|
HC AMPUTATION OF TOE
|
Facility
|
IP
|
$13,234.00
|
|
|
Service Code
|
CPT 28820
|
| Hospital Charge Code |
900501402
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,646.80 |
| Max. Negotiated Rate |
$11,910.60 |
| Rate for Payer: Adventist Health Commercial |
$2,646.80
|
| Rate for Payer: Cash Price |
$5,955.30
|
| Rate for Payer: Central Health Plan Commercial |
$10,587.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,293.60
|
| Rate for Payer: EPIC Health Plan Senior |
$5,293.60
|
| Rate for Payer: Galaxy Health WC |
$11,248.90
|
| Rate for Payer: Global Benefits Group Commercial |
$7,940.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,910.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,827.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,042.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8,191.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,646.80
|
| Rate for Payer: Multiplan Commercial |
$9,925.50
|
| Rate for Payer: Networks By Design Commercial |
$8,602.10
|
| Rate for Payer: Prime Health Services Commercial |
$11,248.90
|
|
|
HC AMPUTATION OF TOE
|
Facility
|
OP
|
$13,234.00
|
|
|
Service Code
|
CPT 28820
|
| Hospital Charge Code |
900501402
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$11,910.60 |
| Rate for Payer: Adventist Health Commercial |
$2,646.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,183.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,534.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,122.60
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,333.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$6,568.63
|
| Rate for Payer: Cash Price |
$5,955.30
|
| Rate for Payer: Cash Price |
$5,955.30
|
| Rate for Payer: Cash Price |
$5,955.30
|
| Rate for Payer: Cash Price |
$5,955.30
|
| Rate for Payer: Central Health Plan Commercial |
$10,587.20
|
| Rate for Payer: Cigna of CA HMO |
$8,469.76
|
| Rate for Payer: Cigna of CA PPO |
$9,793.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,183.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,534.86
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,122.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,565.51
|
| Rate for Payer: EPIC Health Plan Senior |
$4,122.60
|
| Rate for Payer: Galaxy Health WC |
$11,248.90
|
| Rate for Payer: Global Benefits Group Commercial |
$7,940.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,910.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,761.06
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,122.60
|
| Rate for Payer: InnovAge PACE Commercial |
$6,183.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,827.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$433.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,122.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,646.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,524.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,524.28
|
| Rate for Payer: Multiplan Commercial |
$9,925.50
|
| Rate for Payer: Multiplan WC |
$6,568.63
|
| Rate for Payer: Networks By Design Commercial |
$8,602.10
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,122.60
|
| Rate for Payer: Preferred Health Network WC |
$6,702.68
|
| Rate for Payer: Prime Health Services Commercial |
$11,248.90
|
| Rate for Payer: Prime Health Services Medicare |
$4,369.96
|
| Rate for Payer: Prime Health Services WC |
$6,501.60
|
| Rate for Payer: Riverside University Health System MISP |
$4,534.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,940.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,617.00
|
| Rate for Payer: United Healthcare All Other HMO |
$6,617.00
|
| Rate for Payer: United Healthcare HMO Rider |
$6,617.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,617.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,122.60
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,183.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,534.86
|
| Rate for Payer: Vantage Medical Group Senior |
$4,122.60
|
|
|
HC AMYLASE
|
Facility
|
IP
|
$258.00
|
|
|
Service Code
|
CPT 82150
|
| Hospital Charge Code |
900910236
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$51.60 |
| Max. Negotiated Rate |
$232.20 |
| Rate for Payer: Adventist Health Commercial |
$51.60
|
| Rate for Payer: Cash Price |
$116.10
|
| Rate for Payer: Central Health Plan Commercial |
$206.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$103.20
|
| Rate for Payer: EPIC Health Plan Senior |
$103.20
|
| Rate for Payer: Galaxy Health WC |
$219.30
|
| Rate for Payer: Global Benefits Group Commercial |
$154.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$232.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$172.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$98.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$159.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$51.60
|
| Rate for Payer: Multiplan Commercial |
$193.50
|
| Rate for Payer: Networks By Design Commercial |
$167.70
|
| Rate for Payer: Prime Health Services Commercial |
$219.30
|
|
|
HC AMYLASE
|
Facility
|
OP
|
$38.00
|
|
|
Service Code
|
CPT 82150
|
| Hospital Charge Code |
900910236
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.25 |
| Max. Negotiated Rate |
$47.21 |
| Rate for Payer: Adventist Health Commercial |
$7.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$6.48
|
| Rate for Payer: Aetna of CA HMO/PPO |
$23.08
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$9.72
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6.48
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$47.21
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9.58
|
| Rate for Payer: Blue Shield of California Commercial |
$23.07
|
| Rate for Payer: Blue Shield of California EPN |
$15.09
|
| Rate for Payer: Cash Price |
$17.10
|
| Rate for Payer: Cash Price |
$17.10
|
| Rate for Payer: Central Health Plan Commercial |
$30.40
|
| Rate for Payer: Cigna of CA HMO |
$24.32
|
| Rate for Payer: Cigna of CA PPO |
$28.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9.72
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.13
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.75
|
| Rate for Payer: EPIC Health Plan Senior |
$6.48
|
| Rate for Payer: Galaxy Health WC |
$32.30
|
| Rate for Payer: Global Benefits Group Commercial |
$22.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$34.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$10.63
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$9.86
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6.48
|
| Rate for Payer: InnovAge PACE Commercial |
$9.72
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$25.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10.89
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8.68
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8.68
|
| Rate for Payer: Multiplan Commercial |
$28.50
|
| Rate for Payer: Networks By Design Commercial |
$24.70
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$6.48
|
| Rate for Payer: Prime Health Services Commercial |
$32.30
|
| Rate for Payer: Prime Health Services Medicare |
$6.87
|
| Rate for Payer: Riverside University Health System MISP |
$7.13
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$22.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$22.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.25
|
| Rate for Payer: United Healthcare All Other HMO |
$5.25
|
| Rate for Payer: United Healthcare HMO Rider |
$5.25
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.25
|
| Rate for Payer: Upland Medical Group Pediatric |
$6.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$9.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.13
|
| Rate for Payer: Vantage Medical Group Senior |
$6.48
|
|
|
HC AMYLASE BODY FLUID
|
Facility
|
IP
|
$56.00
|
|
|
Service Code
|
CPT 82150
|
| Hospital Charge Code |
900910242
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.20 |
| Max. Negotiated Rate |
$50.40 |
| Rate for Payer: Adventist Health Commercial |
$11.20
|
| Rate for Payer: Cash Price |
$25.20
|
| Rate for Payer: Central Health Plan Commercial |
$44.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$22.40
|
| Rate for Payer: EPIC Health Plan Senior |
$22.40
|
| Rate for Payer: Galaxy Health WC |
$47.60
|
| Rate for Payer: Global Benefits Group Commercial |
$33.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$50.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$37.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$21.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$34.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.20
|
| Rate for Payer: Multiplan Commercial |
$42.00
|
| Rate for Payer: Networks By Design Commercial |
$36.40
|
| Rate for Payer: Prime Health Services Commercial |
$47.60
|
|
|
HC AMYLASE BODY FLUID
|
Facility
|
OP
|
$38.00
|
|
|
Service Code
|
CPT 82150
|
| Hospital Charge Code |
900910242
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.25 |
| Max. Negotiated Rate |
$47.21 |
| Rate for Payer: Adventist Health Commercial |
$7.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$6.48
|
| Rate for Payer: Aetna of CA HMO/PPO |
$23.08
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$9.72
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6.48
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$47.21
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9.58
|
| Rate for Payer: Blue Shield of California Commercial |
$23.07
|
| Rate for Payer: Blue Shield of California EPN |
$15.09
|
| Rate for Payer: Cash Price |
$17.10
|
| Rate for Payer: Cash Price |
$17.10
|
| Rate for Payer: Central Health Plan Commercial |
$30.40
|
| Rate for Payer: Cigna of CA HMO |
$24.32
|
| Rate for Payer: Cigna of CA PPO |
$28.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9.72
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.13
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.75
|
| Rate for Payer: EPIC Health Plan Senior |
$6.48
|
| Rate for Payer: Galaxy Health WC |
$32.30
|
| Rate for Payer: Global Benefits Group Commercial |
$22.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$34.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$10.63
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$9.86
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6.48
|
| Rate for Payer: InnovAge PACE Commercial |
$9.72
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$25.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10.89
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8.68
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8.68
|
| Rate for Payer: Multiplan Commercial |
$28.50
|
| Rate for Payer: Networks By Design Commercial |
$24.70
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$6.48
|
| Rate for Payer: Prime Health Services Commercial |
$32.30
|
| Rate for Payer: Prime Health Services Medicare |
$6.87
|
| Rate for Payer: Riverside University Health System MISP |
$7.13
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$22.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$22.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.25
|
| Rate for Payer: United Healthcare All Other HMO |
$5.25
|
| Rate for Payer: United Healthcare HMO Rider |
$5.25
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.25
|
| Rate for Payer: Upland Medical Group Pediatric |
$6.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$9.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.13
|
| Rate for Payer: Vantage Medical Group Senior |
$6.48
|
|
|
HC AMYLASE URINE
|
Facility
|
IP
|
$258.00
|
|
|
Service Code
|
CPT 82150
|
| Hospital Charge Code |
900910237
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$51.60 |
| Max. Negotiated Rate |
$232.20 |
| Rate for Payer: Adventist Health Commercial |
$51.60
|
| Rate for Payer: Cash Price |
$116.10
|
| Rate for Payer: Central Health Plan Commercial |
$206.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$103.20
|
| Rate for Payer: EPIC Health Plan Senior |
$103.20
|
| Rate for Payer: Galaxy Health WC |
$219.30
|
| Rate for Payer: Global Benefits Group Commercial |
$154.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$232.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$172.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$98.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$159.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$51.60
|
| Rate for Payer: Multiplan Commercial |
$193.50
|
| Rate for Payer: Networks By Design Commercial |
$167.70
|
| Rate for Payer: Prime Health Services Commercial |
$219.30
|
|
|
HC AMYLASE URINE
|
Facility
|
OP
|
$56.00
|
|
|
Service Code
|
CPT 82150
|
| Hospital Charge Code |
900910237
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.25 |
| Max. Negotiated Rate |
$50.40 |
| Rate for Payer: Adventist Health Commercial |
$11.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$6.48
|
| Rate for Payer: Aetna of CA HMO/PPO |
$34.01
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$9.72
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6.48
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$47.21
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9.58
|
| Rate for Payer: Blue Shield of California Commercial |
$33.99
|
| Rate for Payer: Blue Shield of California EPN |
$22.23
|
| Rate for Payer: Cash Price |
$25.20
|
| Rate for Payer: Cash Price |
$25.20
|
| Rate for Payer: Central Health Plan Commercial |
$44.80
|
| Rate for Payer: Cigna of CA HMO |
$35.84
|
| Rate for Payer: Cigna of CA PPO |
$41.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9.72
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.13
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.75
|
| Rate for Payer: EPIC Health Plan Senior |
$6.48
|
| Rate for Payer: Galaxy Health WC |
$47.60
|
| Rate for Payer: Global Benefits Group Commercial |
$33.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$50.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$10.63
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$9.86
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6.48
|
| Rate for Payer: InnovAge PACE Commercial |
$9.72
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$37.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10.89
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8.68
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8.68
|
| Rate for Payer: Multiplan Commercial |
$42.00
|
| Rate for Payer: Networks By Design Commercial |
$36.40
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$6.48
|
| Rate for Payer: Prime Health Services Commercial |
$47.60
|
| Rate for Payer: Prime Health Services Medicare |
$6.87
|
| Rate for Payer: Riverside University Health System MISP |
$7.13
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$33.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$33.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.25
|
| Rate for Payer: United Healthcare All Other HMO |
$5.25
|
| Rate for Payer: United Healthcare HMO Rider |
$5.25
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.25
|
| Rate for Payer: Upland Medical Group Pediatric |
$6.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$9.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.13
|
| Rate for Payer: Vantage Medical Group Senior |
$6.48
|
|
|
HC AMYLASE URINE 24 HOURS
|
Facility
|
IP
|
$258.00
|
|
|
Service Code
|
CPT 82150
|
| Hospital Charge Code |
900912194
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$51.60 |
| Max. Negotiated Rate |
$232.20 |
| Rate for Payer: Adventist Health Commercial |
$51.60
|
| Rate for Payer: Cash Price |
$116.10
|
| Rate for Payer: Central Health Plan Commercial |
$206.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$103.20
|
| Rate for Payer: EPIC Health Plan Senior |
$103.20
|
| Rate for Payer: Galaxy Health WC |
$219.30
|
| Rate for Payer: Global Benefits Group Commercial |
$154.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$232.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$172.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$98.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$159.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$51.60
|
| Rate for Payer: Multiplan Commercial |
$193.50
|
| Rate for Payer: Networks By Design Commercial |
$167.70
|
| Rate for Payer: Prime Health Services Commercial |
$219.30
|
|
|
HC AMYLASE URINE 24 HOURS
|
Facility
|
OP
|
$56.00
|
|
|
Service Code
|
CPT 82150
|
| Hospital Charge Code |
900912194
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.25 |
| Max. Negotiated Rate |
$50.40 |
| Rate for Payer: Adventist Health Commercial |
$11.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$6.48
|
| Rate for Payer: Aetna of CA HMO/PPO |
$34.01
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$9.72
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6.48
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$47.21
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9.58
|
| Rate for Payer: Blue Shield of California Commercial |
$33.99
|
| Rate for Payer: Blue Shield of California EPN |
$22.23
|
| Rate for Payer: Cash Price |
$25.20
|
| Rate for Payer: Cash Price |
$25.20
|
| Rate for Payer: Central Health Plan Commercial |
$44.80
|
| Rate for Payer: Cigna of CA HMO |
$35.84
|
| Rate for Payer: Cigna of CA PPO |
$41.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9.72
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.13
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.75
|
| Rate for Payer: EPIC Health Plan Senior |
$6.48
|
| Rate for Payer: Galaxy Health WC |
$47.60
|
| Rate for Payer: Global Benefits Group Commercial |
$33.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$50.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$10.63
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$9.86
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6.48
|
| Rate for Payer: InnovAge PACE Commercial |
$9.72
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$37.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10.89
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8.68
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8.68
|
| Rate for Payer: Multiplan Commercial |
$42.00
|
| Rate for Payer: Networks By Design Commercial |
$36.40
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$6.48
|
| Rate for Payer: Prime Health Services Commercial |
$47.60
|
| Rate for Payer: Prime Health Services Medicare |
$6.87
|
| Rate for Payer: Riverside University Health System MISP |
$7.13
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$33.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$33.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.25
|
| Rate for Payer: United Healthcare All Other HMO |
$5.25
|
| Rate for Payer: United Healthcare HMO Rider |
$5.25
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.25
|
| Rate for Payer: Upland Medical Group Pediatric |
$6.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$9.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.13
|
| Rate for Payer: Vantage Medical Group Senior |
$6.48
|
|
|
HC AMYLASE URINE RANDOM
|
Facility
|
OP
|
$56.00
|
|
|
Service Code
|
CPT 82150
|
| Hospital Charge Code |
900912193
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.25 |
| Max. Negotiated Rate |
$50.40 |
| Rate for Payer: Adventist Health Commercial |
$11.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$6.48
|
| Rate for Payer: Aetna of CA HMO/PPO |
$34.01
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$9.72
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6.48
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$47.21
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9.58
|
| Rate for Payer: Blue Shield of California Commercial |
$33.99
|
| Rate for Payer: Blue Shield of California EPN |
$22.23
|
| Rate for Payer: Cash Price |
$25.20
|
| Rate for Payer: Cash Price |
$25.20
|
| Rate for Payer: Central Health Plan Commercial |
$44.80
|
| Rate for Payer: Cigna of CA HMO |
$35.84
|
| Rate for Payer: Cigna of CA PPO |
$41.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9.72
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.13
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.75
|
| Rate for Payer: EPIC Health Plan Senior |
$6.48
|
| Rate for Payer: Galaxy Health WC |
$47.60
|
| Rate for Payer: Global Benefits Group Commercial |
$33.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$50.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$10.63
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$9.86
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6.48
|
| Rate for Payer: InnovAge PACE Commercial |
$9.72
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$37.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10.89
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8.68
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8.68
|
| Rate for Payer: Multiplan Commercial |
$42.00
|
| Rate for Payer: Networks By Design Commercial |
$36.40
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$6.48
|
| Rate for Payer: Prime Health Services Commercial |
$47.60
|
| Rate for Payer: Prime Health Services Medicare |
$6.87
|
| Rate for Payer: Riverside University Health System MISP |
$7.13
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$33.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$33.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.25
|
| Rate for Payer: United Healthcare All Other HMO |
$5.25
|
| Rate for Payer: United Healthcare HMO Rider |
$5.25
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.25
|
| Rate for Payer: Upland Medical Group Pediatric |
$6.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$9.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.13
|
| Rate for Payer: Vantage Medical Group Senior |
$6.48
|
|
|
HC AMYLASE URINE RANDOM
|
Facility
|
IP
|
$258.00
|
|
|
Service Code
|
CPT 82150
|
| Hospital Charge Code |
900912193
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$51.60 |
| Max. Negotiated Rate |
$232.20 |
| Rate for Payer: Adventist Health Commercial |
$51.60
|
| Rate for Payer: Cash Price |
$116.10
|
| Rate for Payer: Central Health Plan Commercial |
$206.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$103.20
|
| Rate for Payer: EPIC Health Plan Senior |
$103.20
|
| Rate for Payer: Galaxy Health WC |
$219.30
|
| Rate for Payer: Global Benefits Group Commercial |
$154.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$232.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$172.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$98.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$159.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$51.60
|
| Rate for Payer: Multiplan Commercial |
$193.50
|
| Rate for Payer: Networks By Design Commercial |
$167.70
|
| Rate for Payer: Prime Health Services Commercial |
$219.30
|
|
|
HC ANAEROBIC MIC PANEL
|
Facility
|
IP
|
$313.00
|
|
|
Service Code
|
CPT 87186
|
| Hospital Charge Code |
900912405
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$62.60 |
| Max. Negotiated Rate |
$281.70 |
| Rate for Payer: Adventist Health Commercial |
$62.60
|
| Rate for Payer: Cash Price |
$140.85
|
| Rate for Payer: Central Health Plan Commercial |
$250.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$125.20
|
| Rate for Payer: EPIC Health Plan Senior |
$125.20
|
| Rate for Payer: Galaxy Health WC |
$266.05
|
| Rate for Payer: Global Benefits Group Commercial |
$187.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$281.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$208.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$119.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$193.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$62.60
|
| Rate for Payer: Multiplan Commercial |
$234.75
|
| Rate for Payer: Networks By Design Commercial |
$203.45
|
| Rate for Payer: Prime Health Services Commercial |
$266.05
|
|
|
HC ANAEROBIC MIC PANEL
|
Facility
|
OP
|
$88.00
|
|
|
Service Code
|
CPT 87186
|
| Hospital Charge Code |
900912405
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$7.01 |
| Max. Negotiated Rate |
$225.00 |
| Rate for Payer: Adventist Health Commercial |
$17.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$8.65
|
| Rate for Payer: Aetna of CA HMO/PPO |
$53.44
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.97
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9.52
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.65
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$62.89
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12.76
|
| Rate for Payer: Blue Shield of California Commercial |
$53.42
|
| Rate for Payer: Blue Shield of California EPN |
$34.94
|
| Rate for Payer: Cash Price |
$39.60
|
| Rate for Payer: Cash Price |
$39.60
|
| Rate for Payer: Cash Price |
$39.60
|
| Rate for Payer: Central Health Plan Commercial |
$70.40
|
| Rate for Payer: Cigna of CA HMO |
$56.32
|
| Rate for Payer: Cigna of CA PPO |
$65.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.97
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.52
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.68
|
| Rate for Payer: EPIC Health Plan Senior |
$8.65
|
| Rate for Payer: Galaxy Health WC |
$74.80
|
| Rate for Payer: Global Benefits Group Commercial |
$52.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$79.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$14.19
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$12.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.65
|
| Rate for Payer: InnovAge PACE Commercial |
$12.97
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$58.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14.27
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$17.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11.59
|
| Rate for Payer: Multiplan Commercial |
$66.00
|
| Rate for Payer: Networks By Design Commercial |
$57.20
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$8.65
|
| Rate for Payer: Prime Health Services Commercial |
$74.80
|
| Rate for Payer: Prime Health Services Medicare |
$9.17
|
| Rate for Payer: Riverside University Health System MISP |
$9.52
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$52.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$225.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.01
|
| Rate for Payer: United Healthcare All Other HMO |
$7.01
|
| Rate for Payer: United Healthcare HMO Rider |
$7.01
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.01
|
| Rate for Payer: Upland Medical Group Pediatric |
$8.65
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.97
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.52
|
| Rate for Payer: Vantage Medical Group Senior |
$8.65
|
|
|
HC ANALOGUE CONTROL UNB OR EQUAL
|
Facility
|
IP
|
$5,055.00
|
|
|
Service Code
|
CPT L7272
|
| Hospital Charge Code |
905357272
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$1,011.00 |
| Max. Negotiated Rate |
$4,549.50 |
| Rate for Payer: Adventist Health Commercial |
$1,011.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,907.51
|
| Rate for Payer: Blue Shield of California EPN |
$2,547.72
|
| Rate for Payer: Cash Price |
$2,274.75
|
| Rate for Payer: Central Health Plan Commercial |
$4,044.00
|
| Rate for Payer: Cigna of CA HMO |
$3,538.50
|
| Rate for Payer: Cigna of CA PPO |
$3,538.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,022.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,022.00
|
| Rate for Payer: Galaxy Health WC |
$4,296.75
|
| Rate for Payer: Global Benefits Group Commercial |
$3,033.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,549.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,371.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,925.95
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,129.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,011.00
|
| Rate for Payer: Multiplan Commercial |
$3,791.25
|
| Rate for Payer: Networks By Design Commercial |
$3,285.75
|
| Rate for Payer: Prime Health Services Commercial |
$4,296.75
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,897.14
|
| Rate for Payer: United Healthcare All Other HMO |
$1,846.59
|
| Rate for Payer: United Healthcare HMO Rider |
$1,806.66
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,655.51
|
|
|
HC ANALOGUE CONTROL UNB OR EQUAL
|
Facility
|
OP
|
$5,055.00
|
|
|
Service Code
|
CPT L7272
|
| Hospital Charge Code |
905357272
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$1,655.51 |
| Max. Negotiated Rate |
$4,549.50 |
| Rate for Payer: Adventist Health Commercial |
$2,072.55
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4,296.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,780.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,791.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,968.80
|
| Rate for Payer: Blue Shield of California Commercial |
$3,907.51
|
| Rate for Payer: Blue Shield of California EPN |
$2,547.72
|
| Rate for Payer: Cash Price |
$2,274.75
|
| Rate for Payer: Central Health Plan Commercial |
$4,044.00
|
| Rate for Payer: Cigna of CA HMO |
$3,538.50
|
| Rate for Payer: Cigna of CA PPO |
$3,538.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,296.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,296.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,296.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,022.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,022.00
|
| Rate for Payer: Galaxy Health WC |
$4,296.75
|
| Rate for Payer: Global Benefits Group Commercial |
$3,033.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,549.50
|
| Rate for Payer: InnovAge PACE Commercial |
$2,527.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,371.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,925.95
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,129.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,072.55
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,538.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,538.50
|
| Rate for Payer: Multiplan Commercial |
$3,791.25
|
| Rate for Payer: Networks By Design Commercial |
$2,527.50
|
| Rate for Payer: Prime Health Services Commercial |
$4,296.75
|
| Rate for Payer: Riverside University Health System MISP |
$2,022.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,033.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,033.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,897.14
|
| Rate for Payer: United Healthcare All Other HMO |
$1,846.59
|
| Rate for Payer: United Healthcare HMO Rider |
$1,806.66
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,655.51
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4,296.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,296.75
|
| Rate for Payer: Vantage Medical Group Senior |
$4,296.75
|
|
|
HC ANALYSIS PROG PUMP
|
Facility
|
OP
|
$2,053.00
|
|
|
Service Code
|
CPT 62367
|
| Hospital Charge Code |
911801005
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$37.79 |
| Max. Negotiated Rate |
$6,248.00 |
| Rate for Payer: Adventist Health Commercial |
$410.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$381.07
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$571.61
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$419.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$381.07
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,311.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,246.17
|
| Rate for Payer: Blue Shield of California EPN |
$815.04
|
| Rate for Payer: Cash Price |
$923.85
|
| Rate for Payer: Cash Price |
$923.85
|
| Rate for Payer: Cash Price |
$923.85
|
| Rate for Payer: Central Health Plan Commercial |
$1,642.40
|
| Rate for Payer: Cigna of CA HMO |
$1,313.92
|
| Rate for Payer: Cigna of CA PPO |
$1,519.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$571.61
|
| Rate for Payer: Dignity Health Medi-Cal |
$419.18
|
| Rate for Payer: Dignity Health Medicare Advantage |
$381.07
|
| Rate for Payer: EPIC Health Plan Commercial |
$514.44
|
| Rate for Payer: EPIC Health Plan Senior |
$381.07
|
| Rate for Payer: Galaxy Health WC |
$1,745.05
|
| Rate for Payer: Global Benefits Group Commercial |
$1,231.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,847.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$624.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$37.79
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$381.07
|
| Rate for Payer: InnovAge PACE Commercial |
$571.61
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,369.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$41.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$381.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$410.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$510.63
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$510.63
|
| Rate for Payer: Multiplan Commercial |
$1,539.75
|
| Rate for Payer: Networks By Design Commercial |
$1,334.45
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$381.07
|
| Rate for Payer: Prime Health Services Commercial |
$1,745.05
|
| Rate for Payer: Prime Health Services Medicare |
$403.93
|
| Rate for Payer: Riverside University Health System MISP |
$419.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,231.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,231.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,021.00
|
| Rate for Payer: United Healthcare All Other HMO |
$803.00
|
| Rate for Payer: United Healthcare HMO Rider |
$608.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$558.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$381.07
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$571.61
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$419.18
|
| Rate for Payer: Vantage Medical Group Senior |
$381.07
|
|
|
HC ANALYSIS PROG PUMP
|
Facility
|
IP
|
$2,053.00
|
|
|
Service Code
|
CPT 62367
|
| Hospital Charge Code |
911801005
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$410.60 |
| Max. Negotiated Rate |
$1,847.70 |
| Rate for Payer: Adventist Health Commercial |
$410.60
|
| Rate for Payer: Cash Price |
$923.85
|
| Rate for Payer: Central Health Plan Commercial |
$1,642.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$821.20
|
| Rate for Payer: EPIC Health Plan Senior |
$821.20
|
| Rate for Payer: Galaxy Health WC |
$1,745.05
|
| Rate for Payer: Global Benefits Group Commercial |
$1,231.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,847.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,369.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$782.19
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,270.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$410.60
|
| Rate for Payer: Multiplan Commercial |
$1,539.75
|
| Rate for Payer: Networks By Design Commercial |
$1,334.45
|
| Rate for Payer: Prime Health Services Commercial |
$1,745.05
|
|
|
HC ANALYSIS PUMP W/REPROGRAM
|
Facility
|
IP
|
$1,827.00
|
|
|
Service Code
|
CPT 62368
|
| Hospital Charge Code |
911801006
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$365.40 |
| Max. Negotiated Rate |
$1,644.30 |
| Rate for Payer: Adventist Health Commercial |
$365.40
|
| Rate for Payer: Cash Price |
$822.15
|
| Rate for Payer: Central Health Plan Commercial |
$1,461.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$730.80
|
| Rate for Payer: EPIC Health Plan Senior |
$730.80
|
| Rate for Payer: Galaxy Health WC |
$1,552.95
|
| Rate for Payer: Global Benefits Group Commercial |
$1,096.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,644.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,218.61
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$696.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,130.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$365.40
|
| Rate for Payer: Multiplan Commercial |
$1,370.25
|
| Rate for Payer: Networks By Design Commercial |
$1,187.55
|
| Rate for Payer: Prime Health Services Commercial |
$1,552.95
|
|
|
HC ANALYSIS PUMP W/REPROGRAM
|
Facility
|
OP
|
$1,827.00
|
|
|
Service Code
|
CPT 62368
|
| Hospital Charge Code |
911801006
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$58.91 |
| Max. Negotiated Rate |
$6,248.00 |
| Rate for Payer: Adventist Health Commercial |
$365.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$381.07
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$571.61
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$419.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$381.07
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,311.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,108.99
|
| Rate for Payer: Blue Shield of California EPN |
$725.32
|
| Rate for Payer: Cash Price |
$822.15
|
| Rate for Payer: Cash Price |
$822.15
|
| Rate for Payer: Cash Price |
$822.15
|
| Rate for Payer: Central Health Plan Commercial |
$1,461.60
|
| Rate for Payer: Cigna of CA HMO |
$1,169.28
|
| Rate for Payer: Cigna of CA PPO |
$1,351.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$571.61
|
| Rate for Payer: Dignity Health Medi-Cal |
$419.18
|
| Rate for Payer: Dignity Health Medicare Advantage |
$381.07
|
| Rate for Payer: EPIC Health Plan Commercial |
$514.44
|
| Rate for Payer: EPIC Health Plan Senior |
$381.07
|
| Rate for Payer: Galaxy Health WC |
$1,552.95
|
| Rate for Payer: Global Benefits Group Commercial |
$1,096.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,644.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$624.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$58.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$381.07
|
| Rate for Payer: InnovAge PACE Commercial |
$571.61
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,218.61
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$65.08
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$381.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$365.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$510.63
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$510.63
|
| Rate for Payer: Multiplan Commercial |
$1,370.25
|
| Rate for Payer: Networks By Design Commercial |
$1,187.55
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$381.07
|
| Rate for Payer: Prime Health Services Commercial |
$1,552.95
|
| Rate for Payer: Prime Health Services Medicare |
$403.93
|
| Rate for Payer: Riverside University Health System MISP |
$419.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,096.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,096.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,021.00
|
| Rate for Payer: United Healthcare All Other HMO |
$803.00
|
| Rate for Payer: United Healthcare HMO Rider |
$608.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$558.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$381.07
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$571.61
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$419.18
|
| Rate for Payer: Vantage Medical Group Senior |
$381.07
|
|
|
HC ANALYZE ILR SYSTEM IHI
|
Facility
|
IP
|
$90.00
|
|
|
Service Code
|
CPT 93291
|
| Hospital Charge Code |
900200311
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$18.00 |
| Max. Negotiated Rate |
$81.00 |
| Rate for Payer: Adventist Health Commercial |
$18.00
|
| Rate for Payer: Cash Price |
$40.50
|
| Rate for Payer: Central Health Plan Commercial |
$72.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$36.00
|
| Rate for Payer: EPIC Health Plan Senior |
$36.00
|
| Rate for Payer: Galaxy Health WC |
$76.50
|
| Rate for Payer: Global Benefits Group Commercial |
$54.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$81.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$60.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$34.29
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$55.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18.00
|
| Rate for Payer: Multiplan Commercial |
$67.50
|
| Rate for Payer: Networks By Design Commercial |
$58.50
|
| Rate for Payer: Prime Health Services Commercial |
$76.50
|
|
|
HC ANALYZE ILR SYSTEM IHI
|
Facility
|
OP
|
$90.00
|
|
|
Service Code
|
CPT 93291
|
| Hospital Charge Code |
900200311
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$18.00 |
| Max. Negotiated Rate |
$7,837.47 |
| Rate for Payer: Adventist Health Commercial |
$18.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$31.12
|
| Rate for Payer: Aetna of CA HMO/PPO |
$54.66
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$46.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$34.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$31.12
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$101.77
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$52.86
|
| Rate for Payer: Blue Shield of California Commercial |
$7,837.47
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$40.50
|
| Rate for Payer: Cash Price |
$40.50
|
| Rate for Payer: Cash Price |
$40.50
|
| Rate for Payer: Central Health Plan Commercial |
$72.00
|
| Rate for Payer: Cigna of CA HMO |
$57.60
|
| Rate for Payer: Cigna of CA PPO |
$66.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$46.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$34.23
|
| Rate for Payer: Dignity Health Medicare Advantage |
$31.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$42.01
|
| Rate for Payer: EPIC Health Plan Senior |
$31.12
|
| Rate for Payer: Galaxy Health WC |
$76.50
|
| Rate for Payer: Global Benefits Group Commercial |
$54.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$81.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$51.04
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$62.49
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$31.12
|
| Rate for Payer: InnovAge PACE Commercial |
$46.68
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$60.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$69.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$31.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$41.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$41.70
|
| Rate for Payer: Multiplan Commercial |
$67.50
|
| Rate for Payer: Networks By Design Commercial |
$58.50
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$31.12
|
| Rate for Payer: Prime Health Services Commercial |
$76.50
|
| Rate for Payer: Prime Health Services Medicare |
$32.99
|
| Rate for Payer: Riverside University Health System MISP |
$34.23
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$54.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$54.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,136.00
|
| Rate for Payer: United Healthcare All Other HMO |
$868.00
|
| Rate for Payer: United Healthcare HMO Rider |
$737.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$676.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$31.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$46.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$34.23
|
| Rate for Payer: Vantage Medical Group Senior |
$31.12
|
|
|
HC ANA PANEL
|
Facility
|
IP
|
$171.00
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
900913646
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$34.20 |
| Max. Negotiated Rate |
$153.90 |
| Rate for Payer: Adventist Health Commercial |
$34.20
|
| Rate for Payer: Cash Price |
$76.95
|
| Rate for Payer: Central Health Plan Commercial |
$136.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$68.40
|
| Rate for Payer: EPIC Health Plan Senior |
$68.40
|
| Rate for Payer: Galaxy Health WC |
$145.35
|
| Rate for Payer: Global Benefits Group Commercial |
$102.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$153.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$114.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$65.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$105.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$34.20
|
| Rate for Payer: Multiplan Commercial |
$128.25
|
| Rate for Payer: Networks By Design Commercial |
$111.15
|
| Rate for Payer: Prime Health Services Commercial |
$145.35
|
|
|
HC ANA PANEL
|
Facility
|
OP
|
$154.00
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
900913646
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$14.53 |
| Max. Negotiated Rate |
$138.60 |
| Rate for Payer: Adventist Health Commercial |
$30.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$17.93
|
| Rate for Payer: Aetna of CA HMO/PPO |
$93.52
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$17.93
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$110.79
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$22.48
|
| Rate for Payer: Blue Shield of California Commercial |
$93.48
|
| Rate for Payer: Blue Shield of California EPN |
$61.14
|
| Rate for Payer: Cash Price |
$69.30
|
| Rate for Payer: Cash Price |
$69.30
|
| Rate for Payer: Central Health Plan Commercial |
$123.20
|
| Rate for Payer: Cigna of CA HMO |
$98.56
|
| Rate for Payer: Cigna of CA PPO |
$113.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$26.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$19.72
|
| Rate for Payer: Dignity Health Medicare Advantage |
$17.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$24.21
|
| Rate for Payer: EPIC Health Plan Senior |
$17.93
|
| Rate for Payer: Galaxy Health WC |
$130.90
|
| Rate for Payer: Global Benefits Group Commercial |
$92.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$138.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$29.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$25.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$17.93
|
| Rate for Payer: InnovAge PACE Commercial |
$26.89
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$102.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$27.72
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$17.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$30.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$24.03
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$24.03
|
| Rate for Payer: Multiplan Commercial |
$115.50
|
| Rate for Payer: Networks By Design Commercial |
$100.10
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$17.93
|
| Rate for Payer: Prime Health Services Commercial |
$130.90
|
| Rate for Payer: Prime Health Services Medicare |
$19.01
|
| Rate for Payer: Riverside University Health System MISP |
$19.72
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$92.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$92.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.53
|
| Rate for Payer: United Healthcare All Other HMO |
$14.53
|
| Rate for Payer: United Healthcare HMO Rider |
$14.53
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.53
|
| Rate for Payer: Upland Medical Group Pediatric |
$17.93
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Vantage Medical Group Senior |
$17.93
|
|
|
HC ANCR CATH UMBILICAL UMB-E
|
Facility
|
OP
|
$22.63
|
|
| Hospital Charge Code |
901603825
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$4.53 |
| Max. Negotiated Rate |
$20.37 |
| Rate for Payer: Adventist Health Commercial |
$4.53
|
| Rate for Payer: Aetna of CA HMO/PPO |
$13.74
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19.24
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$12.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$16.97
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$10.96
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13.29
|
| Rate for Payer: Blue Shield of California Commercial |
$13.83
|
| Rate for Payer: Blue Shield of California EPN |
$9.03
|
| Rate for Payer: Cash Price |
$10.18
|
| Rate for Payer: Central Health Plan Commercial |
$18.10
|
| Rate for Payer: Cigna of CA HMO |
$14.48
|
| Rate for Payer: Cigna of CA PPO |
$16.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.24
|
| Rate for Payer: Dignity Health Medi-Cal |
$19.24
|
| Rate for Payer: Dignity Health Medicare Advantage |
$19.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.05
|
| Rate for Payer: EPIC Health Plan Senior |
$9.05
|
| Rate for Payer: Galaxy Health WC |
$19.24
|
| Rate for Payer: Global Benefits Group Commercial |
$13.58
|
| Rate for Payer: Health Management Network EPO/PPO |
$20.37
|
| Rate for Payer: InnovAge PACE Commercial |
$11.31
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.53
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$15.84
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$15.84
|
| Rate for Payer: Multiplan Commercial |
$16.97
|
| Rate for Payer: Networks By Design Commercial |
$14.71
|
| Rate for Payer: Prime Health Services Commercial |
$19.24
|
| Rate for Payer: Riverside University Health System MISP |
$9.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$13.58
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$13.58
|
| Rate for Payer: United Healthcare All Other Commercial |
$11.31
|
| Rate for Payer: United Healthcare All Other HMO |
$11.31
|
| Rate for Payer: United Healthcare HMO Rider |
$11.31
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.31
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.24
|
| Rate for Payer: Vantage Medical Group Senior |
$19.24
|
|
