|
HC CHNG PERC TUBE
|
Facility
|
IP
|
$10,974.00
|
|
|
Service Code
|
CPT 49423
|
| Hospital Charge Code |
909000203
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,194.80 |
| Max. Negotiated Rate |
$9,876.60 |
| Rate for Payer: Adventist Health Commercial |
$2,194.80
|
| Rate for Payer: Cash Price |
$4,938.30
|
| Rate for Payer: Central Health Plan Commercial |
$8,779.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7,681.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,389.60
|
| Rate for Payer: EPIC Health Plan Senior |
$4,389.60
|
| Rate for Payer: Galaxy Health WC |
$9,327.90
|
| Rate for Payer: Global Benefits Group Commercial |
$6,584.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,876.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,968.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6,474.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,194.80
|
| Rate for Payer: Multiplan Commercial |
$8,230.50
|
| Rate for Payer: Networks By Design Commercial |
$7,133.10
|
| Rate for Payer: Prime Health Services Commercial |
$9,327.90
|
|
|
HC CHNG PERC TUBE
|
Facility
|
OP
|
$10,974.00
|
|
|
Service Code
|
CPT 49423
|
| Hospital Charge Code |
909000203
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$117.82 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$2,194.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$2,468.04
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,468.04
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$3,840.40
|
| Rate for Payer: Blue Shield of California Commercial |
$3,293.23
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$4,938.30
|
| Rate for Payer: Cash Price |
$4,938.30
|
| Rate for Payer: Cash Price |
$4,938.30
|
| Rate for Payer: Central Health Plan Commercial |
$8,779.20
|
| Rate for Payer: Cigna of CA HMO |
$7,023.36
|
| Rate for Payer: Cigna of CA PPO |
$8,120.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,714.84
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,468.04
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7,681.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,072.27
|
| Rate for Payer: EPIC Health Plan Senior |
$2,714.84
|
| Rate for Payer: Galaxy Health WC |
$9,327.90
|
| Rate for Payer: Global Benefits Group Commercial |
$6,584.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,876.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$4,047.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$117.82
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,468.04
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,968.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$130.15
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,455.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,194.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3,307.17
|
| Rate for Payer: Multiplan Commercial |
$8,230.50
|
| Rate for Payer: Multiplan WC |
$3,840.40
|
| Rate for Payer: Networks By Design Commercial |
$7,133.10
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,468.04
|
| Rate for Payer: Preferred Health Network WC |
$3,918.78
|
| Rate for Payer: Prime Health Services Commercial |
$9,327.90
|
| Rate for Payer: Prime Health Services Medicare |
$2,616.12
|
| Rate for Payer: Prime Health Services WC |
$3,801.22
|
| Rate for Payer: Riverside University Health System MISP |
$2,714.84
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,584.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,487.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,468.04
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Vantage Medical Group Senior |
$2,468.04
|
|
|
HC CHOLECYSTOSOMY, PERCUTAN
|
Facility
|
IP
|
$13,568.00
|
|
|
Service Code
|
CPT 47490
|
| Hospital Charge Code |
909000143
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,713.60 |
| Max. Negotiated Rate |
$12,211.20 |
| Rate for Payer: Adventist Health Commercial |
$2,713.60
|
| Rate for Payer: Cash Price |
$6,105.60
|
| Rate for Payer: Central Health Plan Commercial |
$10,854.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9,497.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,427.20
|
| Rate for Payer: EPIC Health Plan Senior |
$5,427.20
|
| Rate for Payer: Galaxy Health WC |
$11,532.80
|
| Rate for Payer: Global Benefits Group Commercial |
$8,140.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$12,211.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8,615.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8,005.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,713.60
|
| Rate for Payer: Multiplan Commercial |
$10,176.00
|
| Rate for Payer: Networks By Design Commercial |
$8,819.20
|
| Rate for Payer: Prime Health Services Commercial |
$11,532.80
|
|
|
HC CHOLECYSTOSOMY, PERCUTAN
|
Facility
|
OP
|
$13,568.00
|
|
|
Service Code
|
CPT 47490
|
| Hospital Charge Code |
909000143
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$149.85 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$2,713.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$4,604.99
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,907.48
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,065.49
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,604.99
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$7,144.49
|
| Rate for Payer: Blue Shield of California Commercial |
$3,293.23
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$6,105.60
|
| Rate for Payer: Cash Price |
$6,105.60
|
| Rate for Payer: Cash Price |
$6,105.60
|
| Rate for Payer: Central Health Plan Commercial |
$10,854.40
|
| Rate for Payer: Cigna of CA HMO |
$8,683.52
|
| Rate for Payer: Cigna of CA PPO |
$10,040.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,907.48
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,065.49
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,604.99
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9,497.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,598.23
|
| Rate for Payer: EPIC Health Plan Senior |
$5,065.49
|
| Rate for Payer: Galaxy Health WC |
$11,532.80
|
| Rate for Payer: Global Benefits Group Commercial |
$8,140.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$12,211.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7,552.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$149.85
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,604.99
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8,615.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$165.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6,446.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,713.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$6,170.69
|
| Rate for Payer: Multiplan Commercial |
$10,176.00
|
| Rate for Payer: Multiplan WC |
$7,144.49
|
| Rate for Payer: Networks By Design Commercial |
$8,819.20
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,604.99
|
| Rate for Payer: Preferred Health Network WC |
$7,290.30
|
| Rate for Payer: Prime Health Services Commercial |
$11,532.80
|
| Rate for Payer: Prime Health Services Medicare |
$4,881.29
|
| Rate for Payer: Prime Health Services WC |
$7,071.59
|
| Rate for Payer: Riverside University Health System MISP |
$5,065.49
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8,140.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,784.00
|
| Rate for Payer: United Healthcare All Other HMO |
$20,902.00
|
| Rate for Payer: United Healthcare HMO Rider |
$13,066.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,971.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,604.99
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,907.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,065.49
|
| Rate for Payer: Vantage Medical Group Senior |
$4,604.99
|
|
|
HC CHOLESTEROL BODY FLUID
|
Facility
|
OP
|
$27.00
|
|
|
Service Code
|
CPT 84311
|
| Hospital Charge Code |
900912242
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.40 |
| Max. Negotiated Rate |
$70.75 |
| Rate for Payer: Adventist Health Commercial |
$5.40
|
| Rate for Payer: Adventist Health Commercial |
$5.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$8.10
|
| Rate for Payer: Adventist Health Medi-Cal |
$8.10
|
| Rate for Payer: Aetna of CA HMO/PPO |
$51.29
|
| Rate for Payer: Aetna of CA HMO/PPO |
$51.29
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.15
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.91
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.91
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.10
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$50.89
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$50.89
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$70.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$70.75
|
| Rate for Payer: Blue Shield of California Commercial |
$17.64
|
| Rate for Payer: Blue Shield of California Commercial |
$17.01
|
| Rate for Payer: Blue Shield of California EPN |
$11.12
|
| Rate for Payer: Blue Shield of California EPN |
$10.72
|
| Rate for Payer: Cash Price |
$12.60
|
| Rate for Payer: Cash Price |
$12.60
|
| Rate for Payer: Cash Price |
$12.15
|
| Rate for Payer: Cash Price |
$12.15
|
| Rate for Payer: Central Health Plan Commercial |
$21.60
|
| Rate for Payer: Central Health Plan Commercial |
$22.40
|
| Rate for Payer: Cigna of CA HMO |
$17.92
|
| Rate for Payer: Cigna of CA HMO |
$17.28
|
| Rate for Payer: Cigna of CA PPO |
$20.72
|
| Rate for Payer: Cigna of CA PPO |
$19.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.15
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$8.91
|
| Rate for Payer: Dignity Health Medi-Cal |
$8.91
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8.10
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$18.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$19.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.37
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.37
|
| Rate for Payer: EPIC Health Plan Senior |
$8.91
|
| Rate for Payer: EPIC Health Plan Senior |
$8.91
|
| Rate for Payer: Galaxy Health WC |
$23.80
|
| Rate for Payer: Galaxy Health WC |
$22.95
|
| Rate for Payer: Global Benefits Group Commercial |
$16.80
|
| Rate for Payer: Global Benefits Group Commercial |
$16.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$25.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$24.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$13.28
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$13.28
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$11.15
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$11.15
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$17.14
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$17.78
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$12.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$12.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$11.34
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$11.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$10.85
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$10.85
|
| Rate for Payer: Multiplan Commercial |
$21.00
|
| Rate for Payer: Multiplan Commercial |
$20.25
|
| Rate for Payer: Networks By Design Commercial |
$17.55
|
| Rate for Payer: Networks By Design Commercial |
$18.20
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$8.10
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$8.10
|
| Rate for Payer: Prime Health Services Commercial |
$23.80
|
| Rate for Payer: Prime Health Services Commercial |
$22.95
|
| Rate for Payer: Prime Health Services Medicare |
$8.59
|
| Rate for Payer: Prime Health Services Medicare |
$8.59
|
| Rate for Payer: Riverside University Health System MISP |
$8.91
|
| Rate for Payer: Riverside University Health System MISP |
$8.91
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$16.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$16.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$16.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$16.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.56
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.56
|
| Rate for Payer: United Healthcare All Other HMO |
$6.56
|
| Rate for Payer: United Healthcare All Other HMO |
$6.56
|
| Rate for Payer: United Healthcare HMO Rider |
$6.56
|
| Rate for Payer: United Healthcare HMO Rider |
$6.56
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.56
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.56
|
| Rate for Payer: Upland Medical Group Pediatric |
$8.10
|
| Rate for Payer: Upland Medical Group Pediatric |
$8.10
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.15
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.91
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.91
|
| Rate for Payer: Vantage Medical Group Senior |
$8.10
|
| Rate for Payer: Vantage Medical Group Senior |
$8.10
|
|
|
HC CHOLESTEROL BODY FLUID
|
Facility
|
IP
|
$28.00
|
|
|
Service Code
|
CPT 84311
|
| Hospital Charge Code |
900912242
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.60 |
| Max. Negotiated Rate |
$25.20 |
| Rate for Payer: Adventist Health Commercial |
$5.60
|
| Rate for Payer: Cash Price |
$12.60
|
| Rate for Payer: Central Health Plan Commercial |
$22.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$19.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.20
|
| Rate for Payer: EPIC Health Plan Senior |
$11.20
|
| Rate for Payer: Galaxy Health WC |
$23.80
|
| Rate for Payer: Global Benefits Group Commercial |
$16.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$25.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$17.78
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$16.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.60
|
| Rate for Payer: Multiplan Commercial |
$21.00
|
| Rate for Payer: Networks By Design Commercial |
$18.20
|
| Rate for Payer: Prime Health Services Commercial |
$23.80
|
|
|
HC CHOLESTEROL HDL DIRECT
|
Facility
|
IP
|
$153.00
|
|
|
Service Code
|
CPT 83718
|
| Hospital Charge Code |
900910528
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$30.60 |
| Max. Negotiated Rate |
$137.70 |
| Rate for Payer: Adventist Health Commercial |
$30.60
|
| Rate for Payer: Cash Price |
$68.85
|
| Rate for Payer: Central Health Plan Commercial |
$122.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$107.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$61.20
|
| Rate for Payer: EPIC Health Plan Senior |
$61.20
|
| Rate for Payer: Galaxy Health WC |
$130.05
|
| Rate for Payer: Global Benefits Group Commercial |
$91.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$137.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$97.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$90.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$30.60
|
| Rate for Payer: Multiplan Commercial |
$114.75
|
| Rate for Payer: Networks By Design Commercial |
$99.45
|
| Rate for Payer: Prime Health Services Commercial |
$130.05
|
|
|
HC CHOLESTEROL HDL DIRECT
|
Facility
|
OP
|
$153.00
|
|
|
Service Code
|
CPT 83718
|
| Hospital Charge Code |
900910528
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.63 |
| Max. Negotiated Rate |
$137.70 |
| Rate for Payer: Adventist Health Commercial |
$30.60
|
| Rate for Payer: Adventist Health Commercial |
$5.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$8.19
|
| Rate for Payer: Adventist Health Medi-Cal |
$8.19
|
| Rate for Payer: Aetna of CA HMO/PPO |
$60.07
|
| Rate for Payer: Aetna of CA HMO/PPO |
$60.07
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.29
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.29
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9.01
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.19
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.19
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$59.51
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$59.51
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$82.73
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$82.73
|
| Rate for Payer: Blue Shield of California Commercial |
$17.01
|
| Rate for Payer: Blue Shield of California Commercial |
$96.39
|
| Rate for Payer: Blue Shield of California EPN |
$10.72
|
| Rate for Payer: Blue Shield of California EPN |
$60.74
|
| Rate for Payer: Cash Price |
$12.15
|
| Rate for Payer: Cash Price |
$12.15
|
| Rate for Payer: Cash Price |
$68.85
|
| Rate for Payer: Cash Price |
$68.85
|
| Rate for Payer: Central Health Plan Commercial |
$122.40
|
| Rate for Payer: Central Health Plan Commercial |
$21.60
|
| Rate for Payer: Cigna of CA HMO |
$17.28
|
| Rate for Payer: Cigna of CA HMO |
$97.92
|
| Rate for Payer: Cigna of CA PPO |
$19.98
|
| Rate for Payer: Cigna of CA PPO |
$113.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.29
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.29
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.01
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.01
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8.19
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8.19
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$107.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$18.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.51
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.51
|
| Rate for Payer: EPIC Health Plan Senior |
$9.01
|
| Rate for Payer: EPIC Health Plan Senior |
$9.01
|
| Rate for Payer: Galaxy Health WC |
$22.95
|
| Rate for Payer: Galaxy Health WC |
$130.05
|
| Rate for Payer: Global Benefits Group Commercial |
$16.20
|
| Rate for Payer: Global Benefits Group Commercial |
$91.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$24.30
|
| Rate for Payer: Health Management Network EPO/PPO |
$137.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$13.43
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$13.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$11.61
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$11.61
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.19
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.19
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$97.16
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$17.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$12.82
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$12.82
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$11.47
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$11.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$30.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$10.97
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$10.97
|
| Rate for Payer: Multiplan Commercial |
$20.25
|
| Rate for Payer: Multiplan Commercial |
$114.75
|
| Rate for Payer: Networks By Design Commercial |
$99.45
|
| Rate for Payer: Networks By Design Commercial |
$17.55
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$8.19
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$8.19
|
| Rate for Payer: Prime Health Services Commercial |
$22.95
|
| Rate for Payer: Prime Health Services Commercial |
$130.05
|
| Rate for Payer: Prime Health Services Medicare |
$8.68
|
| Rate for Payer: Prime Health Services Medicare |
$8.68
|
| Rate for Payer: Riverside University Health System MISP |
$9.01
|
| Rate for Payer: Riverside University Health System MISP |
$9.01
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$91.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$16.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$16.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$91.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.63
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.63
|
| Rate for Payer: United Healthcare All Other HMO |
$6.63
|
| Rate for Payer: United Healthcare All Other HMO |
$6.63
|
| Rate for Payer: United Healthcare HMO Rider |
$6.63
|
| Rate for Payer: United Healthcare HMO Rider |
$6.63
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.63
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.63
|
| Rate for Payer: Upland Medical Group Pediatric |
$8.19
|
| Rate for Payer: Upland Medical Group Pediatric |
$8.19
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.29
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.29
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.01
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.01
|
| Rate for Payer: Vantage Medical Group Senior |
$8.19
|
| Rate for Payer: Vantage Medical Group Senior |
$8.19
|
|
|
HC CHOLESTEROL HDL-DIRECT INDIV
|
Facility
|
IP
|
$153.00
|
|
|
Service Code
|
CPT 83718
|
| Hospital Charge Code |
900910527
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$30.60 |
| Max. Negotiated Rate |
$137.70 |
| Rate for Payer: Adventist Health Commercial |
$30.60
|
| Rate for Payer: Cash Price |
$68.85
|
| Rate for Payer: Central Health Plan Commercial |
$122.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$107.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$61.20
|
| Rate for Payer: EPIC Health Plan Senior |
$61.20
|
| Rate for Payer: Galaxy Health WC |
$130.05
|
| Rate for Payer: Global Benefits Group Commercial |
$91.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$137.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$97.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$90.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$30.60
|
| Rate for Payer: Multiplan Commercial |
$114.75
|
| Rate for Payer: Networks By Design Commercial |
$99.45
|
| Rate for Payer: Prime Health Services Commercial |
$130.05
|
|
|
HC CHOLESTEROL HDL-DIRECT INDIV
|
Facility
|
OP
|
$153.00
|
|
|
Service Code
|
CPT 83718
|
| Hospital Charge Code |
900910527
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.63 |
| Max. Negotiated Rate |
$137.70 |
| Rate for Payer: Adventist Health Commercial |
$30.60
|
| Rate for Payer: Adventist Health Commercial |
$5.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$8.19
|
| Rate for Payer: Adventist Health Medi-Cal |
$8.19
|
| Rate for Payer: Aetna of CA HMO/PPO |
$60.07
|
| Rate for Payer: Aetna of CA HMO/PPO |
$60.07
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.29
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.29
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9.01
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.19
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.19
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$59.51
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$59.51
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$82.73
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$82.73
|
| Rate for Payer: Blue Shield of California Commercial |
$17.01
|
| Rate for Payer: Blue Shield of California Commercial |
$96.39
|
| Rate for Payer: Blue Shield of California EPN |
$10.72
|
| Rate for Payer: Blue Shield of California EPN |
$60.74
|
| Rate for Payer: Cash Price |
$12.15
|
| Rate for Payer: Cash Price |
$12.15
|
| Rate for Payer: Cash Price |
$68.85
|
| Rate for Payer: Cash Price |
$68.85
|
| Rate for Payer: Central Health Plan Commercial |
$122.40
|
| Rate for Payer: Central Health Plan Commercial |
$21.60
|
| Rate for Payer: Cigna of CA HMO |
$17.28
|
| Rate for Payer: Cigna of CA HMO |
$97.92
|
| Rate for Payer: Cigna of CA PPO |
$19.98
|
| Rate for Payer: Cigna of CA PPO |
$113.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.29
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.29
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.01
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.01
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8.19
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8.19
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$107.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$18.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.51
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.51
|
| Rate for Payer: EPIC Health Plan Senior |
$9.01
|
| Rate for Payer: EPIC Health Plan Senior |
$9.01
|
| Rate for Payer: Galaxy Health WC |
$22.95
|
| Rate for Payer: Galaxy Health WC |
$130.05
|
| Rate for Payer: Global Benefits Group Commercial |
$16.20
|
| Rate for Payer: Global Benefits Group Commercial |
$91.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$24.30
|
| Rate for Payer: Health Management Network EPO/PPO |
$137.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$13.43
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$13.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$11.61
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$11.61
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.19
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.19
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$97.16
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$17.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$12.82
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$12.82
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$11.47
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$11.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$30.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$10.97
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$10.97
|
| Rate for Payer: Multiplan Commercial |
$20.25
|
| Rate for Payer: Multiplan Commercial |
$114.75
|
| Rate for Payer: Networks By Design Commercial |
$99.45
|
| Rate for Payer: Networks By Design Commercial |
$17.55
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$8.19
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$8.19
|
| Rate for Payer: Prime Health Services Commercial |
$22.95
|
| Rate for Payer: Prime Health Services Commercial |
$130.05
|
| Rate for Payer: Prime Health Services Medicare |
$8.68
|
| Rate for Payer: Prime Health Services Medicare |
$8.68
|
| Rate for Payer: Riverside University Health System MISP |
$9.01
|
| Rate for Payer: Riverside University Health System MISP |
$9.01
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$91.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$16.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$16.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$91.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.63
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.63
|
| Rate for Payer: United Healthcare All Other HMO |
$6.63
|
| Rate for Payer: United Healthcare All Other HMO |
$6.63
|
| Rate for Payer: United Healthcare HMO Rider |
$6.63
|
| Rate for Payer: United Healthcare HMO Rider |
$6.63
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.63
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.63
|
| Rate for Payer: Upland Medical Group Pediatric |
$8.19
|
| Rate for Payer: Upland Medical Group Pediatric |
$8.19
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.29
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.29
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.01
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.01
|
| Rate for Payer: Vantage Medical Group Senior |
$8.19
|
| Rate for Payer: Vantage Medical Group Senior |
$8.19
|
|
|
HC CHOLESTEROL LDL-DIRECT
|
Facility
|
OP
|
$179.00
|
|
|
Service Code
|
CPT 83721
|
| Hospital Charge Code |
900910529
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.51 |
| Max. Negotiated Rate |
$161.10 |
| Rate for Payer: Adventist Health Commercial |
$35.80
|
| Rate for Payer: Adventist Health Commercial |
$13.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$10.50
|
| Rate for Payer: Adventist Health Medi-Cal |
$10.50
|
| Rate for Payer: Aetna of CA HMO/PPO |
$70.01
|
| Rate for Payer: Aetna of CA HMO/PPO |
$70.01
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15.75
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$68.62
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$68.62
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$95.39
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$95.39
|
| Rate for Payer: Blue Shield of California Commercial |
$42.84
|
| Rate for Payer: Blue Shield of California Commercial |
$112.77
|
| Rate for Payer: Blue Shield of California EPN |
$27.00
|
| Rate for Payer: Blue Shield of California EPN |
$71.06
|
| Rate for Payer: Cash Price |
$30.60
|
| Rate for Payer: Cash Price |
$30.60
|
| Rate for Payer: Cash Price |
$80.55
|
| Rate for Payer: Cash Price |
$80.55
|
| Rate for Payer: Central Health Plan Commercial |
$143.20
|
| Rate for Payer: Central Health Plan Commercial |
$54.40
|
| Rate for Payer: Cigna of CA HMO |
$43.52
|
| Rate for Payer: Cigna of CA HMO |
$114.56
|
| Rate for Payer: Cigna of CA PPO |
$50.32
|
| Rate for Payer: Cigna of CA PPO |
$132.46
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$11.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$11.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$125.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$47.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$17.32
|
| Rate for Payer: EPIC Health Plan Commercial |
$17.32
|
| Rate for Payer: EPIC Health Plan Senior |
$11.55
|
| Rate for Payer: EPIC Health Plan Senior |
$11.55
|
| Rate for Payer: Galaxy Health WC |
$57.80
|
| Rate for Payer: Galaxy Health WC |
$152.15
|
| Rate for Payer: Global Benefits Group Commercial |
$40.80
|
| Rate for Payer: Global Benefits Group Commercial |
$107.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$61.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$161.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$17.22
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$17.22
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$14.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$14.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$113.67
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$43.18
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$15.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$15.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$14.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$14.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$35.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$14.07
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$14.07
|
| Rate for Payer: Multiplan Commercial |
$51.00
|
| Rate for Payer: Multiplan Commercial |
$134.25
|
| Rate for Payer: Networks By Design Commercial |
$116.35
|
| Rate for Payer: Networks By Design Commercial |
$44.20
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$10.50
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$10.50
|
| Rate for Payer: Prime Health Services Commercial |
$57.80
|
| Rate for Payer: Prime Health Services Commercial |
$152.15
|
| Rate for Payer: Prime Health Services Medicare |
$11.13
|
| Rate for Payer: Prime Health Services Medicare |
$11.13
|
| Rate for Payer: Riverside University Health System MISP |
$11.55
|
| Rate for Payer: Riverside University Health System MISP |
$11.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$107.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$40.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$40.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$107.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$8.51
|
| Rate for Payer: United Healthcare All Other Commercial |
$8.51
|
| Rate for Payer: United Healthcare All Other HMO |
$8.51
|
| Rate for Payer: United Healthcare All Other HMO |
$8.51
|
| Rate for Payer: United Healthcare HMO Rider |
$8.51
|
| Rate for Payer: United Healthcare HMO Rider |
$8.51
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8.51
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8.51
|
| Rate for Payer: Upland Medical Group Pediatric |
$10.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$10.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15.75
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11.55
|
| Rate for Payer: Vantage Medical Group Senior |
$10.50
|
| Rate for Payer: Vantage Medical Group Senior |
$10.50
|
|
|
HC CHOLESTEROL LDL-DIRECT
|
Facility
|
IP
|
$179.00
|
|
|
Service Code
|
CPT 83721
|
| Hospital Charge Code |
900910529
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$35.80 |
| Max. Negotiated Rate |
$161.10 |
| Rate for Payer: Adventist Health Commercial |
$35.80
|
| Rate for Payer: Cash Price |
$80.55
|
| Rate for Payer: Central Health Plan Commercial |
$143.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$125.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$71.60
|
| Rate for Payer: EPIC Health Plan Senior |
$71.60
|
| Rate for Payer: Galaxy Health WC |
$152.15
|
| Rate for Payer: Global Benefits Group Commercial |
$107.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$161.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$113.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$105.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$35.80
|
| Rate for Payer: Multiplan Commercial |
$134.25
|
| Rate for Payer: Networks By Design Commercial |
$116.35
|
| Rate for Payer: Prime Health Services Commercial |
$152.15
|
|
|
HC CHOLESTEROL TOTAL
|
Facility
|
OP
|
$47.00
|
|
|
Service Code
|
CPT 82465
|
| Hospital Charge Code |
900910221
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.53 |
| Max. Negotiated Rate |
$43.99 |
| Rate for Payer: Adventist Health Commercial |
$9.40
|
| Rate for Payer: Adventist Health Commercial |
$19.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$4.35
|
| Rate for Payer: Adventist Health Medi-Cal |
$4.35
|
| Rate for Payer: Aetna of CA HMO/PPO |
$31.97
|
| Rate for Payer: Aetna of CA HMO/PPO |
$31.97
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6.53
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6.53
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4.79
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4.79
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4.35
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$31.64
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$31.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$43.99
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$43.99
|
| Rate for Payer: Blue Shield of California Commercial |
$61.74
|
| Rate for Payer: Blue Shield of California Commercial |
$29.61
|
| Rate for Payer: Blue Shield of California EPN |
$38.91
|
| Rate for Payer: Blue Shield of California EPN |
$18.66
|
| Rate for Payer: Cash Price |
$44.10
|
| Rate for Payer: Cash Price |
$44.10
|
| Rate for Payer: Cash Price |
$21.15
|
| Rate for Payer: Cash Price |
$21.15
|
| Rate for Payer: Central Health Plan Commercial |
$37.60
|
| Rate for Payer: Central Health Plan Commercial |
$78.40
|
| Rate for Payer: Cigna of CA HMO |
$62.72
|
| Rate for Payer: Cigna of CA HMO |
$30.08
|
| Rate for Payer: Cigna of CA PPO |
$72.52
|
| Rate for Payer: Cigna of CA PPO |
$34.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6.53
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6.53
|
| Rate for Payer: Dignity Health Medi-Cal |
$4.79
|
| Rate for Payer: Dignity Health Medi-Cal |
$4.79
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4.35
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$32.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$68.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.18
|
| Rate for Payer: EPIC Health Plan Senior |
$4.79
|
| Rate for Payer: EPIC Health Plan Senior |
$4.79
|
| Rate for Payer: Galaxy Health WC |
$83.30
|
| Rate for Payer: Galaxy Health WC |
$39.95
|
| Rate for Payer: Global Benefits Group Commercial |
$58.80
|
| Rate for Payer: Global Benefits Group Commercial |
$28.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$88.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$42.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7.13
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7.13
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$6.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$6.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4.35
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$29.84
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$62.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$7.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$7.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5.83
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5.83
|
| Rate for Payer: Multiplan Commercial |
$73.50
|
| Rate for Payer: Multiplan Commercial |
$35.25
|
| Rate for Payer: Networks By Design Commercial |
$30.55
|
| Rate for Payer: Networks By Design Commercial |
$63.70
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4.35
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4.35
|
| Rate for Payer: Prime Health Services Commercial |
$83.30
|
| Rate for Payer: Prime Health Services Commercial |
$39.95
|
| Rate for Payer: Prime Health Services Medicare |
$4.61
|
| Rate for Payer: Prime Health Services Medicare |
$4.61
|
| Rate for Payer: Riverside University Health System MISP |
$4.79
|
| Rate for Payer: Riverside University Health System MISP |
$4.79
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$28.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$58.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$58.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$28.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.53
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.53
|
| Rate for Payer: United Healthcare All Other HMO |
$3.53
|
| Rate for Payer: United Healthcare All Other HMO |
$3.53
|
| Rate for Payer: United Healthcare HMO Rider |
$3.53
|
| Rate for Payer: United Healthcare HMO Rider |
$3.53
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.53
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.53
|
| Rate for Payer: Upland Medical Group Pediatric |
$4.35
|
| Rate for Payer: Upland Medical Group Pediatric |
$4.35
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6.53
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6.53
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4.79
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4.79
|
| Rate for Payer: Vantage Medical Group Senior |
$4.35
|
| Rate for Payer: Vantage Medical Group Senior |
$4.35
|
|
|
HC CHOLESTEROL TOTAL
|
Facility
|
IP
|
$98.00
|
|
|
Service Code
|
CPT 82465
|
| Hospital Charge Code |
900910221
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$19.60 |
| Max. Negotiated Rate |
$88.20 |
| Rate for Payer: Adventist Health Commercial |
$19.60
|
| Rate for Payer: Cash Price |
$44.10
|
| Rate for Payer: Central Health Plan Commercial |
$78.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$68.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$39.20
|
| Rate for Payer: EPIC Health Plan Senior |
$39.20
|
| Rate for Payer: Galaxy Health WC |
$83.30
|
| Rate for Payer: Global Benefits Group Commercial |
$58.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$88.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$62.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$57.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.60
|
| Rate for Payer: Multiplan Commercial |
$73.50
|
| Rate for Payer: Networks By Design Commercial |
$63.70
|
| Rate for Payer: Prime Health Services Commercial |
$83.30
|
|
|
HC CHOLESTEROL TOTAL INDIVIDUAL
|
Facility
|
OP
|
$47.00
|
|
|
Service Code
|
CPT 82465
|
| Hospital Charge Code |
900910525
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.53 |
| Max. Negotiated Rate |
$43.99 |
| Rate for Payer: Adventist Health Commercial |
$9.40
|
| Rate for Payer: Adventist Health Commercial |
$19.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$4.35
|
| Rate for Payer: Adventist Health Medi-Cal |
$4.35
|
| Rate for Payer: Aetna of CA HMO/PPO |
$31.97
|
| Rate for Payer: Aetna of CA HMO/PPO |
$31.97
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6.53
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6.53
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4.79
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4.79
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4.35
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$31.64
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$31.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$43.99
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$43.99
|
| Rate for Payer: Blue Shield of California Commercial |
$61.74
|
| Rate for Payer: Blue Shield of California Commercial |
$29.61
|
| Rate for Payer: Blue Shield of California EPN |
$38.91
|
| Rate for Payer: Blue Shield of California EPN |
$18.66
|
| Rate for Payer: Cash Price |
$44.10
|
| Rate for Payer: Cash Price |
$44.10
|
| Rate for Payer: Cash Price |
$21.15
|
| Rate for Payer: Cash Price |
$21.15
|
| Rate for Payer: Central Health Plan Commercial |
$37.60
|
| Rate for Payer: Central Health Plan Commercial |
$78.40
|
| Rate for Payer: Cigna of CA HMO |
$62.72
|
| Rate for Payer: Cigna of CA HMO |
$30.08
|
| Rate for Payer: Cigna of CA PPO |
$72.52
|
| Rate for Payer: Cigna of CA PPO |
$34.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6.53
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6.53
|
| Rate for Payer: Dignity Health Medi-Cal |
$4.79
|
| Rate for Payer: Dignity Health Medi-Cal |
$4.79
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4.35
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$32.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$68.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.18
|
| Rate for Payer: EPIC Health Plan Senior |
$4.79
|
| Rate for Payer: EPIC Health Plan Senior |
$4.79
|
| Rate for Payer: Galaxy Health WC |
$83.30
|
| Rate for Payer: Galaxy Health WC |
$39.95
|
| Rate for Payer: Global Benefits Group Commercial |
$58.80
|
| Rate for Payer: Global Benefits Group Commercial |
$28.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$88.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$42.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7.13
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7.13
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$6.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$6.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4.35
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$29.84
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$62.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$7.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$7.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5.83
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5.83
|
| Rate for Payer: Multiplan Commercial |
$73.50
|
| Rate for Payer: Multiplan Commercial |
$35.25
|
| Rate for Payer: Networks By Design Commercial |
$30.55
|
| Rate for Payer: Networks By Design Commercial |
$63.70
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4.35
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4.35
|
| Rate for Payer: Prime Health Services Commercial |
$83.30
|
| Rate for Payer: Prime Health Services Commercial |
$39.95
|
| Rate for Payer: Prime Health Services Medicare |
$4.61
|
| Rate for Payer: Prime Health Services Medicare |
$4.61
|
| Rate for Payer: Riverside University Health System MISP |
$4.79
|
| Rate for Payer: Riverside University Health System MISP |
$4.79
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$28.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$58.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$58.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$28.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.53
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.53
|
| Rate for Payer: United Healthcare All Other HMO |
$3.53
|
| Rate for Payer: United Healthcare All Other HMO |
$3.53
|
| Rate for Payer: United Healthcare HMO Rider |
$3.53
|
| Rate for Payer: United Healthcare HMO Rider |
$3.53
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.53
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.53
|
| Rate for Payer: Upland Medical Group Pediatric |
$4.35
|
| Rate for Payer: Upland Medical Group Pediatric |
$4.35
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6.53
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6.53
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4.79
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4.79
|
| Rate for Payer: Vantage Medical Group Senior |
$4.35
|
| Rate for Payer: Vantage Medical Group Senior |
$4.35
|
|
|
HC CHOLESTEROL TOTAL INDIVIDUAL
|
Facility
|
IP
|
$98.00
|
|
|
Service Code
|
CPT 82465
|
| Hospital Charge Code |
900910525
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$19.60 |
| Max. Negotiated Rate |
$88.20 |
| Rate for Payer: Adventist Health Commercial |
$19.60
|
| Rate for Payer: Cash Price |
$44.10
|
| Rate for Payer: Central Health Plan Commercial |
$78.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$68.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$39.20
|
| Rate for Payer: EPIC Health Plan Senior |
$39.20
|
| Rate for Payer: Galaxy Health WC |
$83.30
|
| Rate for Payer: Global Benefits Group Commercial |
$58.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$88.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$62.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$57.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.60
|
| Rate for Payer: Multiplan Commercial |
$73.50
|
| Rate for Payer: Networks By Design Commercial |
$63.70
|
| Rate for Payer: Prime Health Services Commercial |
$83.30
|
|
|
HC CHOME PLATING PER BAR
|
Facility
|
IP
|
$128.00
|
|
|
Service Code
|
CPT L2750
|
| Hospital Charge Code |
905352750
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$25.60 |
| Max. Negotiated Rate |
$115.20 |
| Rate for Payer: Adventist Health Commercial |
$25.60
|
| Rate for Payer: Blue Shield of California Commercial |
$102.66
|
| Rate for Payer: Blue Shield of California EPN |
$64.51
|
| Rate for Payer: Cash Price |
$57.60
|
| Rate for Payer: Central Health Plan Commercial |
$102.40
|
| Rate for Payer: Cigna of CA HMO |
$89.60
|
| Rate for Payer: Cigna of CA PPO |
$89.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$89.60
|
| 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 Foundation Hospitals Commercial/Self Funded |
$81.28
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$75.52
|
| 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
|
| Rate for Payer: United Healthcare All Other Commercial |
$48.04
|
| Rate for Payer: United Healthcare All Other HMO |
$46.76
|
| Rate for Payer: United Healthcare HMO Rider |
$45.75
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$41.92
|
|
|
HC CHOME PLATING PER BAR
|
Facility
|
OP
|
$128.00
|
|
|
Service Code
|
CPT L2750
|
| Hospital Charge Code |
905352750
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$41.92 |
| Max. Negotiated Rate |
$115.20 |
| Rate for Payer: Adventist Health Commercial |
$52.48
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$108.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$70.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$96.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$74.46
|
| Rate for Payer: Blue Shield of California Commercial |
$102.66
|
| Rate for Payer: Blue Shield of California EPN |
$64.51
|
| Rate for Payer: Cash Price |
$57.60
|
| Rate for Payer: Cash Price |
$57.60
|
| Rate for Payer: Central Health Plan Commercial |
$102.40
|
| Rate for Payer: Cigna of CA HMO |
$89.60
|
| Rate for Payer: Cigna of CA PPO |
$89.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$108.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$108.80
|
| Rate for Payer: Dignity Health Medicare Advantage |
$108.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$89.60
|
| 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: Inland Empire Health Plan (IEHP) medi-cal |
$54.49
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$81.28
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$60.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$75.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$52.48
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$89.60
|
| Rate for Payer: Multiplan Commercial |
$96.00
|
| Rate for Payer: Networks By Design Commercial |
$64.00
|
| Rate for Payer: Prime Health Services Commercial |
$108.80
|
| Rate for Payer: Riverside University Health System MISP |
$51.20
|
| 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 |
$48.04
|
| Rate for Payer: United Healthcare All Other HMO |
$46.76
|
| Rate for Payer: United Healthcare HMO Rider |
$45.75
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$41.92
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$108.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$108.80
|
| Rate for Payer: Vantage Medical Group Senior |
$108.80
|
|
|
HC CHOME PLATING PER BAR
|
Facility
|
OP
|
$128.00
|
|
|
Service Code
|
CPT L2750
|
| Hospital Charge Code |
915352750
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$41.92 |
| Max. Negotiated Rate |
$115.20 |
| Rate for Payer: Adventist Health Commercial |
$52.48
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$108.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$70.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$96.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$74.46
|
| Rate for Payer: Blue Shield of California Commercial |
$102.66
|
| Rate for Payer: Blue Shield of California EPN |
$64.51
|
| Rate for Payer: Cash Price |
$57.60
|
| Rate for Payer: Cash Price |
$57.60
|
| Rate for Payer: Central Health Plan Commercial |
$102.40
|
| Rate for Payer: Cigna of CA HMO |
$89.60
|
| Rate for Payer: Cigna of CA PPO |
$89.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$108.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$108.80
|
| Rate for Payer: Dignity Health Medicare Advantage |
$108.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$89.60
|
| 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: Inland Empire Health Plan (IEHP) medi-cal |
$54.49
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$81.28
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$60.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$75.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$52.48
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$89.60
|
| Rate for Payer: Multiplan Commercial |
$96.00
|
| Rate for Payer: Networks By Design Commercial |
$64.00
|
| Rate for Payer: Prime Health Services Commercial |
$108.80
|
| Rate for Payer: Riverside University Health System MISP |
$51.20
|
| 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 |
$48.04
|
| Rate for Payer: United Healthcare All Other HMO |
$46.76
|
| Rate for Payer: United Healthcare HMO Rider |
$45.75
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$41.92
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$108.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$108.80
|
| Rate for Payer: Vantage Medical Group Senior |
$108.80
|
|
|
HC CHOME PLATING PER BAR
|
Facility
|
IP
|
$128.00
|
|
|
Service Code
|
CPT L2750
|
| Hospital Charge Code |
915352750
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$25.60 |
| Max. Negotiated Rate |
$115.20 |
| Rate for Payer: Adventist Health Commercial |
$25.60
|
| Rate for Payer: Blue Shield of California Commercial |
$102.66
|
| Rate for Payer: Blue Shield of California EPN |
$64.51
|
| Rate for Payer: Cash Price |
$57.60
|
| Rate for Payer: Central Health Plan Commercial |
$102.40
|
| Rate for Payer: Cigna of CA HMO |
$89.60
|
| Rate for Payer: Cigna of CA PPO |
$89.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$89.60
|
| 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 Foundation Hospitals Commercial/Self Funded |
$81.28
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$75.52
|
| 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
|
| Rate for Payer: United Healthcare All Other Commercial |
$48.04
|
| Rate for Payer: United Healthcare All Other HMO |
$46.76
|
| Rate for Payer: United Healthcare HMO Rider |
$45.75
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$41.92
|
|
|
HC CHROM ADDL CELL COUNT EA
|
Facility
|
OP
|
$120.00
|
|
|
Service Code
|
CPT 88285
|
| Hospital Charge Code |
900918013
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$13.07 |
| Max. Negotiated Rate |
$163.21 |
| Rate for Payer: Adventist Health Commercial |
$24.00
|
| Rate for Payer: Adventist Health Commercial |
$15.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$26.91
|
| Rate for Payer: Adventist Health Medi-Cal |
$26.91
|
| Rate for Payer: Aetna of CA HMO/PPO |
$139.46
|
| Rate for Payer: Aetna of CA HMO/PPO |
$139.46
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$40.37
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$40.37
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$29.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$29.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$26.91
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$26.91
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$117.40
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$117.40
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$163.21
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$163.21
|
| Rate for Payer: Blue Shield of California Commercial |
$49.14
|
| Rate for Payer: Blue Shield of California Commercial |
$75.60
|
| Rate for Payer: Blue Shield of California EPN |
$30.97
|
| Rate for Payer: Blue Shield of California EPN |
$47.64
|
| Rate for Payer: Cash Price |
$35.10
|
| Rate for Payer: Cash Price |
$35.10
|
| Rate for Payer: Cash Price |
$54.00
|
| Rate for Payer: Cash Price |
$54.00
|
| Rate for Payer: Central Health Plan Commercial |
$96.00
|
| Rate for Payer: Central Health Plan Commercial |
$62.40
|
| Rate for Payer: Cigna of CA HMO |
$49.92
|
| Rate for Payer: Cigna of CA HMO |
$76.80
|
| Rate for Payer: Cigna of CA PPO |
$57.72
|
| Rate for Payer: Cigna of CA PPO |
$88.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$40.37
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$40.37
|
| Rate for Payer: Dignity Health Medi-Cal |
$29.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$29.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$26.91
|
| Rate for Payer: Dignity Health Medicare Advantage |
$26.91
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$84.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$54.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$44.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$44.40
|
| Rate for Payer: EPIC Health Plan Senior |
$29.60
|
| Rate for Payer: EPIC Health Plan Senior |
$29.60
|
| Rate for Payer: Galaxy Health WC |
$66.30
|
| Rate for Payer: Galaxy Health WC |
$102.00
|
| Rate for Payer: Global Benefits Group Commercial |
$46.80
|
| Rate for Payer: Global Benefits Group Commercial |
$72.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$70.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$108.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$44.13
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$44.13
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$13.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$13.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$26.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$26.91
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$76.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$49.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$14.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$14.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$37.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$37.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$36.06
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$36.06
|
| Rate for Payer: Multiplan Commercial |
$58.50
|
| Rate for Payer: Multiplan Commercial |
$90.00
|
| Rate for Payer: Networks By Design Commercial |
$78.00
|
| Rate for Payer: Networks By Design Commercial |
$50.70
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$26.91
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$26.91
|
| Rate for Payer: Prime Health Services Commercial |
$66.30
|
| Rate for Payer: Prime Health Services Commercial |
$102.00
|
| Rate for Payer: Prime Health Services Medicare |
$28.52
|
| Rate for Payer: Prime Health Services Medicare |
$28.52
|
| Rate for Payer: Riverside University Health System MISP |
$29.60
|
| Rate for Payer: Riverside University Health System MISP |
$29.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$72.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$46.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$46.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$72.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$21.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$21.80
|
| Rate for Payer: United Healthcare All Other HMO |
$21.80
|
| Rate for Payer: United Healthcare All Other HMO |
$21.80
|
| Rate for Payer: United Healthcare HMO Rider |
$21.80
|
| Rate for Payer: United Healthcare HMO Rider |
$21.80
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$21.80
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$21.80
|
| Rate for Payer: Upland Medical Group Pediatric |
$26.91
|
| Rate for Payer: Upland Medical Group Pediatric |
$26.91
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$40.37
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$40.37
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$29.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$29.60
|
| Rate for Payer: Vantage Medical Group Senior |
$26.91
|
| Rate for Payer: Vantage Medical Group Senior |
$26.91
|
|
|
HC CHROM ADDL CELL COUNT EA
|
Facility
|
IP
|
$120.00
|
|
|
Service Code
|
CPT 88285
|
| Hospital Charge Code |
900918013
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$24.00 |
| Max. Negotiated Rate |
$108.00 |
| Rate for Payer: Adventist Health Commercial |
$24.00
|
| Rate for Payer: Cash Price |
$54.00
|
| Rate for Payer: Central Health Plan Commercial |
$96.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$84.00
|
| 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 Foundation Hospitals Commercial/Self Funded |
$76.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$70.80
|
| 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 CHROM ADDL SPEC BANDING
|
Facility
|
OP
|
$133.00
|
|
|
Service Code
|
CPT 88283
|
| Hospital Charge Code |
900918012
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$16.70 |
| Max. Negotiated Rate |
$119.70 |
| Rate for Payer: Adventist Health Commercial |
$26.60
|
| Rate for Payer: Adventist Health Commercial |
$18.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$68.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$68.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$63.44
|
| Rate for Payer: Aetna of CA HMO/PPO |
$63.44
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$102.90
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$102.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$75.46
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$75.46
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$68.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$68.60
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$64.60
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$64.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$89.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$89.81
|
| Rate for Payer: Blue Shield of California Commercial |
$58.59
|
| Rate for Payer: Blue Shield of California Commercial |
$83.79
|
| Rate for Payer: Blue Shield of California EPN |
$36.92
|
| Rate for Payer: Blue Shield of California EPN |
$52.80
|
| Rate for Payer: Cash Price |
$41.85
|
| Rate for Payer: Cash Price |
$41.85
|
| Rate for Payer: Cash Price |
$59.85
|
| Rate for Payer: Cash Price |
$59.85
|
| Rate for Payer: Central Health Plan Commercial |
$106.40
|
| Rate for Payer: Central Health Plan Commercial |
$74.40
|
| Rate for Payer: Cigna of CA HMO |
$59.52
|
| Rate for Payer: Cigna of CA HMO |
$85.12
|
| Rate for Payer: Cigna of CA PPO |
$68.82
|
| Rate for Payer: Cigna of CA PPO |
$98.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$102.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$102.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$75.46
|
| Rate for Payer: Dignity Health Medi-Cal |
$75.46
|
| Rate for Payer: Dignity Health Medicare Advantage |
$68.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$68.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$93.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$65.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$113.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$113.19
|
| Rate for Payer: EPIC Health Plan Senior |
$75.46
|
| Rate for Payer: EPIC Health Plan Senior |
$75.46
|
| Rate for Payer: Galaxy Health WC |
$79.05
|
| Rate for Payer: Galaxy Health WC |
$113.05
|
| Rate for Payer: Global Benefits Group Commercial |
$55.80
|
| Rate for Payer: Global Benefits Group Commercial |
$79.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$83.70
|
| Rate for Payer: Health Management Network EPO/PPO |
$119.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$112.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$112.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$16.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$16.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$68.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$68.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$84.45
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$59.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$18.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$18.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$96.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$96.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$26.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$91.92
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$91.92
|
| Rate for Payer: Multiplan Commercial |
$69.75
|
| Rate for Payer: Multiplan Commercial |
$99.75
|
| Rate for Payer: Networks By Design Commercial |
$86.45
|
| Rate for Payer: Networks By Design Commercial |
$60.45
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$68.60
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$68.60
|
| Rate for Payer: Prime Health Services Commercial |
$79.05
|
| Rate for Payer: Prime Health Services Commercial |
$113.05
|
| Rate for Payer: Prime Health Services Medicare |
$72.72
|
| Rate for Payer: Prime Health Services Medicare |
$72.72
|
| Rate for Payer: Riverside University Health System MISP |
$75.46
|
| Rate for Payer: Riverside University Health System MISP |
$75.46
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$79.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$55.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$55.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$79.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$55.57
|
| Rate for Payer: United Healthcare All Other Commercial |
$55.57
|
| Rate for Payer: United Healthcare All Other HMO |
$55.57
|
| Rate for Payer: United Healthcare All Other HMO |
$55.57
|
| Rate for Payer: United Healthcare HMO Rider |
$55.57
|
| Rate for Payer: United Healthcare HMO Rider |
$55.57
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$55.57
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$55.57
|
| Rate for Payer: Upland Medical Group Pediatric |
$68.60
|
| Rate for Payer: Upland Medical Group Pediatric |
$68.60
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$102.90
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$102.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$75.46
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$75.46
|
| Rate for Payer: Vantage Medical Group Senior |
$68.60
|
| Rate for Payer: Vantage Medical Group Senior |
$68.60
|
|
|
HC CHROM ADDL SPEC BANDING
|
Facility
|
IP
|
$133.00
|
|
|
Service Code
|
CPT 88283
|
| Hospital Charge Code |
900918012
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$26.60 |
| Max. Negotiated Rate |
$119.70 |
| Rate for Payer: Adventist Health Commercial |
$26.60
|
| Rate for Payer: Cash Price |
$59.85
|
| Rate for Payer: Central Health Plan Commercial |
$106.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$93.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$53.20
|
| Rate for Payer: EPIC Health Plan Senior |
$53.20
|
| Rate for Payer: Galaxy Health WC |
$113.05
|
| Rate for Payer: Global Benefits Group Commercial |
$79.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$119.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$84.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$78.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$26.60
|
| Rate for Payer: Multiplan Commercial |
$99.75
|
| Rate for Payer: Networks By Design Commercial |
$86.45
|
| Rate for Payer: Prime Health Services Commercial |
$113.05
|
|
|
HC CHROM ADDTL CELL COUNT EA
|
Facility
|
IP
|
$181.00
|
|
|
Service Code
|
CPT 88285
|
| Hospital Charge Code |
910408285
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$36.20 |
| Max. Negotiated Rate |
$162.90 |
| Rate for Payer: Adventist Health Commercial |
$36.20
|
| Rate for Payer: Cash Price |
$81.45
|
| Rate for Payer: Central Health Plan Commercial |
$144.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$126.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$72.40
|
| Rate for Payer: EPIC Health Plan Senior |
$72.40
|
| Rate for Payer: Galaxy Health WC |
$153.85
|
| Rate for Payer: Global Benefits Group Commercial |
$108.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$162.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$114.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$106.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$36.20
|
| Rate for Payer: Multiplan Commercial |
$135.75
|
| Rate for Payer: Networks By Design Commercial |
$117.65
|
| Rate for Payer: Prime Health Services Commercial |
$153.85
|
|
