|
HC ALCOHOL ETHANOL (SERUM/URINE)
|
Facility
|
OP
|
$503.00
|
|
|
Service Code
|
CPT 80320
|
| Hospital Charge Code |
900910322
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$0.06 |
| Max. Negotiated Rate |
$452.70 |
| Rate for Payer: Adventist Health Commercial |
$100.60
|
| Rate for Payer: Adventist Health Commercial |
$11.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.06
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$427.55
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$47.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$30.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$276.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$377.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$42.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$75.42
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$75.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$104.86
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$104.86
|
| Rate for Payer: Blue Shield of California Commercial |
$316.89
|
| Rate for Payer: Blue Shield of California Commercial |
$35.28
|
| Rate for Payer: Blue Shield of California EPN |
$199.69
|
| Rate for Payer: Blue Shield of California EPN |
$22.23
|
| Rate for Payer: Cash Price |
$25.20
|
| Rate for Payer: Cash Price |
$226.35
|
| Rate for Payer: Cash Price |
$226.35
|
| Rate for Payer: Cash Price |
$25.20
|
| Rate for Payer: Central Health Plan Commercial |
$402.40
|
| Rate for Payer: Central Health Plan Commercial |
$44.80
|
| Rate for Payer: Cigna of CA HMO |
$35.84
|
| Rate for Payer: Cigna of CA HMO |
$321.92
|
| Rate for Payer: Cigna of CA PPO |
$372.22
|
| Rate for Payer: Cigna of CA PPO |
$41.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$427.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$47.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$427.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$47.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$427.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$47.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$39.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$352.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$201.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$22.40
|
| Rate for Payer: EPIC Health Plan Senior |
$22.40
|
| Rate for Payer: EPIC Health Plan Senior |
$201.20
|
| Rate for Payer: Galaxy Health WC |
$47.60
|
| Rate for Payer: Galaxy Health WC |
$427.55
|
| Rate for Payer: Global Benefits Group Commercial |
$33.60
|
| Rate for Payer: Global Benefits Group Commercial |
$301.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$452.70
|
| Rate for Payer: Health Management Network EPO/PPO |
$50.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$319.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$35.56
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$20.33
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$182.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$296.77
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$33.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$100.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$352.10
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$39.20
|
| Rate for Payer: Multiplan Commercial |
$42.00
|
| Rate for Payer: Multiplan Commercial |
$377.25
|
| Rate for Payer: Networks By Design Commercial |
$36.40
|
| Rate for Payer: Networks By Design Commercial |
$326.95
|
| Rate for Payer: Prime Health Services Commercial |
$47.60
|
| Rate for Payer: Prime Health Services Commercial |
$427.55
|
| Rate for Payer: Riverside University Health System MISP |
$201.20
|
| Rate for Payer: Riverside University Health System MISP |
$22.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$301.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$33.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$33.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$301.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$251.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$28.00
|
| Rate for Payer: United Healthcare All Other HMO |
$251.50
|
| Rate for Payer: United Healthcare All Other HMO |
$28.00
|
| Rate for Payer: United Healthcare HMO Rider |
$251.50
|
| Rate for Payer: United Healthcare HMO Rider |
$28.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$251.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$28.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$427.55
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$47.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$47.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$427.55
|
| Rate for Payer: Vantage Medical Group Senior |
$47.60
|
| Rate for Payer: Vantage Medical Group Senior |
$427.55
|
|
|
HC ALCOHOL ETHANOL (SERUM/URINE)
|
Facility
|
IP
|
$503.00
|
|
|
Service Code
|
CPT 80320
|
| Hospital Charge Code |
900910322
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$100.60 |
| Max. Negotiated Rate |
$452.70 |
| Rate for Payer: Adventist Health Commercial |
$100.60
|
| Rate for Payer: Cash Price |
$226.35
|
| Rate for Payer: Central Health Plan Commercial |
$402.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$352.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$201.20
|
| Rate for Payer: EPIC Health Plan Senior |
$201.20
|
| Rate for Payer: Galaxy Health WC |
$427.55
|
| Rate for Payer: Global Benefits Group Commercial |
$301.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$452.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$319.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$296.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$100.60
|
| Rate for Payer: Multiplan Commercial |
$377.25
|
| Rate for Payer: Networks By Design Commercial |
$326.95
|
| Rate for Payer: Prime Health Services Commercial |
$427.55
|
|
|
HC ALCOHOL INJECTION INTO ORBIT
|
Facility
|
OP
|
$1,513.00
|
|
|
Service Code
|
CPT 67505
|
| Hospital Charge Code |
900567505
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$229.20 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$620.33
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$429.62
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$612.36
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$449.06
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$408.24
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$605.18
|
| Rate for Payer: Cash Price |
$680.85
|
| Rate for Payer: Cash Price |
$680.85
|
| Rate for Payer: Cash Price |
$680.85
|
| Rate for Payer: Cash Price |
$680.85
|
| Rate for Payer: Central Health Plan Commercial |
$1,210.40
|
| Rate for Payer: Cigna of CA HMO |
$968.32
|
| Rate for Payer: Cigna of CA PPO |
$1,119.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$612.36
|
| Rate for Payer: Dignity Health Medi-Cal |
$449.06
|
| Rate for Payer: Dignity Health Medicare Advantage |
$408.24
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,059.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$673.60
|
| Rate for Payer: EPIC Health Plan Senior |
$449.06
|
| Rate for Payer: Galaxy Health WC |
$1,286.05
|
| Rate for Payer: Global Benefits Group Commercial |
$907.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,361.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$669.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$408.24
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$960.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$229.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$438.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$302.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$547.04
|
| Rate for Payer: Multiplan Commercial |
$1,134.75
|
| Rate for Payer: Multiplan WC |
$605.18
|
| Rate for Payer: Networks By Design Commercial |
$983.45
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$408.24
|
| Rate for Payer: Preferred Health Network WC |
$617.53
|
| Rate for Payer: Prime Health Services Commercial |
$1,286.05
|
| Rate for Payer: Prime Health Services Medicare |
$432.73
|
| Rate for Payer: Prime Health Services WC |
$599.00
|
| Rate for Payer: Riverside University Health System MISP |
$449.06
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$907.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$907.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$408.24
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$612.36
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$449.06
|
| Rate for Payer: Vantage Medical Group Senior |
$408.24
|
|
|
HC ALCOHOL INJECTION INTO ORBIT
|
Facility
|
OP
|
$1,513.00
|
|
|
Service Code
|
CPT 67505
|
| Hospital Charge Code |
900567505
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$229.20 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$302.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$612.36
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$449.06
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$408.24
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$605.18
|
| Rate for Payer: Cash Price |
$680.85
|
| Rate for Payer: Cash Price |
$680.85
|
| Rate for Payer: Cash Price |
$680.85
|
| Rate for Payer: Cash Price |
$680.85
|
| Rate for Payer: Central Health Plan Commercial |
$1,210.40
|
| Rate for Payer: Cigna of CA HMO |
$968.32
|
| Rate for Payer: Cigna of CA PPO |
$1,119.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$612.36
|
| Rate for Payer: Dignity Health Medi-Cal |
$449.06
|
| Rate for Payer: Dignity Health Medicare Advantage |
$408.24
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,059.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$673.60
|
| Rate for Payer: EPIC Health Plan Senior |
$449.06
|
| Rate for Payer: Galaxy Health WC |
$1,286.05
|
| Rate for Payer: Global Benefits Group Commercial |
$907.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,361.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$669.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$408.24
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$960.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$229.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$438.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$302.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$547.04
|
| Rate for Payer: Multiplan Commercial |
$1,134.75
|
| Rate for Payer: Multiplan WC |
$605.18
|
| Rate for Payer: Networks By Design Commercial |
$983.45
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$408.24
|
| Rate for Payer: Preferred Health Network WC |
$617.53
|
| Rate for Payer: Prime Health Services Commercial |
$1,286.05
|
| Rate for Payer: Prime Health Services Medicare |
$432.73
|
| Rate for Payer: Prime Health Services WC |
$599.00
|
| Rate for Payer: Riverside University Health System MISP |
$449.06
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$907.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$756.50
|
| Rate for Payer: United Healthcare All Other HMO |
$756.50
|
| Rate for Payer: United Healthcare HMO Rider |
$756.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$756.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$408.24
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$612.36
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$449.06
|
| Rate for Payer: Vantage Medical Group Senior |
$408.24
|
|
|
HC ALCOHOL INJECTION INTO ORBIT
|
Facility
|
IP
|
$1,513.00
|
|
|
Service Code
|
CPT 67505
|
| Hospital Charge Code |
900567505
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$302.60 |
| Max. Negotiated Rate |
$1,361.70 |
| Rate for Payer: Adventist Health Commercial |
$302.60
|
| Rate for Payer: Cash Price |
$680.85
|
| Rate for Payer: Central Health Plan Commercial |
$1,210.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,059.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$605.20
|
| Rate for Payer: EPIC Health Plan Senior |
$605.20
|
| Rate for Payer: Galaxy Health WC |
$1,286.05
|
| Rate for Payer: Global Benefits Group Commercial |
$907.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,361.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$960.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$892.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$302.60
|
| Rate for Payer: Multiplan Commercial |
$1,134.75
|
| Rate for Payer: Networks By Design Commercial |
$983.45
|
| Rate for Payer: Prime Health Services Commercial |
$1,286.05
|
|
|
HC ALCOHOL INJECTION INTO ORBIT
|
Facility
|
IP
|
$1,513.00
|
|
|
Service Code
|
CPT 67505
|
| Hospital Charge Code |
900567505
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$302.60 |
| Max. Negotiated Rate |
$1,361.70 |
| Rate for Payer: Adventist Health Commercial |
$302.60
|
| Rate for Payer: Cash Price |
$680.85
|
| Rate for Payer: Central Health Plan Commercial |
$1,210.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,059.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$605.20
|
| Rate for Payer: EPIC Health Plan Senior |
$605.20
|
| Rate for Payer: Galaxy Health WC |
$1,286.05
|
| Rate for Payer: Global Benefits Group Commercial |
$907.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,361.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$960.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$892.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$302.60
|
| Rate for Payer: Multiplan Commercial |
$1,134.75
|
| Rate for Payer: Networks By Design Commercial |
$983.45
|
| Rate for Payer: Prime Health Services Commercial |
$1,286.05
|
|
|
HC ALCOHOL INJECTION INTO ORBIT
|
Facility
|
OP
|
$1,513.00
|
|
|
Service Code
|
CPT 67505
|
| Hospital Charge Code |
900567505
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$207.48 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$302.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$408.24
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$612.36
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$449.06
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$408.24
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$605.18
|
| Rate for Payer: Blue Shield of California Commercial |
$1,017.03
|
| Rate for Payer: Blue Shield of California EPN |
$639.21
|
| Rate for Payer: Cash Price |
$680.85
|
| Rate for Payer: Cash Price |
$680.85
|
| Rate for Payer: Cash Price |
$680.85
|
| Rate for Payer: Central Health Plan Commercial |
$1,210.40
|
| Rate for Payer: Cigna of CA HMO |
$968.32
|
| Rate for Payer: Cigna of CA PPO |
$1,119.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$612.36
|
| Rate for Payer: Dignity Health Medi-Cal |
$449.06
|
| Rate for Payer: Dignity Health Medicare Advantage |
$408.24
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,059.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$673.60
|
| Rate for Payer: EPIC Health Plan Senior |
$449.06
|
| Rate for Payer: Galaxy Health WC |
$1,286.05
|
| Rate for Payer: Global Benefits Group Commercial |
$907.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,361.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$669.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$207.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$408.24
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$960.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$229.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$571.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$302.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$547.04
|
| Rate for Payer: Multiplan Commercial |
$1,134.75
|
| Rate for Payer: Multiplan WC |
$605.18
|
| Rate for Payer: Networks By Design Commercial |
$983.45
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$408.24
|
| Rate for Payer: Preferred Health Network WC |
$617.53
|
| Rate for Payer: Prime Health Services Commercial |
$1,286.05
|
| Rate for Payer: Prime Health Services Medicare |
$432.73
|
| Rate for Payer: Prime Health Services WC |
$599.00
|
| Rate for Payer: Riverside University Health System MISP |
$449.06
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$907.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$756.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$408.24
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$612.36
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$449.06
|
| Rate for Payer: Vantage Medical Group Senior |
$408.24
|
|
|
HC ALCOHOL INJECTION INTO ORBIT
|
Facility
|
IP
|
$1,513.00
|
|
|
Service Code
|
CPT 67505
|
| Hospital Charge Code |
900567505
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$302.60 |
| Max. Negotiated Rate |
$1,361.70 |
| Rate for Payer: Adventist Health Commercial |
$302.60
|
| Rate for Payer: Cash Price |
$680.85
|
| Rate for Payer: Central Health Plan Commercial |
$1,210.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,059.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$605.20
|
| Rate for Payer: EPIC Health Plan Senior |
$605.20
|
| Rate for Payer: Galaxy Health WC |
$1,286.05
|
| Rate for Payer: Global Benefits Group Commercial |
$907.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,361.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$960.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$892.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$302.60
|
| Rate for Payer: Multiplan Commercial |
$1,134.75
|
| Rate for Payer: Networks By Design Commercial |
$983.45
|
| Rate for Payer: Prime Health Services Commercial |
$1,286.05
|
|
|
HC ALCOHOL URINE
|
Facility
|
OP
|
$426.00
|
|
|
Service Code
|
CPT 80320
|
| Hospital Charge Code |
900912192
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$0.06 |
| Max. Negotiated Rate |
$383.40 |
| Rate for Payer: Adventist Health Commercial |
$85.20
|
| Rate for Payer: Adventist Health Commercial |
$10.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.06
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$362.10
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$43.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$28.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$234.30
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$319.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$38.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$75.42
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$75.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$104.86
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$104.86
|
| Rate for Payer: Blue Shield of California Commercial |
$268.38
|
| Rate for Payer: Blue Shield of California Commercial |
$32.13
|
| Rate for Payer: Blue Shield of California EPN |
$169.12
|
| Rate for Payer: Blue Shield of California EPN |
$20.25
|
| Rate for Payer: Cash Price |
$22.95
|
| Rate for Payer: Cash Price |
$191.70
|
| Rate for Payer: Cash Price |
$191.70
|
| Rate for Payer: Cash Price |
$22.95
|
| Rate for Payer: Central Health Plan Commercial |
$340.80
|
| Rate for Payer: Central Health Plan Commercial |
$40.80
|
| Rate for Payer: Cigna of CA HMO |
$32.64
|
| Rate for Payer: Cigna of CA HMO |
$272.64
|
| Rate for Payer: Cigna of CA PPO |
$315.24
|
| Rate for Payer: Cigna of CA PPO |
$37.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$362.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$43.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$362.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$43.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$362.10
|
| Rate for Payer: Dignity Health Medicare Advantage |
$43.35
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$35.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$298.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$170.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$20.40
|
| Rate for Payer: EPIC Health Plan Senior |
$20.40
|
| Rate for Payer: EPIC Health Plan Senior |
$170.40
|
| Rate for Payer: Galaxy Health WC |
$43.35
|
| Rate for Payer: Galaxy Health WC |
$362.10
|
| Rate for Payer: Global Benefits Group Commercial |
$30.60
|
| Rate for Payer: Global Benefits Group Commercial |
$255.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$383.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$45.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$270.51
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$32.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$18.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$154.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$251.34
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$30.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$85.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$298.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$35.70
|
| Rate for Payer: Multiplan Commercial |
$38.25
|
| Rate for Payer: Multiplan Commercial |
$319.50
|
| Rate for Payer: Networks By Design Commercial |
$33.15
|
| Rate for Payer: Networks By Design Commercial |
$276.90
|
| Rate for Payer: Prime Health Services Commercial |
$43.35
|
| Rate for Payer: Prime Health Services Commercial |
$362.10
|
| Rate for Payer: Riverside University Health System MISP |
$170.40
|
| Rate for Payer: Riverside University Health System MISP |
$20.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$255.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$30.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$30.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$255.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$213.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$25.50
|
| Rate for Payer: United Healthcare All Other HMO |
$213.00
|
| Rate for Payer: United Healthcare All Other HMO |
$25.50
|
| Rate for Payer: United Healthcare HMO Rider |
$213.00
|
| Rate for Payer: United Healthcare HMO Rider |
$25.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$213.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$25.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$362.10
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$43.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$43.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$362.10
|
| Rate for Payer: Vantage Medical Group Senior |
$43.35
|
| Rate for Payer: Vantage Medical Group Senior |
$362.10
|
|
|
HC ALCOHOL URINE
|
Facility
|
IP
|
$426.00
|
|
|
Service Code
|
CPT 80320
|
| Hospital Charge Code |
900912192
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$85.20 |
| Max. Negotiated Rate |
$383.40 |
| Rate for Payer: Adventist Health Commercial |
$85.20
|
| Rate for Payer: Cash Price |
$191.70
|
| Rate for Payer: Central Health Plan Commercial |
$340.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$298.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$170.40
|
| Rate for Payer: EPIC Health Plan Senior |
$170.40
|
| Rate for Payer: Galaxy Health WC |
$362.10
|
| Rate for Payer: Global Benefits Group Commercial |
$255.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$383.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$270.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$251.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$85.20
|
| Rate for Payer: Multiplan Commercial |
$319.50
|
| Rate for Payer: Networks By Design Commercial |
$276.90
|
| Rate for Payer: Prime Health Services Commercial |
$362.10
|
|
|
HC ALELRGEN CUCUMBER IGE
|
Facility
|
IP
|
$66.00
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
900913581
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.20 |
| Max. Negotiated Rate |
$59.40 |
| Rate for Payer: Adventist Health Commercial |
$13.20
|
| Rate for Payer: Cash Price |
$29.70
|
| Rate for Payer: Central Health Plan Commercial |
$52.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$46.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.40
|
| Rate for Payer: EPIC Health Plan Senior |
$26.40
|
| Rate for Payer: Galaxy Health WC |
$56.10
|
| Rate for Payer: Global Benefits Group Commercial |
$39.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$59.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$41.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$38.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.20
|
| Rate for Payer: Multiplan Commercial |
$49.50
|
| Rate for Payer: Networks By Design Commercial |
$42.90
|
| Rate for Payer: Prime Health Services Commercial |
$56.10
|
|
|
HC ALELRGEN CUCUMBER IGE
|
Facility
|
OP
|
$50.00
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
900913581
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.23 |
| Max. Negotiated Rate |
$159.88 |
| Rate for Payer: Adventist Health Commercial |
$10.00
|
| Rate for Payer: Adventist Health Commercial |
$13.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$5.22
|
| Rate for Payer: Adventist Health Medi-Cal |
$5.22
|
| Rate for Payer: Aetna of CA HMO/PPO |
$38.29
|
| Rate for Payer: Aetna of CA HMO/PPO |
$38.29
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.83
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.83
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.74
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.74
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.22
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.22
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$115.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$115.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$159.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$159.88
|
| Rate for Payer: Blue Shield of California Commercial |
$41.58
|
| Rate for Payer: Blue Shield of California Commercial |
$31.50
|
| Rate for Payer: Blue Shield of California EPN |
$26.20
|
| Rate for Payer: Blue Shield of California EPN |
$19.85
|
| Rate for Payer: Cash Price |
$29.70
|
| Rate for Payer: Cash Price |
$29.70
|
| Rate for Payer: Cash Price |
$22.50
|
| Rate for Payer: Cash Price |
$22.50
|
| Rate for Payer: Central Health Plan Commercial |
$40.00
|
| Rate for Payer: Central Health Plan Commercial |
$52.80
|
| Rate for Payer: Cigna of CA HMO |
$42.24
|
| Rate for Payer: Cigna of CA HMO |
$32.00
|
| Rate for Payer: Cigna of CA PPO |
$48.84
|
| Rate for Payer: Cigna of CA PPO |
$37.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.83
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.83
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.74
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.74
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.22
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.22
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$35.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$46.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.61
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.61
|
| Rate for Payer: EPIC Health Plan Senior |
$5.74
|
| Rate for Payer: EPIC Health Plan Senior |
$5.74
|
| Rate for Payer: Galaxy Health WC |
$56.10
|
| Rate for Payer: Galaxy Health WC |
$42.50
|
| Rate for Payer: Global Benefits Group Commercial |
$39.60
|
| Rate for Payer: Global Benefits Group Commercial |
$30.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$59.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$45.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$8.56
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$8.56
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$7.98
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$7.98
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.22
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.22
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$31.75
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$41.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.82
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.82
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$6.99
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$6.99
|
| Rate for Payer: Multiplan Commercial |
$49.50
|
| Rate for Payer: Multiplan Commercial |
$37.50
|
| Rate for Payer: Networks By Design Commercial |
$32.50
|
| Rate for Payer: Networks By Design Commercial |
$42.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$5.22
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$5.22
|
| Rate for Payer: Prime Health Services Commercial |
$56.10
|
| Rate for Payer: Prime Health Services Commercial |
$42.50
|
| Rate for Payer: Prime Health Services Medicare |
$5.53
|
| Rate for Payer: Prime Health Services Medicare |
$5.53
|
| Rate for Payer: Riverside University Health System MISP |
$5.74
|
| Rate for Payer: Riverside University Health System MISP |
$5.74
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$30.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$39.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$39.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$30.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.23
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.23
|
| Rate for Payer: United Healthcare All Other HMO |
$4.23
|
| Rate for Payer: United Healthcare All Other HMO |
$4.23
|
| Rate for Payer: United Healthcare HMO Rider |
$4.23
|
| Rate for Payer: United Healthcare HMO Rider |
$4.23
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.23
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.23
|
| Rate for Payer: Upland Medical Group Pediatric |
$5.22
|
| Rate for Payer: Upland Medical Group Pediatric |
$5.22
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.83
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.74
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.74
|
| Rate for Payer: Vantage Medical Group Senior |
$5.22
|
| Rate for Payer: Vantage Medical Group Senior |
$5.22
|
|
|
HC ALELRGEN GRAPEFRUIT IGE
|
Facility
|
OP
|
$50.00
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
900913587
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.23 |
| Max. Negotiated Rate |
$159.88 |
| Rate for Payer: Adventist Health Commercial |
$10.00
|
| Rate for Payer: Adventist Health Commercial |
$13.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$5.22
|
| Rate for Payer: Adventist Health Medi-Cal |
$5.22
|
| Rate for Payer: Aetna of CA HMO/PPO |
$38.29
|
| Rate for Payer: Aetna of CA HMO/PPO |
$38.29
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.83
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.83
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.74
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.74
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.22
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.22
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$115.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$115.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$159.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$159.88
|
| Rate for Payer: Blue Shield of California Commercial |
$41.58
|
| Rate for Payer: Blue Shield of California Commercial |
$31.50
|
| Rate for Payer: Blue Shield of California EPN |
$26.20
|
| Rate for Payer: Blue Shield of California EPN |
$19.85
|
| Rate for Payer: Cash Price |
$29.70
|
| Rate for Payer: Cash Price |
$29.70
|
| Rate for Payer: Cash Price |
$22.50
|
| Rate for Payer: Cash Price |
$22.50
|
| Rate for Payer: Central Health Plan Commercial |
$40.00
|
| Rate for Payer: Central Health Plan Commercial |
$52.80
|
| Rate for Payer: Cigna of CA HMO |
$42.24
|
| Rate for Payer: Cigna of CA HMO |
$32.00
|
| Rate for Payer: Cigna of CA PPO |
$48.84
|
| Rate for Payer: Cigna of CA PPO |
$37.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.83
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.83
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.74
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.74
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.22
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.22
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$35.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$46.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.61
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.61
|
| Rate for Payer: EPIC Health Plan Senior |
$5.74
|
| Rate for Payer: EPIC Health Plan Senior |
$5.74
|
| Rate for Payer: Galaxy Health WC |
$56.10
|
| Rate for Payer: Galaxy Health WC |
$42.50
|
| Rate for Payer: Global Benefits Group Commercial |
$39.60
|
| Rate for Payer: Global Benefits Group Commercial |
$30.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$59.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$45.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$8.56
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$8.56
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$7.98
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$7.98
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.22
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.22
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$31.75
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$41.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.82
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.82
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$6.99
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$6.99
|
| Rate for Payer: Multiplan Commercial |
$49.50
|
| Rate for Payer: Multiplan Commercial |
$37.50
|
| Rate for Payer: Networks By Design Commercial |
$32.50
|
| Rate for Payer: Networks By Design Commercial |
$42.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$5.22
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$5.22
|
| Rate for Payer: Prime Health Services Commercial |
$56.10
|
| Rate for Payer: Prime Health Services Commercial |
$42.50
|
| Rate for Payer: Prime Health Services Medicare |
$5.53
|
| Rate for Payer: Prime Health Services Medicare |
$5.53
|
| Rate for Payer: Riverside University Health System MISP |
$5.74
|
| Rate for Payer: Riverside University Health System MISP |
$5.74
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$30.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$39.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$39.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$30.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.23
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.23
|
| Rate for Payer: United Healthcare All Other HMO |
$4.23
|
| Rate for Payer: United Healthcare All Other HMO |
$4.23
|
| Rate for Payer: United Healthcare HMO Rider |
$4.23
|
| Rate for Payer: United Healthcare HMO Rider |
$4.23
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.23
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.23
|
| Rate for Payer: Upland Medical Group Pediatric |
$5.22
|
| Rate for Payer: Upland Medical Group Pediatric |
$5.22
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.83
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.74
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.74
|
| Rate for Payer: Vantage Medical Group Senior |
$5.22
|
| Rate for Payer: Vantage Medical Group Senior |
$5.22
|
|
|
HC ALELRGEN GRAPEFRUIT IGE
|
Facility
|
IP
|
$66.00
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
900913587
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.20 |
| Max. Negotiated Rate |
$59.40 |
| Rate for Payer: Adventist Health Commercial |
$13.20
|
| Rate for Payer: Cash Price |
$29.70
|
| Rate for Payer: Central Health Plan Commercial |
$52.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$46.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.40
|
| Rate for Payer: EPIC Health Plan Senior |
$26.40
|
| Rate for Payer: Galaxy Health WC |
$56.10
|
| Rate for Payer: Global Benefits Group Commercial |
$39.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$59.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$41.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$38.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.20
|
| Rate for Payer: Multiplan Commercial |
$49.50
|
| Rate for Payer: Networks By Design Commercial |
$42.90
|
| Rate for Payer: Prime Health Services Commercial |
$56.10
|
|
|
HC ALKALINE PHOSPHATASE
|
Facility
|
IP
|
$94.00
|
|
|
Service Code
|
CPT 84075
|
| Hospital Charge Code |
900910219
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$18.80 |
| Max. Negotiated Rate |
$84.60 |
| Rate for Payer: Adventist Health Commercial |
$18.80
|
| Rate for Payer: Cash Price |
$42.30
|
| Rate for Payer: Central Health Plan Commercial |
$75.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$65.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$37.60
|
| Rate for Payer: EPIC Health Plan Senior |
$37.60
|
| Rate for Payer: Galaxy Health WC |
$79.90
|
| Rate for Payer: Global Benefits Group Commercial |
$56.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$84.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$59.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$55.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18.80
|
| Rate for Payer: Multiplan Commercial |
$70.50
|
| Rate for Payer: Networks By Design Commercial |
$61.10
|
| Rate for Payer: Prime Health Services Commercial |
$79.90
|
|
|
HC ALKALINE PHOSPHATASE
|
Facility
|
OP
|
$34.00
|
|
|
Service Code
|
CPT 84075
|
| Hospital Charge Code |
900910219
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.19 |
| Max. Negotiated Rate |
$52.29 |
| Rate for Payer: Adventist Health Commercial |
$6.80
|
| Rate for Payer: Adventist Health Commercial |
$18.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$5.18
|
| Rate for Payer: Adventist Health Medi-Cal |
$5.18
|
| Rate for Payer: Aetna of CA HMO/PPO |
$37.98
|
| Rate for Payer: Aetna of CA HMO/PPO |
$37.98
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.77
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.77
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.18
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$37.61
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$37.61
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$52.29
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$52.29
|
| Rate for Payer: Blue Shield of California Commercial |
$59.22
|
| Rate for Payer: Blue Shield of California Commercial |
$21.42
|
| Rate for Payer: Blue Shield of California EPN |
$37.32
|
| Rate for Payer: Blue Shield of California EPN |
$13.50
|
| Rate for Payer: Cash Price |
$42.30
|
| Rate for Payer: Cash Price |
$42.30
|
| Rate for Payer: Cash Price |
$15.30
|
| Rate for Payer: Cash Price |
$15.30
|
| Rate for Payer: Central Health Plan Commercial |
$27.20
|
| Rate for Payer: Central Health Plan Commercial |
$75.20
|
| Rate for Payer: Cigna of CA HMO |
$60.16
|
| Rate for Payer: Cigna of CA HMO |
$21.76
|
| Rate for Payer: Cigna of CA PPO |
$69.56
|
| Rate for Payer: Cigna of CA PPO |
$25.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.77
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.77
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.18
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.18
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$23.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$65.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.55
|
| Rate for Payer: EPIC Health Plan Senior |
$5.70
|
| Rate for Payer: EPIC Health Plan Senior |
$5.70
|
| Rate for Payer: Galaxy Health WC |
$79.90
|
| Rate for Payer: Galaxy Health WC |
$28.90
|
| Rate for Payer: Global Benefits Group Commercial |
$56.40
|
| Rate for Payer: Global Benefits Group Commercial |
$20.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$84.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$30.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$8.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$8.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$7.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$7.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.18
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$21.59
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$59.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$7.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$7.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$6.94
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$6.94
|
| Rate for Payer: Multiplan Commercial |
$70.50
|
| Rate for Payer: Multiplan Commercial |
$25.50
|
| Rate for Payer: Networks By Design Commercial |
$22.10
|
| Rate for Payer: Networks By Design Commercial |
$61.10
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$5.18
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$5.18
|
| Rate for Payer: Prime Health Services Commercial |
$79.90
|
| Rate for Payer: Prime Health Services Commercial |
$28.90
|
| Rate for Payer: Prime Health Services Medicare |
$5.49
|
| Rate for Payer: Prime Health Services Medicare |
$5.49
|
| Rate for Payer: Riverside University Health System MISP |
$5.70
|
| Rate for Payer: Riverside University Health System MISP |
$5.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$20.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$56.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$56.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$20.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.19
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.19
|
| Rate for Payer: United Healthcare All Other HMO |
$4.19
|
| Rate for Payer: United Healthcare All Other HMO |
$4.19
|
| Rate for Payer: United Healthcare HMO Rider |
$4.19
|
| Rate for Payer: United Healthcare HMO Rider |
$4.19
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.19
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.19
|
| Rate for Payer: Upland Medical Group Pediatric |
$5.18
|
| Rate for Payer: Upland Medical Group Pediatric |
$5.18
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.77
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.77
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.70
|
| Rate for Payer: Vantage Medical Group Senior |
$5.18
|
| Rate for Payer: Vantage Medical Group Senior |
$5.18
|
|
|
HC ALKALINE PHOSPHATASE INDIV
|
Facility
|
OP
|
$34.00
|
|
|
Service Code
|
CPT 84075
|
| Hospital Charge Code |
900910508
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.19 |
| Max. Negotiated Rate |
$52.29 |
| Rate for Payer: Adventist Health Commercial |
$6.80
|
| Rate for Payer: Adventist Health Commercial |
$19.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$5.18
|
| Rate for Payer: Adventist Health Medi-Cal |
$5.18
|
| Rate for Payer: Aetna of CA HMO/PPO |
$37.98
|
| Rate for Payer: Aetna of CA HMO/PPO |
$37.98
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.77
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.77
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.18
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$37.61
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$37.61
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$52.29
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$52.29
|
| Rate for Payer: Blue Shield of California Commercial |
$61.74
|
| Rate for Payer: Blue Shield of California Commercial |
$21.42
|
| Rate for Payer: Blue Shield of California EPN |
$38.91
|
| Rate for Payer: Blue Shield of California EPN |
$13.50
|
| Rate for Payer: Cash Price |
$44.10
|
| Rate for Payer: Cash Price |
$44.10
|
| Rate for Payer: Cash Price |
$15.30
|
| Rate for Payer: Cash Price |
$15.30
|
| Rate for Payer: Central Health Plan Commercial |
$27.20
|
| Rate for Payer: Central Health Plan Commercial |
$78.40
|
| Rate for Payer: Cigna of CA HMO |
$62.72
|
| Rate for Payer: Cigna of CA HMO |
$21.76
|
| Rate for Payer: Cigna of CA PPO |
$72.52
|
| Rate for Payer: Cigna of CA PPO |
$25.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.77
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.77
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.18
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.18
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$23.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$68.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.55
|
| Rate for Payer: EPIC Health Plan Senior |
$5.70
|
| Rate for Payer: EPIC Health Plan Senior |
$5.70
|
| Rate for Payer: Galaxy Health WC |
$83.30
|
| Rate for Payer: Galaxy Health WC |
$28.90
|
| Rate for Payer: Global Benefits Group Commercial |
$58.80
|
| Rate for Payer: Global Benefits Group Commercial |
$20.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$88.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$30.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$8.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$8.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$7.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$7.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.18
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$21.59
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$62.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$7.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$7.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$6.94
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$6.94
|
| Rate for Payer: Multiplan Commercial |
$73.50
|
| Rate for Payer: Multiplan Commercial |
$25.50
|
| Rate for Payer: Networks By Design Commercial |
$22.10
|
| Rate for Payer: Networks By Design Commercial |
$63.70
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$5.18
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$5.18
|
| Rate for Payer: Prime Health Services Commercial |
$83.30
|
| Rate for Payer: Prime Health Services Commercial |
$28.90
|
| Rate for Payer: Prime Health Services Medicare |
$5.49
|
| Rate for Payer: Prime Health Services Medicare |
$5.49
|
| Rate for Payer: Riverside University Health System MISP |
$5.70
|
| Rate for Payer: Riverside University Health System MISP |
$5.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$20.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$58.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$58.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$20.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.19
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.19
|
| Rate for Payer: United Healthcare All Other HMO |
$4.19
|
| Rate for Payer: United Healthcare All Other HMO |
$4.19
|
| Rate for Payer: United Healthcare HMO Rider |
$4.19
|
| Rate for Payer: United Healthcare HMO Rider |
$4.19
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.19
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.19
|
| Rate for Payer: Upland Medical Group Pediatric |
$5.18
|
| Rate for Payer: Upland Medical Group Pediatric |
$5.18
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.77
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.77
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.70
|
| Rate for Payer: Vantage Medical Group Senior |
$5.18
|
| Rate for Payer: Vantage Medical Group Senior |
$5.18
|
|
|
HC ALKALINE PHOSPHATASE INDIV
|
Facility
|
IP
|
$98.00
|
|
|
Service Code
|
CPT 84075
|
| Hospital Charge Code |
900910508
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$19.60 |
| Max. Negotiated Rate |
$88.20 |
| Rate for Payer: Adventist Health Commercial |
$19.60
|
| Rate for Payer: Cash Price |
$44.10
|
| Rate for Payer: Central Health Plan Commercial |
$78.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$68.60
|
| 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 Foundation Hospitals Commercial/Self Funded |
$62.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$57.82
|
| 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 ALLELRGEN GREEN PEPPER IGE
|
Facility
|
OP
|
$50.00
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
900913601
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.23 |
| Max. Negotiated Rate |
$159.88 |
| Rate for Payer: Adventist Health Commercial |
$10.00
|
| Rate for Payer: Adventist Health Commercial |
$13.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$5.22
|
| Rate for Payer: Adventist Health Medi-Cal |
$5.22
|
| Rate for Payer: Aetna of CA HMO/PPO |
$38.29
|
| Rate for Payer: Aetna of CA HMO/PPO |
$38.29
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.83
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.83
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.74
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.74
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.22
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.22
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$115.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$115.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$159.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$159.88
|
| Rate for Payer: Blue Shield of California Commercial |
$41.58
|
| Rate for Payer: Blue Shield of California Commercial |
$31.50
|
| Rate for Payer: Blue Shield of California EPN |
$26.20
|
| Rate for Payer: Blue Shield of California EPN |
$19.85
|
| Rate for Payer: Cash Price |
$29.70
|
| Rate for Payer: Cash Price |
$29.70
|
| Rate for Payer: Cash Price |
$22.50
|
| Rate for Payer: Cash Price |
$22.50
|
| Rate for Payer: Central Health Plan Commercial |
$40.00
|
| Rate for Payer: Central Health Plan Commercial |
$52.80
|
| Rate for Payer: Cigna of CA HMO |
$42.24
|
| Rate for Payer: Cigna of CA HMO |
$32.00
|
| Rate for Payer: Cigna of CA PPO |
$48.84
|
| Rate for Payer: Cigna of CA PPO |
$37.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.83
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.83
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.74
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.74
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.22
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.22
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$35.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$46.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.61
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.61
|
| Rate for Payer: EPIC Health Plan Senior |
$5.74
|
| Rate for Payer: EPIC Health Plan Senior |
$5.74
|
| Rate for Payer: Galaxy Health WC |
$56.10
|
| Rate for Payer: Galaxy Health WC |
$42.50
|
| Rate for Payer: Global Benefits Group Commercial |
$39.60
|
| Rate for Payer: Global Benefits Group Commercial |
$30.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$59.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$45.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$8.56
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$8.56
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$7.98
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$7.98
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.22
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.22
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$31.75
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$41.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.82
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.82
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$6.99
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$6.99
|
| Rate for Payer: Multiplan Commercial |
$49.50
|
| Rate for Payer: Multiplan Commercial |
$37.50
|
| Rate for Payer: Networks By Design Commercial |
$32.50
|
| Rate for Payer: Networks By Design Commercial |
$42.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$5.22
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$5.22
|
| Rate for Payer: Prime Health Services Commercial |
$56.10
|
| Rate for Payer: Prime Health Services Commercial |
$42.50
|
| Rate for Payer: Prime Health Services Medicare |
$5.53
|
| Rate for Payer: Prime Health Services Medicare |
$5.53
|
| Rate for Payer: Riverside University Health System MISP |
$5.74
|
| Rate for Payer: Riverside University Health System MISP |
$5.74
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$30.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$39.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$39.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$30.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.23
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.23
|
| Rate for Payer: United Healthcare All Other HMO |
$4.23
|
| Rate for Payer: United Healthcare All Other HMO |
$4.23
|
| Rate for Payer: United Healthcare HMO Rider |
$4.23
|
| Rate for Payer: United Healthcare HMO Rider |
$4.23
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.23
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.23
|
| Rate for Payer: Upland Medical Group Pediatric |
$5.22
|
| Rate for Payer: Upland Medical Group Pediatric |
$5.22
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.83
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.74
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.74
|
| Rate for Payer: Vantage Medical Group Senior |
$5.22
|
| Rate for Payer: Vantage Medical Group Senior |
$5.22
|
|
|
HC ALLELRGEN GREEN PEPPER IGE
|
Facility
|
IP
|
$66.00
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
900913601
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.20 |
| Max. Negotiated Rate |
$59.40 |
| Rate for Payer: Adventist Health Commercial |
$13.20
|
| Rate for Payer: Cash Price |
$29.70
|
| Rate for Payer: Central Health Plan Commercial |
$52.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$46.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.40
|
| Rate for Payer: EPIC Health Plan Senior |
$26.40
|
| Rate for Payer: Galaxy Health WC |
$56.10
|
| Rate for Payer: Global Benefits Group Commercial |
$39.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$59.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$41.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$38.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.20
|
| Rate for Payer: Multiplan Commercial |
$49.50
|
| Rate for Payer: Networks By Design Commercial |
$42.90
|
| Rate for Payer: Prime Health Services Commercial |
$56.10
|
|
|
HC ALLERGEN A ALTERNATA IGE
|
Facility
|
IP
|
$66.00
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
900912344
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.20 |
| Max. Negotiated Rate |
$59.40 |
| Rate for Payer: Adventist Health Commercial |
$13.20
|
| Rate for Payer: Cash Price |
$29.70
|
| Rate for Payer: Central Health Plan Commercial |
$52.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$46.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.40
|
| Rate for Payer: EPIC Health Plan Senior |
$26.40
|
| Rate for Payer: Galaxy Health WC |
$56.10
|
| Rate for Payer: Global Benefits Group Commercial |
$39.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$59.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$41.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$38.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.20
|
| Rate for Payer: Multiplan Commercial |
$49.50
|
| Rate for Payer: Networks By Design Commercial |
$42.90
|
| Rate for Payer: Prime Health Services Commercial |
$56.10
|
|
|
HC ALLERGEN A ALTERNATA IGE
|
Facility
|
OP
|
$50.00
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
900912344
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.23 |
| Max. Negotiated Rate |
$159.88 |
| Rate for Payer: Adventist Health Commercial |
$10.00
|
| Rate for Payer: Adventist Health Commercial |
$13.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$5.22
|
| Rate for Payer: Adventist Health Medi-Cal |
$5.22
|
| Rate for Payer: Aetna of CA HMO/PPO |
$38.29
|
| Rate for Payer: Aetna of CA HMO/PPO |
$38.29
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.83
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.83
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.74
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.74
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.22
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.22
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$115.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$115.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$159.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$159.88
|
| Rate for Payer: Blue Shield of California Commercial |
$41.58
|
| Rate for Payer: Blue Shield of California Commercial |
$31.50
|
| Rate for Payer: Blue Shield of California EPN |
$26.20
|
| Rate for Payer: Blue Shield of California EPN |
$19.85
|
| Rate for Payer: Cash Price |
$29.70
|
| Rate for Payer: Cash Price |
$29.70
|
| Rate for Payer: Cash Price |
$22.50
|
| Rate for Payer: Cash Price |
$22.50
|
| Rate for Payer: Central Health Plan Commercial |
$40.00
|
| Rate for Payer: Central Health Plan Commercial |
$52.80
|
| Rate for Payer: Cigna of CA HMO |
$42.24
|
| Rate for Payer: Cigna of CA HMO |
$32.00
|
| Rate for Payer: Cigna of CA PPO |
$48.84
|
| Rate for Payer: Cigna of CA PPO |
$37.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.83
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.83
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.74
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.74
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.22
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.22
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$35.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$46.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.61
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.61
|
| Rate for Payer: EPIC Health Plan Senior |
$5.74
|
| Rate for Payer: EPIC Health Plan Senior |
$5.74
|
| Rate for Payer: Galaxy Health WC |
$56.10
|
| Rate for Payer: Galaxy Health WC |
$42.50
|
| Rate for Payer: Global Benefits Group Commercial |
$39.60
|
| Rate for Payer: Global Benefits Group Commercial |
$30.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$59.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$45.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$8.56
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$8.56
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$7.98
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$7.98
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.22
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.22
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$31.75
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$41.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.82
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.82
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$6.99
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$6.99
|
| Rate for Payer: Multiplan Commercial |
$49.50
|
| Rate for Payer: Multiplan Commercial |
$37.50
|
| Rate for Payer: Networks By Design Commercial |
$32.50
|
| Rate for Payer: Networks By Design Commercial |
$42.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$5.22
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$5.22
|
| Rate for Payer: Prime Health Services Commercial |
$56.10
|
| Rate for Payer: Prime Health Services Commercial |
$42.50
|
| Rate for Payer: Prime Health Services Medicare |
$5.53
|
| Rate for Payer: Prime Health Services Medicare |
$5.53
|
| Rate for Payer: Riverside University Health System MISP |
$5.74
|
| Rate for Payer: Riverside University Health System MISP |
$5.74
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$30.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$39.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$39.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$30.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.23
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.23
|
| Rate for Payer: United Healthcare All Other HMO |
$4.23
|
| Rate for Payer: United Healthcare All Other HMO |
$4.23
|
| Rate for Payer: United Healthcare HMO Rider |
$4.23
|
| Rate for Payer: United Healthcare HMO Rider |
$4.23
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.23
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.23
|
| Rate for Payer: Upland Medical Group Pediatric |
$5.22
|
| Rate for Payer: Upland Medical Group Pediatric |
$5.22
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.83
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.74
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.74
|
| Rate for Payer: Vantage Medical Group Senior |
$5.22
|
| Rate for Payer: Vantage Medical Group Senior |
$5.22
|
|
|
HC ALLERGEN ALDER E IGE
|
Facility
|
OP
|
$50.00
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
900912345
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.23 |
| Max. Negotiated Rate |
$159.88 |
| Rate for Payer: Adventist Health Commercial |
$10.00
|
| Rate for Payer: Adventist Health Commercial |
$13.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$5.22
|
| Rate for Payer: Adventist Health Medi-Cal |
$5.22
|
| Rate for Payer: Aetna of CA HMO/PPO |
$38.29
|
| Rate for Payer: Aetna of CA HMO/PPO |
$38.29
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.83
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.83
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.74
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.74
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.22
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.22
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$115.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$115.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$159.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$159.88
|
| Rate for Payer: Blue Shield of California Commercial |
$41.58
|
| Rate for Payer: Blue Shield of California Commercial |
$31.50
|
| Rate for Payer: Blue Shield of California EPN |
$26.20
|
| Rate for Payer: Blue Shield of California EPN |
$19.85
|
| Rate for Payer: Cash Price |
$29.70
|
| Rate for Payer: Cash Price |
$29.70
|
| Rate for Payer: Cash Price |
$22.50
|
| Rate for Payer: Cash Price |
$22.50
|
| Rate for Payer: Central Health Plan Commercial |
$40.00
|
| Rate for Payer: Central Health Plan Commercial |
$52.80
|
| Rate for Payer: Cigna of CA HMO |
$42.24
|
| Rate for Payer: Cigna of CA HMO |
$32.00
|
| Rate for Payer: Cigna of CA PPO |
$48.84
|
| Rate for Payer: Cigna of CA PPO |
$37.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.83
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.83
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.74
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.74
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.22
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.22
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$35.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$46.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.61
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.61
|
| Rate for Payer: EPIC Health Plan Senior |
$5.74
|
| Rate for Payer: EPIC Health Plan Senior |
$5.74
|
| Rate for Payer: Galaxy Health WC |
$56.10
|
| Rate for Payer: Galaxy Health WC |
$42.50
|
| Rate for Payer: Global Benefits Group Commercial |
$39.60
|
| Rate for Payer: Global Benefits Group Commercial |
$30.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$59.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$45.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$8.56
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$8.56
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$7.98
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$7.98
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.22
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.22
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$31.75
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$41.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.82
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.82
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$6.99
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$6.99
|
| Rate for Payer: Multiplan Commercial |
$49.50
|
| Rate for Payer: Multiplan Commercial |
$37.50
|
| Rate for Payer: Networks By Design Commercial |
$32.50
|
| Rate for Payer: Networks By Design Commercial |
$42.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$5.22
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$5.22
|
| Rate for Payer: Prime Health Services Commercial |
$56.10
|
| Rate for Payer: Prime Health Services Commercial |
$42.50
|
| Rate for Payer: Prime Health Services Medicare |
$5.53
|
| Rate for Payer: Prime Health Services Medicare |
$5.53
|
| Rate for Payer: Riverside University Health System MISP |
$5.74
|
| Rate for Payer: Riverside University Health System MISP |
$5.74
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$30.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$39.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$39.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$30.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.23
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.23
|
| Rate for Payer: United Healthcare All Other HMO |
$4.23
|
| Rate for Payer: United Healthcare All Other HMO |
$4.23
|
| Rate for Payer: United Healthcare HMO Rider |
$4.23
|
| Rate for Payer: United Healthcare HMO Rider |
$4.23
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.23
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.23
|
| Rate for Payer: Upland Medical Group Pediatric |
$5.22
|
| Rate for Payer: Upland Medical Group Pediatric |
$5.22
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.83
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.74
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.74
|
| Rate for Payer: Vantage Medical Group Senior |
$5.22
|
| Rate for Payer: Vantage Medical Group Senior |
$5.22
|
|
|
HC ALLERGEN ALDER E IGE
|
Facility
|
IP
|
$66.00
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
900912345
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.20 |
| Max. Negotiated Rate |
$59.40 |
| Rate for Payer: Adventist Health Commercial |
$13.20
|
| Rate for Payer: Cash Price |
$29.70
|
| Rate for Payer: Central Health Plan Commercial |
$52.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$46.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.40
|
| Rate for Payer: EPIC Health Plan Senior |
$26.40
|
| Rate for Payer: Galaxy Health WC |
$56.10
|
| Rate for Payer: Global Benefits Group Commercial |
$39.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$59.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$41.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$38.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.20
|
| Rate for Payer: Multiplan Commercial |
$49.50
|
| Rate for Payer: Networks By Design Commercial |
$42.90
|
| Rate for Payer: Prime Health Services Commercial |
$56.10
|
|
|
HC ALLERGEN ALMOND IGE
|
Facility
|
OP
|
$50.00
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
900912346
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.23 |
| Max. Negotiated Rate |
$159.88 |
| Rate for Payer: Adventist Health Commercial |
$10.00
|
| Rate for Payer: Adventist Health Commercial |
$13.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$5.22
|
| Rate for Payer: Adventist Health Medi-Cal |
$5.22
|
| Rate for Payer: Aetna of CA HMO/PPO |
$38.29
|
| Rate for Payer: Aetna of CA HMO/PPO |
$38.29
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.83
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.83
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.74
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.74
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.22
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.22
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$115.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$115.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$159.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$159.88
|
| Rate for Payer: Blue Shield of California Commercial |
$41.58
|
| Rate for Payer: Blue Shield of California Commercial |
$31.50
|
| Rate for Payer: Blue Shield of California EPN |
$26.20
|
| Rate for Payer: Blue Shield of California EPN |
$19.85
|
| Rate for Payer: Cash Price |
$29.70
|
| Rate for Payer: Cash Price |
$29.70
|
| Rate for Payer: Cash Price |
$22.50
|
| Rate for Payer: Cash Price |
$22.50
|
| Rate for Payer: Central Health Plan Commercial |
$40.00
|
| Rate for Payer: Central Health Plan Commercial |
$52.80
|
| Rate for Payer: Cigna of CA HMO |
$42.24
|
| Rate for Payer: Cigna of CA HMO |
$32.00
|
| Rate for Payer: Cigna of CA PPO |
$48.84
|
| Rate for Payer: Cigna of CA PPO |
$37.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.83
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.83
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.74
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.74
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.22
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.22
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$35.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$46.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.61
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.61
|
| Rate for Payer: EPIC Health Plan Senior |
$5.74
|
| Rate for Payer: EPIC Health Plan Senior |
$5.74
|
| Rate for Payer: Galaxy Health WC |
$56.10
|
| Rate for Payer: Galaxy Health WC |
$42.50
|
| Rate for Payer: Global Benefits Group Commercial |
$39.60
|
| Rate for Payer: Global Benefits Group Commercial |
$30.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$59.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$45.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$8.56
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$8.56
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$7.98
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$7.98
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.22
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.22
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$31.75
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$41.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.82
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.82
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$6.99
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$6.99
|
| Rate for Payer: Multiplan Commercial |
$49.50
|
| Rate for Payer: Multiplan Commercial |
$37.50
|
| Rate for Payer: Networks By Design Commercial |
$32.50
|
| Rate for Payer: Networks By Design Commercial |
$42.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$5.22
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$5.22
|
| Rate for Payer: Prime Health Services Commercial |
$56.10
|
| Rate for Payer: Prime Health Services Commercial |
$42.50
|
| Rate for Payer: Prime Health Services Medicare |
$5.53
|
| Rate for Payer: Prime Health Services Medicare |
$5.53
|
| Rate for Payer: Riverside University Health System MISP |
$5.74
|
| Rate for Payer: Riverside University Health System MISP |
$5.74
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$30.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$39.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$39.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$30.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.23
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.23
|
| Rate for Payer: United Healthcare All Other HMO |
$4.23
|
| Rate for Payer: United Healthcare All Other HMO |
$4.23
|
| Rate for Payer: United Healthcare HMO Rider |
$4.23
|
| Rate for Payer: United Healthcare HMO Rider |
$4.23
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.23
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.23
|
| Rate for Payer: Upland Medical Group Pediatric |
$5.22
|
| Rate for Payer: Upland Medical Group Pediatric |
$5.22
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.83
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.74
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.74
|
| Rate for Payer: Vantage Medical Group Senior |
$5.22
|
| Rate for Payer: Vantage Medical Group Senior |
$5.22
|
|
