|
HC CHLORIDE
|
Facility
|
OP
|
$17.00
|
|
|
Service Code
|
CPT 82435
|
| Hospital Charge Code |
900910256
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.40 |
| Max. Negotiated Rate |
$33.75 |
| Rate for Payer: Adventist Health Commercial |
$3.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$4.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10.32
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.06
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4.60
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$33.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6.85
|
| Rate for Payer: Blue Shield of California Commercial |
$10.32
|
| Rate for Payer: Blue Shield of California EPN |
$6.75
|
| Rate for Payer: Cash Price |
$7.65
|
| Rate for Payer: Cash Price |
$7.65
|
| Rate for Payer: Central Health Plan Commercial |
$13.60
|
| Rate for Payer: Cigna of CA HMO |
$10.88
|
| Rate for Payer: Cigna of CA PPO |
$12.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.06
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.21
|
| Rate for Payer: EPIC Health Plan Senior |
$4.60
|
| Rate for Payer: Galaxy Health WC |
$14.45
|
| Rate for Payer: Global Benefits Group Commercial |
$10.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$15.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7.54
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$5.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4.60
|
| Rate for Payer: InnovAge PACE Commercial |
$6.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.72
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.16
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.16
|
| Rate for Payer: Multiplan Commercial |
$12.75
|
| Rate for Payer: Networks By Design Commercial |
$11.05
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4.60
|
| Rate for Payer: Prime Health Services Commercial |
$14.45
|
| Rate for Payer: Prime Health Services Medicare |
$4.88
|
| Rate for Payer: Riverside University Health System MISP |
$5.06
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$10.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.73
|
| Rate for Payer: United Healthcare All Other HMO |
$3.73
|
| Rate for Payer: United Healthcare HMO Rider |
$3.73
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.73
|
| Rate for Payer: Upland Medical Group Pediatric |
$4.60
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.06
|
| Rate for Payer: Vantage Medical Group Senior |
$4.60
|
|
|
HC CHLORIDE
|
Facility
|
IP
|
$98.00
|
|
|
Service Code
|
CPT 82435
|
| Hospital Charge Code |
900910256
|
|
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: 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 Permanente of CA Commercial/Self Funded |
$65.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$37.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$60.66
|
| 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 CHLORIDE STOOL
|
Facility
|
OP
|
$26.00
|
|
|
Service Code
|
CPT 82438
|
| Hospital Charge Code |
900910420
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.05 |
| Max. Negotiated Rate |
$35.56 |
| Rate for Payer: Adventist Health Commercial |
$5.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$5.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$15.79
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$35.56
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7.22
|
| Rate for Payer: Blue Shield of California Commercial |
$15.78
|
| Rate for Payer: Blue Shield of California EPN |
$10.32
|
| Rate for Payer: Cash Price |
$11.70
|
| Rate for Payer: Cash Price |
$11.70
|
| Rate for Payer: Central Health Plan Commercial |
$20.80
|
| Rate for Payer: Cigna of CA HMO |
$16.64
|
| Rate for Payer: Cigna of CA PPO |
$19.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.75
|
| Rate for Payer: EPIC Health Plan Senior |
$5.00
|
| Rate for Payer: Galaxy Health WC |
$22.10
|
| Rate for Payer: Global Benefits Group Commercial |
$15.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$23.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$8.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$7.46
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.00
|
| Rate for Payer: InnovAge PACE Commercial |
$7.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.70
|
| Rate for Payer: Multiplan Commercial |
$19.50
|
| Rate for Payer: Networks By Design Commercial |
$16.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$5.00
|
| Rate for Payer: Prime Health Services Commercial |
$22.10
|
| Rate for Payer: Prime Health Services Medicare |
$5.30
|
| Rate for Payer: Riverside University Health System MISP |
$5.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$15.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.05
|
| Rate for Payer: United Healthcare All Other HMO |
$4.05
|
| Rate for Payer: United Healthcare HMO Rider |
$4.05
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.05
|
| Rate for Payer: Upland Medical Group Pediatric |
$5.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.50
|
| Rate for Payer: Vantage Medical Group Senior |
$5.00
|
|
|
HC CHLORIDE STOOL
|
Facility
|
IP
|
$198.00
|
|
|
Service Code
|
CPT 82438
|
| Hospital Charge Code |
900910420
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$39.60 |
| Max. Negotiated Rate |
$178.20 |
| Rate for Payer: Adventist Health Commercial |
$39.60
|
| Rate for Payer: Cash Price |
$89.10
|
| Rate for Payer: Central Health Plan Commercial |
$158.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$79.20
|
| Rate for Payer: EPIC Health Plan Senior |
$79.20
|
| Rate for Payer: Galaxy Health WC |
$168.30
|
| Rate for Payer: Global Benefits Group Commercial |
$118.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$178.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$132.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$75.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$122.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$39.60
|
| Rate for Payer: Multiplan Commercial |
$148.50
|
| Rate for Payer: Networks By Design Commercial |
$128.70
|
| Rate for Payer: Prime Health Services Commercial |
$168.30
|
|
|
HC CHLORIDE URINE
|
Facility
|
OP
|
$34.00
|
|
|
Service Code
|
CPT 82436
|
| Hospital Charge Code |
900910268
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.66 |
| Max. Negotiated Rate |
$36.54 |
| Rate for Payer: Adventist Health Commercial |
$6.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$5.75
|
| Rate for Payer: Aetna of CA HMO/PPO |
$20.65
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$8.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6.33
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$36.54
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7.42
|
| Rate for Payer: Blue Shield of California Commercial |
$20.64
|
| Rate for Payer: Blue Shield of California EPN |
$13.50
|
| Rate for Payer: Cash Price |
$15.30
|
| Rate for Payer: Cash Price |
$15.30
|
| Rate for Payer: Central Health Plan Commercial |
$27.20
|
| Rate for Payer: Cigna of CA HMO |
$21.76
|
| Rate for Payer: Cigna of CA PPO |
$25.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$6.33
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.76
|
| Rate for Payer: EPIC Health Plan Senior |
$5.75
|
| Rate for Payer: Galaxy Health WC |
$28.90
|
| Rate for Payer: Global Benefits Group Commercial |
$20.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$30.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$9.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$7.55
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.75
|
| Rate for Payer: InnovAge PACE Commercial |
$8.62
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$22.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$7.71
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$7.71
|
| Rate for Payer: Multiplan Commercial |
$25.50
|
| Rate for Payer: Networks By Design Commercial |
$22.10
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$5.75
|
| Rate for Payer: Prime Health Services Commercial |
$28.90
|
| Rate for Payer: Prime Health Services Medicare |
$6.09
|
| Rate for Payer: Riverside University Health System MISP |
$6.33
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$20.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$20.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.66
|
| Rate for Payer: United Healthcare All Other HMO |
$4.66
|
| Rate for Payer: United Healthcare HMO Rider |
$4.66
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.66
|
| Rate for Payer: Upland Medical Group Pediatric |
$5.75
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$8.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6.33
|
| Rate for Payer: Vantage Medical Group Senior |
$5.75
|
|
|
HC CHLORIDE URINE
|
Facility
|
IP
|
$117.00
|
|
|
Service Code
|
CPT 82436
|
| Hospital Charge Code |
900910268
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$23.40 |
| Max. Negotiated Rate |
$105.30 |
| Rate for Payer: Adventist Health Commercial |
$23.40
|
| Rate for Payer: Cash Price |
$52.65
|
| Rate for Payer: Central Health Plan Commercial |
$93.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$46.80
|
| Rate for Payer: EPIC Health Plan Senior |
$46.80
|
| Rate for Payer: Galaxy Health WC |
$99.45
|
| Rate for Payer: Global Benefits Group Commercial |
$70.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$105.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$78.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$44.58
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$72.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23.40
|
| Rate for Payer: Multiplan Commercial |
$87.75
|
| Rate for Payer: Networks By Design Commercial |
$76.05
|
| Rate for Payer: Prime Health Services Commercial |
$99.45
|
|
|
HC CHLORIDE URINE 24 HOURS
|
Facility
|
OP
|
$34.00
|
|
|
Service Code
|
CPT 82436
|
| Hospital Charge Code |
900912201
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.66 |
| Max. Negotiated Rate |
$36.54 |
| Rate for Payer: Adventist Health Commercial |
$6.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$5.75
|
| Rate for Payer: Aetna of CA HMO/PPO |
$20.65
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$8.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6.33
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$36.54
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7.42
|
| Rate for Payer: Blue Shield of California Commercial |
$20.64
|
| Rate for Payer: Blue Shield of California EPN |
$13.50
|
| Rate for Payer: Cash Price |
$15.30
|
| Rate for Payer: Cash Price |
$15.30
|
| Rate for Payer: Central Health Plan Commercial |
$27.20
|
| Rate for Payer: Cigna of CA HMO |
$21.76
|
| Rate for Payer: Cigna of CA PPO |
$25.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$6.33
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.76
|
| Rate for Payer: EPIC Health Plan Senior |
$5.75
|
| Rate for Payer: Galaxy Health WC |
$28.90
|
| Rate for Payer: Global Benefits Group Commercial |
$20.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$30.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$9.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$7.55
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.75
|
| Rate for Payer: InnovAge PACE Commercial |
$8.62
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$22.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$7.71
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$7.71
|
| Rate for Payer: Multiplan Commercial |
$25.50
|
| Rate for Payer: Networks By Design Commercial |
$22.10
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$5.75
|
| Rate for Payer: Prime Health Services Commercial |
$28.90
|
| Rate for Payer: Prime Health Services Medicare |
$6.09
|
| Rate for Payer: Riverside University Health System MISP |
$6.33
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$20.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$20.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.66
|
| Rate for Payer: United Healthcare All Other HMO |
$4.66
|
| Rate for Payer: United Healthcare HMO Rider |
$4.66
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.66
|
| Rate for Payer: Upland Medical Group Pediatric |
$5.75
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$8.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6.33
|
| Rate for Payer: Vantage Medical Group Senior |
$5.75
|
|
|
HC CHLORIDE URINE 24 HOURS
|
Facility
|
IP
|
$117.00
|
|
|
Service Code
|
CPT 82436
|
| Hospital Charge Code |
900912201
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$23.40 |
| Max. Negotiated Rate |
$105.30 |
| Rate for Payer: Adventist Health Commercial |
$23.40
|
| Rate for Payer: Cash Price |
$52.65
|
| Rate for Payer: Central Health Plan Commercial |
$93.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$46.80
|
| Rate for Payer: EPIC Health Plan Senior |
$46.80
|
| Rate for Payer: Galaxy Health WC |
$99.45
|
| Rate for Payer: Global Benefits Group Commercial |
$70.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$105.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$78.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$44.58
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$72.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23.40
|
| Rate for Payer: Multiplan Commercial |
$87.75
|
| Rate for Payer: Networks By Design Commercial |
$76.05
|
| Rate for Payer: Prime Health Services Commercial |
$99.45
|
|
|
HC CHLORIDE URINE RANDOM
|
Facility
|
OP
|
$34.00
|
|
|
Service Code
|
CPT 82436
|
| Hospital Charge Code |
900912200
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.66 |
| Max. Negotiated Rate |
$36.54 |
| Rate for Payer: Adventist Health Commercial |
$6.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$5.75
|
| Rate for Payer: Aetna of CA HMO/PPO |
$20.65
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$8.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6.33
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$36.54
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7.42
|
| Rate for Payer: Blue Shield of California Commercial |
$20.64
|
| Rate for Payer: Blue Shield of California EPN |
$13.50
|
| Rate for Payer: Cash Price |
$15.30
|
| Rate for Payer: Cash Price |
$15.30
|
| Rate for Payer: Central Health Plan Commercial |
$27.20
|
| Rate for Payer: Cigna of CA HMO |
$21.76
|
| Rate for Payer: Cigna of CA PPO |
$25.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$6.33
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.76
|
| Rate for Payer: EPIC Health Plan Senior |
$5.75
|
| Rate for Payer: Galaxy Health WC |
$28.90
|
| Rate for Payer: Global Benefits Group Commercial |
$20.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$30.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$9.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$7.55
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.75
|
| Rate for Payer: InnovAge PACE Commercial |
$8.62
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$22.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$7.71
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$7.71
|
| Rate for Payer: Multiplan Commercial |
$25.50
|
| Rate for Payer: Networks By Design Commercial |
$22.10
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$5.75
|
| Rate for Payer: Prime Health Services Commercial |
$28.90
|
| Rate for Payer: Prime Health Services Medicare |
$6.09
|
| Rate for Payer: Riverside University Health System MISP |
$6.33
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$20.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$20.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.66
|
| Rate for Payer: United Healthcare All Other HMO |
$4.66
|
| Rate for Payer: United Healthcare HMO Rider |
$4.66
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.66
|
| Rate for Payer: Upland Medical Group Pediatric |
$5.75
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$8.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6.33
|
| Rate for Payer: Vantage Medical Group Senior |
$5.75
|
|
|
HC CHLORIDE URINE RANDOM
|
Facility
|
IP
|
$117.00
|
|
|
Service Code
|
CPT 82436
|
| Hospital Charge Code |
900912200
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$23.40 |
| Max. Negotiated Rate |
$105.30 |
| Rate for Payer: Adventist Health Commercial |
$23.40
|
| Rate for Payer: Cash Price |
$52.65
|
| Rate for Payer: Central Health Plan Commercial |
$93.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$46.80
|
| Rate for Payer: EPIC Health Plan Senior |
$46.80
|
| Rate for Payer: Galaxy Health WC |
$99.45
|
| Rate for Payer: Global Benefits Group Commercial |
$70.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$105.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$78.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$44.58
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$72.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23.40
|
| Rate for Payer: Multiplan Commercial |
$87.75
|
| Rate for Payer: Networks By Design Commercial |
$76.05
|
| Rate for Payer: Prime Health Services Commercial |
$99.45
|
|
|
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 |
$9,876.60 |
| Rate for Payer: Adventist Health Commercial |
$2,194.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$2,410.32
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,615.48
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,651.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,410.32
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,311.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$3,840.40
|
| Rate for Payer: Blue Shield of California Commercial |
$3,172.31
|
| 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 |
$3,615.48
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,651.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,410.32
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,253.93
|
| Rate for Payer: EPIC Health Plan Senior |
$2,410.32
|
| 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 |
$3,952.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$117.82
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,410.32
|
| Rate for Payer: InnovAge PACE Commercial |
$3,615.48
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,319.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$130.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,410.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,194.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,229.83
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,229.83
|
| 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 |
$2,410.32
|
| 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 |
$2,554.94
|
| Rate for Payer: Prime Health Services WC |
$3,801.22
|
| Rate for Payer: Riverside University Health System MISP |
$2,651.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,584.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,208.00
|
| 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 |
$2,410.32
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,615.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,651.35
|
| Rate for Payer: Vantage Medical Group Senior |
$2,410.32
|
|
|
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: 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 Permanente of CA Commercial/Self Funded |
$7,319.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,181.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6,792.91
|
| 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 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: 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 Permanente of CA Commercial/Self Funded |
$9,049.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,169.41
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8,398.59
|
| 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 |
$748.58 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$2,713.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$4,484.02
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,726.03
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,932.42
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,484.02
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,311.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$7,144.49
|
| Rate for Payer: Blue Shield of California Commercial |
$3,172.31
|
| 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 |
$6,726.03
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,932.42
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,484.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,053.43
|
| Rate for Payer: EPIC Health Plan Senior |
$4,484.02
|
| 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 |
$7,353.79
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$748.58
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,484.02
|
| Rate for Payer: InnovAge PACE Commercial |
$6,726.03
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9,049.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$826.92
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,484.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,713.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,008.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,008.59
|
| 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 |
$4,484.02
|
| 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 |
$4,753.06
|
| Rate for Payer: Prime Health Services WC |
$7,071.59
|
| Rate for Payer: Riverside University Health System MISP |
$4,932.42
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8,140.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$14,261.00
|
| 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 |
$4,484.02
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,726.03
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,932.42
|
| Rate for Payer: Vantage Medical Group Senior |
$4,484.02
|
|
|
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: 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 Permanente of CA Commercial/Self Funded |
$18.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$17.33
|
| 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 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 |
$50.89 |
| Rate for Payer: Adventist Health Commercial |
$5.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$8.10
|
| Rate for Payer: Aetna of CA HMO/PPO |
$16.40
|
| 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 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 HMO/PPO |
$10.33
|
| Rate for Payer: Blue Shield of California Commercial |
$16.39
|
| Rate for Payer: Blue Shield of California EPN |
$10.72
|
| 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: Cigna of CA HMO |
$17.28
|
| Rate for Payer: Cigna of CA PPO |
$19.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$8.91
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.94
|
| Rate for Payer: EPIC Health Plan Senior |
$8.10
|
| Rate for Payer: Galaxy Health WC |
$22.95
|
| Rate for Payer: Global Benefits Group Commercial |
$16.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$24.30
|
| 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) Medicare Advantage |
$8.10
|
| Rate for Payer: InnovAge PACE Commercial |
$12.15
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$18.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12.31
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.85
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10.85
|
| Rate for Payer: Multiplan Commercial |
$20.25
|
| Rate for Payer: Networks By Design Commercial |
$17.55
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$8.10
|
| Rate for Payer: Prime Health Services Commercial |
$22.95
|
| Rate for Payer: Prime Health Services Medicare |
$8.59
|
| Rate for Payer: Riverside University Health System MISP |
$8.91
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$16.20
|
| 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 HMO |
$6.56
|
| Rate for Payer: United Healthcare HMO Rider |
$6.56
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.56
|
| 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 Medi-Cal |
$8.91
|
| Rate for Payer: Vantage Medical Group Senior |
$8.10
|
|
|
HC CHOLESTEROL HDL DIRECT
|
Facility
|
OP
|
$27.00
|
|
|
Service Code
|
CPT 83718
|
| Hospital Charge Code |
900910528
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.40 |
| Max. Negotiated Rate |
$59.51 |
| Rate for Payer: Adventist Health Commercial |
$5.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$8.19
|
| Rate for Payer: Aetna of CA HMO/PPO |
$16.40
|
| 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 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 HMO/PPO |
$12.08
|
| Rate for Payer: Blue Shield of California Commercial |
$16.39
|
| Rate for Payer: Blue Shield of California EPN |
$10.72
|
| 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: Cigna of CA HMO |
$17.28
|
| Rate for Payer: Cigna of CA PPO |
$19.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.29
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.01
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.06
|
| Rate for Payer: EPIC Health Plan Senior |
$8.19
|
| Rate for Payer: Galaxy Health WC |
$22.95
|
| Rate for Payer: Global Benefits Group Commercial |
$16.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$24.30
|
| 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) Medicare Advantage |
$8.19
|
| Rate for Payer: InnovAge PACE Commercial |
$12.29
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$18.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.97
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10.97
|
| Rate for Payer: Multiplan Commercial |
$20.25
|
| Rate for Payer: Networks By Design Commercial |
$17.55
|
| 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 Medicare |
$8.68
|
| Rate for Payer: Riverside University Health System MISP |
$9.01
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$16.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$16.20
|
| 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 HMO Rider |
$6.63
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.63
|
| 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 Medi-Cal |
$9.01
|
| Rate for Payer: Vantage Medical Group Senior |
$8.19
|
|
|
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: 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 Permanente of CA Commercial/Self Funded |
$102.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$58.29
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$94.71
|
| 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
|
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: 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 Permanente of CA Commercial/Self Funded |
$102.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$58.29
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$94.71
|
| 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
|
$27.00
|
|
|
Service Code
|
CPT 83718
|
| Hospital Charge Code |
900910527
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.40 |
| Max. Negotiated Rate |
$59.51 |
| Rate for Payer: Adventist Health Commercial |
$5.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$8.19
|
| Rate for Payer: Aetna of CA HMO/PPO |
$16.40
|
| 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 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 HMO/PPO |
$12.08
|
| Rate for Payer: Blue Shield of California Commercial |
$16.39
|
| Rate for Payer: Blue Shield of California EPN |
$10.72
|
| 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: Cigna of CA HMO |
$17.28
|
| Rate for Payer: Cigna of CA PPO |
$19.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.29
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.01
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.06
|
| Rate for Payer: EPIC Health Plan Senior |
$8.19
|
| Rate for Payer: Galaxy Health WC |
$22.95
|
| Rate for Payer: Global Benefits Group Commercial |
$16.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$24.30
|
| 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) Medicare Advantage |
$8.19
|
| Rate for Payer: InnovAge PACE Commercial |
$12.29
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$18.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.97
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10.97
|
| Rate for Payer: Multiplan Commercial |
$20.25
|
| Rate for Payer: Networks By Design Commercial |
$17.55
|
| 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 Medicare |
$8.68
|
| Rate for Payer: Riverside University Health System MISP |
$9.01
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$16.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$16.20
|
| 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 HMO Rider |
$6.63
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.63
|
| 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 Medi-Cal |
$9.01
|
| Rate for Payer: Vantage Medical Group Senior |
$8.19
|
|
|
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: 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 Permanente of CA Commercial/Self Funded |
$119.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$68.20
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$110.80
|
| 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 LDL-DIRECT
|
Facility
|
OP
|
$68.00
|
|
|
Service Code
|
CPT 83721
|
| Hospital Charge Code |
900910529
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.51 |
| Max. Negotiated Rate |
$68.62 |
| Rate for Payer: Adventist Health Commercial |
$13.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$10.50
|
| Rate for Payer: Aetna of CA HMO/PPO |
$41.30
|
| 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 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 HMO/PPO |
$13.93
|
| Rate for Payer: Blue Shield of California Commercial |
$41.28
|
| Rate for Payer: Blue Shield of California EPN |
$27.00
|
| Rate for Payer: Cash Price |
$30.60
|
| Rate for Payer: Cash Price |
$30.60
|
| Rate for Payer: Central Health Plan Commercial |
$54.40
|
| Rate for Payer: Cigna of CA HMO |
$43.52
|
| Rate for Payer: Cigna of CA PPO |
$50.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$11.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.18
|
| Rate for Payer: EPIC Health Plan Senior |
$10.50
|
| Rate for Payer: Galaxy Health WC |
$57.80
|
| Rate for Payer: Global Benefits Group Commercial |
$40.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$61.20
|
| 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) Medicare Advantage |
$10.50
|
| Rate for Payer: InnovAge PACE Commercial |
$15.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$45.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$15.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$14.07
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14.07
|
| Rate for Payer: Multiplan Commercial |
$51.00
|
| Rate for Payer: Networks By Design Commercial |
$44.20
|
| 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 Medicare |
$11.13
|
| Rate for Payer: Riverside University Health System MISP |
$11.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$40.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$40.80
|
| 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 HMO Rider |
$8.51
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8.51
|
| 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 Medi-Cal |
$11.55
|
| Rate for Payer: Vantage Medical Group Senior |
$10.50
|
|
|
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 |
$42.30 |
| Rate for Payer: Adventist Health Commercial |
$9.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$4.35
|
| Rate for Payer: Aetna of CA HMO/PPO |
$28.54
|
| 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 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 HMO/PPO |
$6.42
|
| Rate for Payer: Blue Shield of California Commercial |
$28.53
|
| Rate for Payer: Blue Shield of California EPN |
$18.66
|
| 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: Cigna of CA HMO |
$30.08
|
| Rate for Payer: Cigna of CA PPO |
$34.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6.53
|
| Rate for Payer: Dignity Health Medi-Cal |
$4.79
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.87
|
| Rate for Payer: EPIC Health Plan Senior |
$4.35
|
| Rate for Payer: Galaxy Health WC |
$39.95
|
| Rate for Payer: Global Benefits Group Commercial |
$28.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$42.30
|
| 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) Medicare Advantage |
$4.35
|
| Rate for Payer: InnovAge PACE Commercial |
$6.53
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$31.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5.83
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5.83
|
| Rate for Payer: Multiplan Commercial |
$35.25
|
| Rate for Payer: Networks By Design Commercial |
$30.55
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4.35
|
| Rate for Payer: Prime Health Services Commercial |
$39.95
|
| Rate for Payer: Prime Health Services Medicare |
$4.61
|
| Rate for Payer: Riverside University Health System MISP |
$4.79
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$28.20
|
| 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 HMO |
$3.53
|
| Rate for Payer: United Healthcare HMO Rider |
$3.53
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.53
|
| 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 Medi-Cal |
$4.79
|
| 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: 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 Permanente of CA Commercial/Self Funded |
$65.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$37.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$60.66
|
| 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 |
$42.30 |
| Rate for Payer: Adventist Health Commercial |
$9.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$4.35
|
| Rate for Payer: Aetna of CA HMO/PPO |
$28.54
|
| 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 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 HMO/PPO |
$6.42
|
| Rate for Payer: Blue Shield of California Commercial |
$28.53
|
| Rate for Payer: Blue Shield of California EPN |
$18.66
|
| 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: Cigna of CA HMO |
$30.08
|
| Rate for Payer: Cigna of CA PPO |
$34.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6.53
|
| Rate for Payer: Dignity Health Medi-Cal |
$4.79
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.87
|
| Rate for Payer: EPIC Health Plan Senior |
$4.35
|
| Rate for Payer: Galaxy Health WC |
$39.95
|
| Rate for Payer: Global Benefits Group Commercial |
$28.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$42.30
|
| 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) Medicare Advantage |
$4.35
|
| Rate for Payer: InnovAge PACE Commercial |
$6.53
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$31.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5.83
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5.83
|
| Rate for Payer: Multiplan Commercial |
$35.25
|
| Rate for Payer: Networks By Design Commercial |
$30.55
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4.35
|
| Rate for Payer: Prime Health Services Commercial |
$39.95
|
| Rate for Payer: Prime Health Services Medicare |
$4.61
|
| Rate for Payer: Riverside University Health System MISP |
$4.79
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$28.20
|
| 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 HMO |
$3.53
|
| Rate for Payer: United Healthcare HMO Rider |
$3.53
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.53
|
| 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 Medi-Cal |
$4.79
|
| Rate for Payer: Vantage Medical Group Senior |
$4.35
|
|
