|
HC CAPILLARY BLOOD DRAW HEEL FNGR EAR
|
Facility
|
OP
|
$52.00
|
|
|
Service Code
|
CPT 36416
|
| Hospital Charge Code |
900802002
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$2.52 |
| Max. Negotiated Rate |
$46.80 |
| Rate for Payer: Adventist Health Commercial |
$10.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$31.58
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$44.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$28.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$39.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$25.18
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$30.54
|
| Rate for Payer: Blue Shield of California Commercial |
$31.56
|
| Rate for Payer: Blue Shield of California EPN |
$20.64
|
| Rate for Payer: Cash Price |
$28.60
|
| Rate for Payer: Cash Price |
$28.60
|
| Rate for Payer: Central Health Plan Commercial |
$41.60
|
| Rate for Payer: Cigna of CA HMO |
$33.28
|
| Rate for Payer: Cigna of CA PPO |
$38.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$44.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$44.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$44.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$20.80
|
| Rate for Payer: EPIC Health Plan Senior |
$20.80
|
| Rate for Payer: Galaxy Health WC |
$44.20
|
| Rate for Payer: Global Benefits Group Commercial |
$31.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$46.80
|
| Rate for Payer: InnovAge PACE Commercial |
$26.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$34.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$19.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$32.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$36.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$36.40
|
| Rate for Payer: Multiplan Commercial |
$39.00
|
| Rate for Payer: Networks By Design Commercial |
$33.80
|
| Rate for Payer: Prime Health Services Commercial |
$44.20
|
| Rate for Payer: Riverside University Health System MISP |
$20.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$31.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$31.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.52
|
| Rate for Payer: United Healthcare All Other HMO |
$2.52
|
| Rate for Payer: United Healthcare HMO Rider |
$2.52
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.52
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$44.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$44.20
|
| Rate for Payer: Vantage Medical Group Senior |
$44.20
|
|
|
HC CAPILLARY BLOOD DRAW HEEL FNGR EAR
|
Facility
|
IP
|
$52.00
|
|
|
Service Code
|
CPT 36416
|
| Hospital Charge Code |
902400137
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$10.40 |
| Max. Negotiated Rate |
$46.80 |
| Rate for Payer: Adventist Health Commercial |
$10.40
|
| Rate for Payer: Cash Price |
$28.60
|
| Rate for Payer: Central Health Plan Commercial |
$41.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$20.80
|
| Rate for Payer: EPIC Health Plan Senior |
$20.80
|
| Rate for Payer: Galaxy Health WC |
$44.20
|
| Rate for Payer: Global Benefits Group Commercial |
$31.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$46.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$34.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$19.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$32.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.40
|
| Rate for Payer: Multiplan Commercial |
$39.00
|
| Rate for Payer: Networks By Design Commercial |
$33.80
|
| Rate for Payer: Prime Health Services Commercial |
$44.20
|
|
|
HC CAPILLARY BLOOD DRAW HEEL FNGR EAR
|
Facility
|
OP
|
$52.00
|
|
|
Service Code
|
CPT 36416
|
| Hospital Charge Code |
902400137
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$2.52 |
| Max. Negotiated Rate |
$46.80 |
| Rate for Payer: Adventist Health Commercial |
$10.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$31.58
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$44.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$28.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$39.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$25.18
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$30.54
|
| Rate for Payer: Blue Shield of California Commercial |
$31.56
|
| Rate for Payer: Blue Shield of California EPN |
$20.64
|
| Rate for Payer: Cash Price |
$28.60
|
| Rate for Payer: Cash Price |
$28.60
|
| Rate for Payer: Central Health Plan Commercial |
$41.60
|
| Rate for Payer: Cigna of CA HMO |
$33.28
|
| Rate for Payer: Cigna of CA PPO |
$38.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$44.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$44.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$44.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$20.80
|
| Rate for Payer: EPIC Health Plan Senior |
$20.80
|
| Rate for Payer: Galaxy Health WC |
$44.20
|
| Rate for Payer: Global Benefits Group Commercial |
$31.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$46.80
|
| Rate for Payer: InnovAge PACE Commercial |
$26.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$34.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$19.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$32.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$36.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$36.40
|
| Rate for Payer: Multiplan Commercial |
$39.00
|
| Rate for Payer: Networks By Design Commercial |
$33.80
|
| Rate for Payer: Prime Health Services Commercial |
$44.20
|
| Rate for Payer: Riverside University Health System MISP |
$20.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$31.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$31.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.52
|
| Rate for Payer: United Healthcare All Other HMO |
$2.52
|
| Rate for Payer: United Healthcare HMO Rider |
$2.52
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.52
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$44.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$44.20
|
| Rate for Payer: Vantage Medical Group Senior |
$44.20
|
|
|
HC CAPILLARY BLOOD DRAW HEEL FNGR EAR
|
Facility
|
IP
|
$52.00
|
|
|
Service Code
|
CPT 36416
|
| Hospital Charge Code |
900802002
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$10.40 |
| Max. Negotiated Rate |
$46.80 |
| Rate for Payer: Adventist Health Commercial |
$10.40
|
| Rate for Payer: Cash Price |
$28.60
|
| Rate for Payer: Central Health Plan Commercial |
$41.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$20.80
|
| Rate for Payer: EPIC Health Plan Senior |
$20.80
|
| Rate for Payer: Galaxy Health WC |
$44.20
|
| Rate for Payer: Global Benefits Group Commercial |
$31.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$46.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$34.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$19.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$32.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.40
|
| Rate for Payer: Multiplan Commercial |
$39.00
|
| Rate for Payer: Networks By Design Commercial |
$33.80
|
| Rate for Payer: Prime Health Services Commercial |
$44.20
|
|
|
HC CAPILLARY HA1C
|
Facility
|
OP
|
$80.00
|
|
|
Service Code
|
CPT 83036
|
| Hospital Charge Code |
902501902
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$7.87 |
| Max. Negotiated Rate |
$72.00 |
| Rate for Payer: Adventist Health Commercial |
$16.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$9.71
|
| Rate for Payer: Aetna of CA HMO/PPO |
$48.58
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$14.56
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10.68
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9.71
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$70.62
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14.33
|
| Rate for Payer: Blue Shield of California Commercial |
$48.56
|
| Rate for Payer: Blue Shield of California EPN |
$31.76
|
| Rate for Payer: Cash Price |
$44.00
|
| Rate for Payer: Cash Price |
$44.00
|
| Rate for Payer: Central Health Plan Commercial |
$64.00
|
| Rate for Payer: Cigna of CA HMO |
$51.20
|
| Rate for Payer: Cigna of CA PPO |
$59.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$14.56
|
| Rate for Payer: Dignity Health Medi-Cal |
$10.68
|
| Rate for Payer: Dignity Health Medicare Advantage |
$9.71
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.11
|
| Rate for Payer: EPIC Health Plan Senior |
$9.71
|
| Rate for Payer: Galaxy Health WC |
$68.00
|
| Rate for Payer: Global Benefits Group Commercial |
$48.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$72.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$15.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$14.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$9.71
|
| Rate for Payer: InnovAge PACE Commercial |
$14.56
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$53.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$16.23
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$13.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$13.01
|
| Rate for Payer: Multiplan Commercial |
$60.00
|
| Rate for Payer: Networks By Design Commercial |
$52.00
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$9.71
|
| Rate for Payer: Prime Health Services Commercial |
$68.00
|
| Rate for Payer: Prime Health Services Medicare |
$10.29
|
| Rate for Payer: Riverside University Health System MISP |
$10.68
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$48.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$48.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.87
|
| Rate for Payer: United Healthcare All Other HMO |
$7.87
|
| Rate for Payer: United Healthcare HMO Rider |
$7.87
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.87
|
| Rate for Payer: Upland Medical Group Pediatric |
$9.71
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$14.56
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.68
|
| Rate for Payer: Vantage Medical Group Senior |
$9.71
|
|
|
HC CAPILLARY HA1C
|
Facility
|
IP
|
$80.00
|
|
|
Service Code
|
CPT 83036
|
| Hospital Charge Code |
902501902
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$16.00 |
| Max. Negotiated Rate |
$72.00 |
| Rate for Payer: Adventist Health Commercial |
$16.00
|
| Rate for Payer: Cash Price |
$44.00
|
| Rate for Payer: Central Health Plan Commercial |
$64.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$32.00
|
| Rate for Payer: EPIC Health Plan Senior |
$32.00
|
| Rate for Payer: Galaxy Health WC |
$68.00
|
| Rate for Payer: Global Benefits Group Commercial |
$48.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$72.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$53.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$30.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$49.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.00
|
| Rate for Payer: Multiplan Commercial |
$60.00
|
| Rate for Payer: Networks By Design Commercial |
$52.00
|
| Rate for Payer: Prime Health Services Commercial |
$68.00
|
|
|
HC CAP NEWBORN LRG 16IN PINK
|
Facility
|
OP
|
$481.40
|
|
| Hospital Charge Code |
901608014
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$96.28 |
| Max. Negotiated Rate |
$433.26 |
| Rate for Payer: Adventist Health Commercial |
$96.28
|
| Rate for Payer: Aetna of CA HMO/PPO |
$292.35
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$409.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$264.77
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$361.05
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$233.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$282.73
|
| Rate for Payer: Blue Shield of California Commercial |
$294.14
|
| Rate for Payer: Blue Shield of California EPN |
$192.08
|
| Rate for Payer: Cash Price |
$264.77
|
| Rate for Payer: Central Health Plan Commercial |
$385.12
|
| Rate for Payer: Cigna of CA HMO |
$308.10
|
| Rate for Payer: Cigna of CA PPO |
$356.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$409.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$409.19
|
| Rate for Payer: Dignity Health Medicare Advantage |
$409.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$192.56
|
| Rate for Payer: EPIC Health Plan Senior |
$192.56
|
| Rate for Payer: Galaxy Health WC |
$409.19
|
| Rate for Payer: Global Benefits Group Commercial |
$288.84
|
| Rate for Payer: Health Management Network EPO/PPO |
$433.26
|
| Rate for Payer: InnovAge PACE Commercial |
$240.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$321.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$183.41
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$297.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$96.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$336.98
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$336.98
|
| Rate for Payer: Multiplan Commercial |
$361.05
|
| Rate for Payer: Networks By Design Commercial |
$312.91
|
| Rate for Payer: Prime Health Services Commercial |
$409.19
|
| Rate for Payer: Riverside University Health System MISP |
$192.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$288.84
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$288.84
|
| Rate for Payer: United Healthcare All Other Commercial |
$240.70
|
| Rate for Payer: United Healthcare All Other HMO |
$240.70
|
| Rate for Payer: United Healthcare HMO Rider |
$240.70
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$240.70
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$409.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$409.19
|
| Rate for Payer: Vantage Medical Group Senior |
$409.19
|
|
|
HC CAP NEWBORN LRG 16IN PINK
|
Facility
|
IP
|
$481.40
|
|
| Hospital Charge Code |
901608014
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$96.28 |
| Max. Negotiated Rate |
$433.26 |
| Rate for Payer: Adventist Health Commercial |
$96.28
|
| Rate for Payer: Cash Price |
$264.77
|
| Rate for Payer: Central Health Plan Commercial |
$385.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$192.56
|
| Rate for Payer: EPIC Health Plan Senior |
$192.56
|
| Rate for Payer: Galaxy Health WC |
$409.19
|
| Rate for Payer: Global Benefits Group Commercial |
$288.84
|
| Rate for Payer: Health Management Network EPO/PPO |
$433.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$321.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$183.41
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$297.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$96.28
|
| Rate for Payer: Multiplan Commercial |
$361.05
|
| Rate for Payer: Networks By Design Commercial |
$312.91
|
| Rate for Payer: Prime Health Services Commercial |
$409.19
|
|
|
HC CAP NEWBORN MED 15IN PINK
|
Facility
|
IP
|
$481.40
|
|
| Hospital Charge Code |
901608013
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$96.28 |
| Max. Negotiated Rate |
$433.26 |
| Rate for Payer: Adventist Health Commercial |
$96.28
|
| Rate for Payer: Cash Price |
$264.77
|
| Rate for Payer: Central Health Plan Commercial |
$385.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$192.56
|
| Rate for Payer: EPIC Health Plan Senior |
$192.56
|
| Rate for Payer: Galaxy Health WC |
$409.19
|
| Rate for Payer: Global Benefits Group Commercial |
$288.84
|
| Rate for Payer: Health Management Network EPO/PPO |
$433.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$321.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$183.41
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$297.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$96.28
|
| Rate for Payer: Multiplan Commercial |
$361.05
|
| Rate for Payer: Networks By Design Commercial |
$312.91
|
| Rate for Payer: Prime Health Services Commercial |
$409.19
|
|
|
HC CAP NEWBORN MED 15IN PINK
|
Facility
|
OP
|
$481.40
|
|
| Hospital Charge Code |
901608013
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$96.28 |
| Max. Negotiated Rate |
$433.26 |
| Rate for Payer: Adventist Health Commercial |
$96.28
|
| Rate for Payer: Aetna of CA HMO/PPO |
$292.35
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$409.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$264.77
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$361.05
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$233.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$282.73
|
| Rate for Payer: Blue Shield of California Commercial |
$294.14
|
| Rate for Payer: Blue Shield of California EPN |
$192.08
|
| Rate for Payer: Cash Price |
$264.77
|
| Rate for Payer: Central Health Plan Commercial |
$385.12
|
| Rate for Payer: Cigna of CA HMO |
$308.10
|
| Rate for Payer: Cigna of CA PPO |
$356.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$409.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$409.19
|
| Rate for Payer: Dignity Health Medicare Advantage |
$409.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$192.56
|
| Rate for Payer: EPIC Health Plan Senior |
$192.56
|
| Rate for Payer: Galaxy Health WC |
$409.19
|
| Rate for Payer: Global Benefits Group Commercial |
$288.84
|
| Rate for Payer: Health Management Network EPO/PPO |
$433.26
|
| Rate for Payer: InnovAge PACE Commercial |
$240.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$321.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$183.41
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$297.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$96.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$336.98
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$336.98
|
| Rate for Payer: Multiplan Commercial |
$361.05
|
| Rate for Payer: Networks By Design Commercial |
$312.91
|
| Rate for Payer: Prime Health Services Commercial |
$409.19
|
| Rate for Payer: Riverside University Health System MISP |
$192.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$288.84
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$288.84
|
| Rate for Payer: United Healthcare All Other Commercial |
$240.70
|
| Rate for Payer: United Healthcare All Other HMO |
$240.70
|
| Rate for Payer: United Healthcare HMO Rider |
$240.70
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$240.70
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$409.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$409.19
|
| Rate for Payer: Vantage Medical Group Senior |
$409.19
|
|
|
HC CAPTOPRIL RENOGRAM
|
Facility
|
OP
|
$3,187.00
|
|
|
Service Code
|
CPT 78708
|
| Hospital Charge Code |
909301431
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$267.61 |
| Max. Negotiated Rate |
$2,868.30 |
| Rate for Payer: Adventist Health Commercial |
$637.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$683.93
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,935.47
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,025.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$752.32
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$683.93
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$930.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,871.73
|
| Rate for Payer: Blue Shield of California Commercial |
$1,934.51
|
| Rate for Payer: Blue Shield of California EPN |
$1,265.24
|
| Rate for Payer: Cash Price |
$1,752.85
|
| Rate for Payer: Cash Price |
$1,752.85
|
| Rate for Payer: Central Health Plan Commercial |
$2,549.60
|
| Rate for Payer: Cigna of CA HMO |
$2,039.68
|
| Rate for Payer: Cigna of CA PPO |
$2,358.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,025.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$752.32
|
| Rate for Payer: Dignity Health Medicare Advantage |
$683.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$923.31
|
| Rate for Payer: EPIC Health Plan Senior |
$683.93
|
| Rate for Payer: Galaxy Health WC |
$2,708.95
|
| Rate for Payer: Global Benefits Group Commercial |
$1,912.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,868.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,121.65
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$267.61
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$683.93
|
| Rate for Payer: InnovAge PACE Commercial |
$1,025.89
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,125.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$295.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$683.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$637.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$916.47
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$916.47
|
| Rate for Payer: Multiplan Commercial |
$2,390.25
|
| Rate for Payer: Networks By Design Commercial |
$2,071.55
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$683.93
|
| Rate for Payer: Prime Health Services Commercial |
$2,708.95
|
| Rate for Payer: Prime Health Services Medicare |
$724.97
|
| Rate for Payer: Riverside University Health System MISP |
$752.32
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,912.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,912.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$815.78
|
| Rate for Payer: United Healthcare All Other HMO |
$815.78
|
| Rate for Payer: United Healthcare HMO Rider |
$815.78
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$815.78
|
| Rate for Payer: Upland Medical Group Pediatric |
$683.93
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,025.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$752.32
|
| Rate for Payer: Vantage Medical Group Senior |
$683.93
|
|
|
HC CAPTOPRIL RENOGRAM
|
Facility
|
IP
|
$3,187.00
|
|
|
Service Code
|
CPT 78708
|
| Hospital Charge Code |
909301431
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$637.40 |
| Max. Negotiated Rate |
$2,868.30 |
| Rate for Payer: Adventist Health Commercial |
$637.40
|
| Rate for Payer: Cash Price |
$1,752.85
|
| Rate for Payer: Central Health Plan Commercial |
$2,549.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,274.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,274.80
|
| Rate for Payer: Galaxy Health WC |
$2,708.95
|
| Rate for Payer: Global Benefits Group Commercial |
$1,912.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,868.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,125.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,214.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,972.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$637.40
|
| Rate for Payer: Multiplan Commercial |
$2,390.25
|
| Rate for Payer: Networks By Design Commercial |
$2,071.55
|
| Rate for Payer: Prime Health Services Commercial |
$2,708.95
|
|
|
HC CARBA5
|
Facility
|
IP
|
$33.00
|
|
|
Service Code
|
CPT 87185
|
| Hospital Charge Code |
900913012
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.60 |
| Max. Negotiated Rate |
$29.70 |
| Rate for Payer: Adventist Health Commercial |
$6.60
|
| Rate for Payer: Cash Price |
$18.15
|
| Rate for Payer: Central Health Plan Commercial |
$26.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.20
|
| Rate for Payer: EPIC Health Plan Senior |
$13.20
|
| Rate for Payer: Galaxy Health WC |
$28.05
|
| Rate for Payer: Global Benefits Group Commercial |
$19.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$29.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$22.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$20.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.60
|
| Rate for Payer: Multiplan Commercial |
$24.75
|
| Rate for Payer: Networks By Design Commercial |
$21.45
|
| Rate for Payer: Prime Health Services Commercial |
$28.05
|
|
|
HC CARBA5
|
Facility
|
OP
|
$33.00
|
|
|
Service Code
|
CPT 87185
|
| Hospital Charge Code |
900913012
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$2.08 |
| Max. Negotiated Rate |
$29.70 |
| Rate for Payer: Adventist Health Commercial |
$6.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$4.75
|
| Rate for Payer: Aetna of CA HMO/PPO |
$20.04
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.12
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.22
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$20.96
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4.25
|
| Rate for Payer: Blue Shield of California Commercial |
$20.03
|
| Rate for Payer: Blue Shield of California EPN |
$13.10
|
| Rate for Payer: Cash Price |
$18.15
|
| Rate for Payer: Cash Price |
$18.15
|
| Rate for Payer: Central Health Plan Commercial |
$26.40
|
| Rate for Payer: Cigna of CA HMO |
$21.12
|
| Rate for Payer: Cigna of CA PPO |
$24.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.22
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.41
|
| Rate for Payer: EPIC Health Plan Senior |
$4.75
|
| Rate for Payer: Galaxy Health WC |
$28.05
|
| Rate for Payer: Global Benefits Group Commercial |
$19.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$29.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7.79
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$2.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4.75
|
| Rate for Payer: InnovAge PACE Commercial |
$7.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$22.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.37
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.37
|
| Rate for Payer: Multiplan Commercial |
$24.75
|
| Rate for Payer: Networks By Design Commercial |
$21.45
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4.75
|
| Rate for Payer: Prime Health Services Commercial |
$28.05
|
| Rate for Payer: Prime Health Services Medicare |
$5.04
|
| Rate for Payer: Riverside University Health System MISP |
$5.22
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$19.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$19.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.85
|
| Rate for Payer: United Healthcare All Other HMO |
$3.85
|
| Rate for Payer: United Healthcare HMO Rider |
$3.85
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.85
|
| Rate for Payer: Upland Medical Group Pediatric |
$4.75
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.22
|
| Rate for Payer: Vantage Medical Group Senior |
$4.75
|
|
|
HC CARBAMATES CONF & ID
|
Facility
|
IP
|
$259.00
|
|
|
Service Code
|
CPT 82482
|
| Hospital Charge Code |
900910513
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$51.80 |
| Max. Negotiated Rate |
$233.10 |
| Rate for Payer: Adventist Health Commercial |
$51.80
|
| Rate for Payer: Cash Price |
$142.45
|
| Rate for Payer: Central Health Plan Commercial |
$207.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$103.60
|
| Rate for Payer: EPIC Health Plan Senior |
$103.60
|
| Rate for Payer: Galaxy Health WC |
$220.15
|
| Rate for Payer: Global Benefits Group Commercial |
$155.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$233.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$172.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$98.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$160.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$51.80
|
| Rate for Payer: Multiplan Commercial |
$194.25
|
| Rate for Payer: Networks By Design Commercial |
$168.35
|
| Rate for Payer: Prime Health Services Commercial |
$220.15
|
|
|
HC CARBAMATES CONF & ID
|
Facility
|
OP
|
$259.00
|
|
|
Service Code
|
CPT 82482
|
| Hospital Charge Code |
900910513
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.95 |
| Max. Negotiated Rate |
$233.10 |
| Rate for Payer: Adventist Health Commercial |
$51.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$9.81
|
| Rate for Payer: Aetna of CA HMO/PPO |
$157.29
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$14.71
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10.79
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9.81
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$55.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11.34
|
| Rate for Payer: Blue Shield of California Commercial |
$157.21
|
| Rate for Payer: Blue Shield of California EPN |
$102.82
|
| Rate for Payer: Cash Price |
$142.45
|
| Rate for Payer: Cash Price |
$142.45
|
| Rate for Payer: Central Health Plan Commercial |
$207.20
|
| Rate for Payer: Cigna of CA HMO |
$165.76
|
| Rate for Payer: Cigna of CA PPO |
$191.66
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$14.71
|
| Rate for Payer: Dignity Health Medi-Cal |
$10.79
|
| Rate for Payer: Dignity Health Medicare Advantage |
$9.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.24
|
| Rate for Payer: EPIC Health Plan Senior |
$9.81
|
| Rate for Payer: Galaxy Health WC |
$220.15
|
| Rate for Payer: Global Benefits Group Commercial |
$155.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$233.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$16.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$13.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$9.81
|
| Rate for Payer: InnovAge PACE Commercial |
$14.71
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$172.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$51.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$13.15
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$13.15
|
| Rate for Payer: Multiplan Commercial |
$194.25
|
| Rate for Payer: Networks By Design Commercial |
$168.35
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$9.81
|
| Rate for Payer: Prime Health Services Commercial |
$220.15
|
| Rate for Payer: Prime Health Services Medicare |
$10.40
|
| Rate for Payer: Riverside University Health System MISP |
$10.79
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$155.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$155.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.95
|
| Rate for Payer: United Healthcare All Other HMO |
$7.95
|
| Rate for Payer: United Healthcare HMO Rider |
$7.95
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.95
|
| Rate for Payer: Upland Medical Group Pediatric |
$9.81
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$14.71
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.79
|
| Rate for Payer: Vantage Medical Group Senior |
$9.81
|
|
|
HC CARBAMAZEPINE
|
Facility
|
OP
|
$120.00
|
|
|
Service Code
|
CPT 80156
|
| Hospital Charge Code |
900910396
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.80 |
| Max. Negotiated Rate |
$108.00 |
| Rate for Payer: Adventist Health Commercial |
$24.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$14.57
|
| Rate for Payer: Aetna of CA HMO/PPO |
$72.88
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21.86
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$16.03
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14.57
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$105.94
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$21.50
|
| Rate for Payer: Blue Shield of California Commercial |
$72.84
|
| Rate for Payer: Blue Shield of California EPN |
$47.64
|
| Rate for Payer: Cash Price |
$66.00
|
| Rate for Payer: Cash Price |
$66.00
|
| Rate for Payer: Central Health Plan Commercial |
$96.00
|
| Rate for Payer: Cigna of CA HMO |
$76.80
|
| Rate for Payer: Cigna of CA PPO |
$88.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21.86
|
| Rate for Payer: Dignity Health Medi-Cal |
$16.03
|
| Rate for Payer: Dignity Health Medicare Advantage |
$14.57
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.67
|
| Rate for Payer: EPIC Health Plan Senior |
$14.57
|
| Rate for Payer: Galaxy Health WC |
$102.00
|
| Rate for Payer: Global Benefits Group Commercial |
$72.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$108.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$23.89
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$21.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$14.57
|
| Rate for Payer: InnovAge PACE Commercial |
$21.86
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$80.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$23.96
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$19.52
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$19.52
|
| Rate for Payer: Multiplan Commercial |
$90.00
|
| Rate for Payer: Networks By Design Commercial |
$78.00
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$14.57
|
| Rate for Payer: Prime Health Services Commercial |
$102.00
|
| Rate for Payer: Prime Health Services Medicare |
$15.44
|
| Rate for Payer: Riverside University Health System MISP |
$16.03
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$72.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$72.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$11.80
|
| Rate for Payer: United Healthcare All Other HMO |
$11.80
|
| Rate for Payer: United Healthcare HMO Rider |
$11.80
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.80
|
| Rate for Payer: Upland Medical Group Pediatric |
$14.57
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21.86
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$16.03
|
| Rate for Payer: Vantage Medical Group Senior |
$14.57
|
|
|
HC CARBAMAZEPINE
|
Facility
|
IP
|
$120.00
|
|
|
Service Code
|
CPT 80156
|
| Hospital Charge Code |
900910396
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$24.00 |
| Max. Negotiated Rate |
$108.00 |
| Rate for Payer: Adventist Health Commercial |
$24.00
|
| Rate for Payer: Cash Price |
$66.00
|
| Rate for Payer: Central Health Plan Commercial |
$96.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$48.00
|
| Rate for Payer: EPIC Health Plan Senior |
$48.00
|
| Rate for Payer: Galaxy Health WC |
$102.00
|
| Rate for Payer: Global Benefits Group Commercial |
$72.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$108.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$80.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$45.72
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$74.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.00
|
| Rate for Payer: Multiplan Commercial |
$90.00
|
| Rate for Payer: Networks By Design Commercial |
$78.00
|
| Rate for Payer: Prime Health Services Commercial |
$102.00
|
|
|
HC CARBA NP
|
Facility
|
IP
|
$21.00
|
|
|
Service Code
|
CPT 87185
|
| Hospital Charge Code |
900913010
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$4.20 |
| Max. Negotiated Rate |
$18.90 |
| Rate for Payer: Adventist Health Commercial |
$4.20
|
| Rate for Payer: Cash Price |
$11.55
|
| Rate for Payer: Central Health Plan Commercial |
$16.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.40
|
| Rate for Payer: EPIC Health Plan Senior |
$8.40
|
| Rate for Payer: Galaxy Health WC |
$17.85
|
| Rate for Payer: Global Benefits Group Commercial |
$12.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$18.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$14.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.20
|
| Rate for Payer: Multiplan Commercial |
$15.75
|
| Rate for Payer: Networks By Design Commercial |
$13.65
|
| Rate for Payer: Prime Health Services Commercial |
$17.85
|
|
|
HC CARBA NP
|
Facility
|
OP
|
$21.00
|
|
|
Service Code
|
CPT 87185
|
| Hospital Charge Code |
900913010
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$2.08 |
| Max. Negotiated Rate |
$20.96 |
| Rate for Payer: Adventist Health Commercial |
$4.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$4.75
|
| Rate for Payer: Aetna of CA HMO/PPO |
$12.75
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.12
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.22
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$20.96
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4.25
|
| Rate for Payer: Blue Shield of California Commercial |
$12.75
|
| Rate for Payer: Blue Shield of California EPN |
$8.34
|
| Rate for Payer: Cash Price |
$11.55
|
| Rate for Payer: Cash Price |
$11.55
|
| Rate for Payer: Central Health Plan Commercial |
$16.80
|
| Rate for Payer: Cigna of CA HMO |
$13.44
|
| Rate for Payer: Cigna of CA PPO |
$15.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.22
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.41
|
| Rate for Payer: EPIC Health Plan Senior |
$4.75
|
| Rate for Payer: Galaxy Health WC |
$17.85
|
| Rate for Payer: Global Benefits Group Commercial |
$12.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$18.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7.79
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$2.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4.75
|
| Rate for Payer: InnovAge PACE Commercial |
$7.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$14.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.37
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.37
|
| Rate for Payer: Multiplan Commercial |
$15.75
|
| Rate for Payer: Networks By Design Commercial |
$13.65
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4.75
|
| Rate for Payer: Prime Health Services Commercial |
$17.85
|
| Rate for Payer: Prime Health Services Medicare |
$5.04
|
| Rate for Payer: Riverside University Health System MISP |
$5.22
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$12.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$12.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.85
|
| Rate for Payer: United Healthcare All Other HMO |
$3.85
|
| Rate for Payer: United Healthcare HMO Rider |
$3.85
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.85
|
| Rate for Payer: Upland Medical Group Pediatric |
$4.75
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.22
|
| Rate for Payer: Vantage Medical Group Senior |
$4.75
|
|
|
HC CARCINOEMBRYONIC ANTIGEN (CEA)
|
Facility
|
IP
|
$128.00
|
|
|
Service Code
|
CPT 82378
|
| Hospital Charge Code |
900910865
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$25.60 |
| Max. Negotiated Rate |
$115.20 |
| Rate for Payer: Adventist Health Commercial |
$25.60
|
| Rate for Payer: Cash Price |
$70.40
|
| Rate for Payer: Central Health Plan Commercial |
$102.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$51.20
|
| Rate for Payer: EPIC Health Plan Senior |
$51.20
|
| Rate for Payer: Galaxy Health WC |
$108.80
|
| Rate for Payer: Global Benefits Group Commercial |
$76.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$115.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$85.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$48.77
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$79.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.60
|
| Rate for Payer: Multiplan Commercial |
$96.00
|
| Rate for Payer: Networks By Design Commercial |
$83.20
|
| Rate for Payer: Prime Health Services Commercial |
$108.80
|
|
|
HC CARCINOEMBRYONIC ANTIGEN (CEA)
|
Facility
|
OP
|
$128.00
|
|
|
Service Code
|
CPT 82378
|
| Hospital Charge Code |
900910865
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.35 |
| Max. Negotiated Rate |
$137.77 |
| Rate for Payer: Adventist Health Commercial |
$25.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$18.96
|
| Rate for Payer: Aetna of CA HMO/PPO |
$77.73
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$28.44
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$20.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$18.96
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$137.77
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$27.96
|
| Rate for Payer: Blue Shield of California Commercial |
$77.70
|
| Rate for Payer: Blue Shield of California EPN |
$50.82
|
| Rate for Payer: Cash Price |
$70.40
|
| Rate for Payer: Cash Price |
$70.40
|
| Rate for Payer: Central Health Plan Commercial |
$102.40
|
| Rate for Payer: Cigna of CA HMO |
$81.92
|
| Rate for Payer: Cigna of CA PPO |
$94.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$28.44
|
| Rate for Payer: Dignity Health Medi-Cal |
$20.86
|
| Rate for Payer: Dignity Health Medicare Advantage |
$18.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$25.60
|
| Rate for Payer: EPIC Health Plan Senior |
$18.96
|
| Rate for Payer: Galaxy Health WC |
$108.80
|
| Rate for Payer: Global Benefits Group Commercial |
$76.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$115.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$31.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$28.98
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$18.96
|
| Rate for Payer: InnovAge PACE Commercial |
$28.44
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$85.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$32.02
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$25.41
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$25.41
|
| Rate for Payer: Multiplan Commercial |
$96.00
|
| Rate for Payer: Networks By Design Commercial |
$83.20
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$18.96
|
| Rate for Payer: Prime Health Services Commercial |
$108.80
|
| Rate for Payer: Prime Health Services Medicare |
$20.10
|
| Rate for Payer: Riverside University Health System MISP |
$20.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$76.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$76.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$15.35
|
| Rate for Payer: United Healthcare All Other HMO |
$15.35
|
| Rate for Payer: United Healthcare HMO Rider |
$15.35
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15.35
|
| Rate for Payer: Upland Medical Group Pediatric |
$18.96
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$28.44
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$20.86
|
| Rate for Payer: Vantage Medical Group Senior |
$18.96
|
|
|
HC CARDIAC ANGIO CONG HEART DZ
|
Facility
|
OP
|
$2,360.00
|
|
|
Service Code
|
CPT 75573
|
| Hospital Charge Code |
909201406
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$255.00 |
| Max. Negotiated Rate |
$2,364.00 |
| Rate for Payer: Adventist Health Commercial |
$472.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$453.77
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,364.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$680.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$499.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$453.77
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,411.13
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,386.03
|
| Rate for Payer: Blue Shield of California Commercial |
$1,432.52
|
| Rate for Payer: Blue Shield of California EPN |
$936.92
|
| Rate for Payer: Cash Price |
$1,298.00
|
| Rate for Payer: Cash Price |
$1,298.00
|
| Rate for Payer: Cash Price |
$1,298.00
|
| Rate for Payer: Center for Health Promotion Commercial |
$255.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,888.00
|
| Rate for Payer: Cigna of CA HMO |
$1,510.40
|
| Rate for Payer: Cigna of CA PPO |
$1,746.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$680.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$499.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$453.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$612.59
|
| Rate for Payer: EPIC Health Plan Senior |
$453.77
|
| Rate for Payer: Galaxy Health WC |
$2,006.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,416.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,124.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$744.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$502.89
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$453.77
|
| Rate for Payer: InnovAge PACE Commercial |
$680.65
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,574.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$555.52
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$453.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$472.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$608.05
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$608.05
|
| Rate for Payer: Multiplan Commercial |
$1,770.00
|
| Rate for Payer: Networks By Design Commercial |
$1,534.00
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$453.77
|
| Rate for Payer: Prime Health Services Commercial |
$2,006.00
|
| Rate for Payer: Prime Health Services Medicare |
$481.00
|
| Rate for Payer: Riverside University Health System MISP |
$499.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,416.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,416.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$669.92
|
| Rate for Payer: United Healthcare All Other HMO |
$669.92
|
| Rate for Payer: United Healthcare HMO Rider |
$669.92
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$669.92
|
| Rate for Payer: Upland Medical Group Pediatric |
$453.77
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$680.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$499.15
|
| Rate for Payer: Vantage Medical Group Senior |
$453.77
|
|
|
HC CARDIAC ANGIO CONG HEART DZ
|
Facility
|
IP
|
$2,360.00
|
|
|
Service Code
|
CPT 75573
|
| Hospital Charge Code |
909201406
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$472.00 |
| Max. Negotiated Rate |
$2,124.00 |
| Rate for Payer: Adventist Health Commercial |
$472.00
|
| Rate for Payer: Cash Price |
$1,298.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,888.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$944.00
|
| Rate for Payer: EPIC Health Plan Senior |
$944.00
|
| Rate for Payer: Galaxy Health WC |
$2,006.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,416.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,124.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,574.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$899.16
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,460.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$472.00
|
| Rate for Payer: Multiplan Commercial |
$1,770.00
|
| Rate for Payer: Networks By Design Commercial |
$1,534.00
|
| Rate for Payer: Prime Health Services Commercial |
$2,006.00
|
|
|
HC CARDIAC ANGIO, STRUCTURE/MORPH
|
Facility
|
IP
|
$2,360.00
|
|
|
Service Code
|
CPT 75572
|
| Hospital Charge Code |
909201405
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$472.00 |
| Max. Negotiated Rate |
$2,124.00 |
| Rate for Payer: Adventist Health Commercial |
$472.00
|
| Rate for Payer: Cash Price |
$1,298.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,888.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$944.00
|
| Rate for Payer: EPIC Health Plan Senior |
$944.00
|
| Rate for Payer: Galaxy Health WC |
$2,006.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,416.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,124.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,574.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$899.16
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,460.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$472.00
|
| Rate for Payer: Multiplan Commercial |
$1,770.00
|
| Rate for Payer: Networks By Design Commercial |
$1,534.00
|
| Rate for Payer: Prime Health Services Commercial |
$2,006.00
|
|
