for Payer: Prime Health Services Commercial |
$73.95
|
| Rate for Payer: Prime Health Services Medicare |
$2.38
|
| Rate for Payer: Riverside University Health System MISP |
$2.48
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$52.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$52.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.83
|
| Rate for Payer: United Healthcare All Other HMO |
$1.83
|
| Rate for Payer: United Healthcare HMO Rider |
$1.83
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.83
|
| Rate for Payer: Upland Medical Group Pediatric |
$2.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3.38
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2.48
|
| Rate for Payer: Vantage Medical Group Senior |
$2.25
|
|
|
HC URINE CHEMISTRY SCREEN
|
Facility
|
IP
|
$87.00
|
|
|
Service Code
|
CPT 81003
|
| Hospital Charge Code |
900910180
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$17.40 |
| Max. Negotiated Rate |
$78.30 |
| Rate for Payer: Adventist Health Commercial |
$17.40
|
| Rate for Payer: Cash Price |
$47.85
|
| Rate for Payer: Central Health Plan Commercial |
$69.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$34.80
|
| Rate for Payer: EPIC Health Plan Senior |
$34.80
|
| Rate for Payer: Galaxy Health WC |
$73.95
|
| Rate for Payer: Global Benefits Group Commercial |
$52.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$78.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$58.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$33.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$53.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$17.40
|
| Rate for Payer: Multiplan Commercial |
$65.25
|
| Rate for Payer: Networks By Design Commercial |
$56.55
|
| Rate for Payer: Prime Health Services Commercial |
$73.95
|
|
|
HC URINE CHEM SCREEN POC
|
Facility
|
IP
|
$87.00
|
|
|
Service Code
|
CPT 81003
|
| Hospital Charge Code |
900912015
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$17.40 |
| Max. Negotiated Rate |
$78.30 |
| Rate for Payer: Adventist Health Commercial |
$17.40
|
| Rate for Payer: Cash Price |
$47.85
|
| Rate for Payer: Central Health Plan Commercial |
$69.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$34.80
|
| Rate for Payer: EPIC Health Plan Senior |
$34.80
|
| Rate for Payer: Galaxy Health WC |
$73.95
|
| Rate for Payer: Global Benefits Group Commercial |
$52.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$78.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$58.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$33.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$53.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$17.40
|
| Rate for Payer: Multiplan Commercial |
$65.25
|
| Rate for Payer: Networks By Design Commercial |
$56.55
|
| Rate for Payer: Prime Health Services Commercial |
$73.95
|
|
|
HC URINE CHEM SCREEN POC
|
Facility
|
OP
|
$87.00
|
|
|
Service Code
|
CPT 81003
|
| Hospital Charge Code |
900912015
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$1.83 |
| Max. Negotiated Rate |
$78.30 |
| Rate for Payer: Adventist Health Commercial |
$17.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$2.25
|
| Rate for Payer: Aetna of CA HMO/PPO |
$52.84
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3.38
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2.48
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$16.36
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3.32
|
| Rate for Payer: Blue Shield of California Commercial |
$52.81
|
| Rate for Payer: Blue Shield of California EPN |
$34.54
|
| Rate for Payer: Cash Price |
$47.85
|
| Rate for Payer: Cash Price |
$47.85
|
| Rate for Payer: Central Health Plan Commercial |
$69.60
|
| Rate for Payer: Cigna of CA HMO |
$55.68
|
| Rate for Payer: Cigna of CA PPO |
$64.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3.38
|
| Rate for Payer: Dignity Health Medi-Cal |
$2.48
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.04
|
| Rate for Payer: EPIC Health Plan Senior |
$2.25
|
| Rate for Payer: Galaxy Health WC |
$73.95
|
| Rate for Payer: Global Benefits Group Commercial |
$52.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$78.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3.37
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2.25
|
| Rate for Payer: InnovAge PACE Commercial |
$3.38
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$58.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.72
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$17.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3.02
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3.02
|
| Rate for Payer: Multiplan Commercial |
$65.25
|
| Rate for Payer: Networks By Design Commercial |
$56.55
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2.25
|
| Rate for Payer: Prime Health Services Commercial |
$73.95
|
| Rate for Payer: Prime Health Services Medicare |
$2.38
|
| Rate for Payer: Riverside University Health System MISP |
$2.48
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$52.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$52.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.83
|
| Rate for Payer: United Healthcare All Other HMO |
$1.83
|
| Rate for Payer: United Healthcare HMO Rider |
$1.83
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.83
|
| Rate for Payer: Upland Medical Group Pediatric |
$2.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3.38
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2.48
|
| Rate for Payer: Vantage Medical Group Senior |
$2.25
|
|
|
HC URINE COLL KIT W/5FR CATH
|
Facility
|
OP
|
$219.73
|
|
| Hospital Charge Code |
901698695
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$43.95 |
| Max. Negotiated Rate |
$197.76 |
| Rate for Payer: Adventist Health Commercial |
$43.95
|
| Rate for Payer: Aetna of CA HMO/PPO |
$133.44
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$186.77
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$120.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$164.80
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$106.39
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$129.05
|
| Rate for Payer: Blue Shield of California Commercial |
$134.26
|
| Rate for Payer: Blue Shield of California EPN |
$87.67
|
| Rate for Payer: Cash Price |
$120.85
|
| Rate for Payer: Central Health Plan Commercial |
$175.78
|
| Rate for Payer: Cigna of CA HMO |
$140.63
|
| Rate for Payer: Cigna of CA PPO |
$162.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$186.77
|
| Rate for Payer: Dignity Health Medi-Cal |
$186.77
|
| Rate for Payer: Dignity Health Medicare Advantage |
$186.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$87.89
|
| Rate for Payer: EPIC Health Plan Senior |
$87.89
|
| Rate for Payer: Galaxy Health WC |
$186.77
|
| Rate for Payer: Global Benefits Group Commercial |
$131.84
|
| Rate for Payer: Health Management Network EPO/PPO |
$197.76
|
| Rate for Payer: InnovAge PACE Commercial |
$109.86
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$146.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$83.72
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$136.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$43.95
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$153.81
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$153.81
|
| Rate for Payer: Multiplan Commercial |
$164.80
|
| Rate for Payer: Networks By Design Commercial |
$142.82
|
| Rate for Payer: Prime Health Services Commercial |
$186.77
|
| Rate for Payer: Riverside University Health System MISP |
$87.89
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$131.84
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$131.84
|
| Rate for Payer: United Healthcare All Other Commercial |
$109.86
|
| Rate for Payer: United Healthcare All Other HMO |
$109.86
|
| Rate for Payer: United Healthcare HMO Rider |
$109.86
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$109.86
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$186.77
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$186.77
|
| Rate for Payer: Vantage Medical Group Senior |
$186.77
|
|
|
HC URINE COLL KIT W/5FR CATH
|
Facility
|
IP
|
$219.73
|
|
| Hospital Charge Code |
901698695
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$43.95 |
| Max. Negotiated Rate |
$197.76 |
| Rate for Payer: Adventist Health Commercial |
$43.95
|
| Rate for Payer: Cash Price |
$120.85
|
| Rate for Payer: Central Health Plan Commercial |
$175.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$87.89
|
| Rate for Payer: EPIC Health Plan Senior |
$87.89
|
| Rate for Payer: Galaxy Health WC |
$186.77
|
| Rate for Payer: Global Benefits Group Commercial |
$131.84
|
| Rate for Payer: Health Management Network EPO/PPO |
$197.76
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$146.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$83.72
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$136.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$43.95
|
| Rate for Payer: Multiplan Commercial |
$164.80
|
| Rate for Payer: Networks By Design Commercial |
$142.82
|
| Rate for Payer: Prime Health Services Commercial |
$186.77
|
|
|
HC UROGRAPHY ANTEGRADE
|
Facility
|
IP
|
$993.00
|
|
|
Service Code
|
CPT 74425
|
| Hospital Charge Code |
909001935
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$198.60 |
| Max. Negotiated Rate |
$893.70 |
| Rate for Payer: Adventist Health Commercial |
$198.60
|
| Rate for Payer: Cash Price |
$546.15
|
| Rate for Payer: Central Health Plan Commercial |
$794.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$397.20
|
| Rate for Payer: EPIC Health Plan Senior |
$397.20
|
| Rate for Payer: Galaxy Health WC |
$844.05
|
| Rate for Payer: Global Benefits Group Commercial |
$595.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$893.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$662.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$378.33
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$614.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$198.60
|
| Rate for Payer: Multiplan Commercial |
$744.75
|
| Rate for Payer: Networks By Design Commercial |
$645.45
|
| Rate for Payer: Prime Health Services Commercial |
$844.05
|
|
