|
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: 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 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 |
$98.94
|
| 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: EPIC Health Plan Commercial |
$51.20
|
| Rate for Payer: EPIC Health Plan Senior |
$51.20
|
| Rate for Payer: Galaxy Health WC |
$108.80
|
| Rate for Payer: Global Benefits Group Commercial |
$76.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$115.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$85.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$48.77
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$79.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.60
|
| Rate for Payer: Multiplan Commercial |
$96.00
|
| Rate for Payer: Networks By Design Commercial |
$83.20
|
| Rate for Payer: Prime Health Services Commercial |
$108.80
|
| 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 |
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 |
$75.17
|
| Rate for Payer: Blue Shield of California Commercial |
$98.94
|
| 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: 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: InnovAge PACE Commercial |
$64.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$85.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$60.19
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$79.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$52.48
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$89.60
|
| Rate for Payer: Molina Healthcare of CA 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 |
$98.94
|
| 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: EPIC Health Plan Commercial |
$51.20
|
| Rate for Payer: EPIC Health Plan Senior |
$51.20
|
| Rate for Payer: Galaxy Health WC |
$108.80
|
| Rate for Payer: Global Benefits Group Commercial |
$76.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$115.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$85.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$48.77
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$79.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.60
|
| Rate for Payer: Multiplan Commercial |
$96.00
|
| Rate for Payer: Networks By Design Commercial |
$83.20
|
| Rate for Payer: Prime Health Services Commercial |
$108.80
|
| 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 |
$75.17
|
| Rate for Payer: Blue Shield of California Commercial |
$98.94
|
| 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: 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: InnovAge PACE Commercial |
$64.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$85.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$60.19
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$79.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$52.48
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$89.60
|
| Rate for Payer: Molina Healthcare of CA 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 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: EPIC Health Plan Commercial |
$48.00
|
| Rate for Payer: EPIC Health Plan Senior |
$48.00
|
| Rate for Payer: Galaxy Health WC |
$102.00
|
| Rate for Payer: Global Benefits Group Commercial |
$72.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$108.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$80.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$45.72
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$74.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.00
|
| Rate for Payer: Multiplan Commercial |
$90.00
|
| Rate for Payer: Networks By Design Commercial |
$78.00
|
| Rate for Payer: Prime Health Services Commercial |
$102.00
|
|
|
HC CHROM ADDL CELL COUNT EA
|
Facility
|
OP
|
$78.00
|
|
|
Service Code
|
CPT 88285
|
| Hospital Charge Code |
900918013
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$13.07 |
| Max. Negotiated Rate |
$117.40 |
| Rate for Payer: Adventist Health Commercial |
$15.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$26.91
|
| Rate for Payer: Aetna of CA HMO/PPO |
$47.37
|
| 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 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 HMO/PPO |
$23.83
|
| Rate for Payer: Blue Shield of California Commercial |
$47.35
|
| Rate for Payer: Blue Shield of California EPN |
$30.97
|
| Rate for Payer: Cash Price |
$35.10
|
| Rate for Payer: Cash Price |
$35.10
|
| Rate for Payer: Central Health Plan Commercial |
$62.40
|
| Rate for Payer: Cigna of CA HMO |
$49.92
|
| Rate for Payer: Cigna of CA PPO |
$57.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$40.37
|
| Rate for Payer: Dignity Health Medi-Cal |
$29.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$26.91
|
| Rate for Payer: EPIC Health Plan Commercial |
$36.33
|
| Rate for Payer: EPIC Health Plan Senior |
$26.91
|
| Rate for Payer: Galaxy Health WC |
$66.30
|
| Rate for Payer: Global Benefits Group Commercial |
$46.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$70.20
|
| 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) Medicare Advantage |
$26.91
|
| Rate for Payer: InnovAge PACE Commercial |
$40.37
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$52.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$26.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$36.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$36.06
|
| Rate for Payer: Multiplan Commercial |
$58.50
|
| Rate for Payer: Networks By Design Commercial |
$50.70
|
| 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 Medicare |
$28.52
|
| Rate for Payer: Riverside University Health System MISP |
$29.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$46.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$46.80
|
| 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 HMO Rider |
$21.80
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$21.80
|
| 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 Medi-Cal |
$29.60
|
| Rate for Payer: Vantage Medical Group Senior |
$26.91
|
|
|
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: 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 Permanente of CA Commercial/Self Funded |
$88.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$50.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$82.33
|
| 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 ADDL SPEC BANDING
|
Facility
|
OP
|
$93.00
|
|
|
Service Code
|
CPT 88283
|
| Hospital Charge Code |
900918012
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$13.11 |
| Max. Negotiated Rate |
$112.50 |
| Rate for Payer: Adventist Health Commercial |
$18.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$68.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$56.48
|
| 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 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 HMO/PPO |
$13.11
|
| Rate for Payer: Blue Shield of California Commercial |
$56.45
|
| Rate for Payer: Blue Shield of California EPN |
$36.92
|
| Rate for Payer: Cash Price |
$41.85
|
| Rate for Payer: Cash Price |
$41.85
|
| Rate for Payer: Central Health Plan Commercial |
$74.40
|
| Rate for Payer: Cigna of CA HMO |
$59.52
|
| Rate for Payer: Cigna of CA PPO |
$68.82
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$102.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$75.46
|
| Rate for Payer: Dignity Health Medicare Advantage |
$68.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$92.61
|
| Rate for Payer: EPIC Health Plan Senior |
$68.60
|
| Rate for Payer: Galaxy Health WC |
$79.05
|
| Rate for Payer: Global Benefits Group Commercial |
$55.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$83.70
|
| 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) Medicare Advantage |
$68.60
|
| Rate for Payer: InnovAge PACE Commercial |
$102.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$62.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$18.45
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$68.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$91.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$91.92
|
| Rate for Payer: Multiplan Commercial |
$69.75
|
| Rate for Payer: Networks By Design Commercial |
$60.45
|
| 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 Medicare |
$72.72
|
| Rate for Payer: Riverside University Health System MISP |
$75.46
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$55.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$55.80
|
| 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 HMO Rider |
$55.57
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$55.57
|
| 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 Medi-Cal |
$75.46
|
| Rate for Payer: Vantage Medical Group Senior |
$68.60
|
|
|
HC CHROM AMNIO 15 CELLS 1 KARYO
|
Facility
|
OP
|
$246.00
|
|
|
Service Code
|
CPT 88267
|
| Hospital Charge Code |
900918015
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$49.20 |
| Max. Negotiated Rate |
$1,307.78 |
| Rate for Payer: Adventist Health Commercial |
$49.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$188.57
|
| Rate for Payer: Aetna of CA HMO/PPO |
$149.40
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$282.86
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$207.43
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$188.57
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,307.78
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$265.42
|
| Rate for Payer: Blue Shield of California Commercial |
$149.32
|
| Rate for Payer: Blue Shield of California EPN |
$97.66
|
| Rate for Payer: Cash Price |
$110.70
|
| Rate for Payer: Cash Price |
$110.70
|
| Rate for Payer: Central Health Plan Commercial |
$196.80
|
| Rate for Payer: Cigna of CA HMO |
$157.44
|
| Rate for Payer: Cigna of CA PPO |
$182.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$282.86
|
| Rate for Payer: Dignity Health Medi-Cal |
$207.43
|
| Rate for Payer: Dignity Health Medicare Advantage |
$188.57
|
| Rate for Payer: EPIC Health Plan Commercial |
$254.57
|
| Rate for Payer: EPIC Health Plan Senior |
$188.57
|
| Rate for Payer: Galaxy Health WC |
$209.10
|
| Rate for Payer: Global Benefits Group Commercial |
$147.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$221.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$309.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$274.86
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$188.57
|
| Rate for Payer: InnovAge PACE Commercial |
$282.86
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$164.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$303.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$188.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$49.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$252.68
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$252.68
|
| Rate for Payer: Multiplan Commercial |
$184.50
|
| Rate for Payer: Networks By Design Commercial |
$159.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$188.57
|
| Rate for Payer: Prime Health Services Commercial |
$209.10
|
| Rate for Payer: Prime Health Services Medicare |
$199.88
|
| Rate for Payer: Riverside University Health System MISP |
$207.43
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$147.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$147.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$152.74
|
| Rate for Payer: United Healthcare All Other HMO |
$152.74
|
| Rate for Payer: United Healthcare HMO Rider |
$152.74
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$152.74
|
| Rate for Payer: Upland Medical Group Pediatric |
$188.57
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$282.86
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$207.43
|
| Rate for Payer: Vantage Medical Group Senior |
$188.57
|
|
|
HC CHROM AMNIO 15 CELLS 1 KARYO
|
Facility
|
IP
|
$339.00
|
|
|
Service Code
|
CPT 88267
|
| Hospital Charge Code |
900918015
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$67.80 |
| Max. Negotiated Rate |
$305.10 |
| Rate for Payer: Adventist Health Commercial |
$67.80
|
| Rate for Payer: Cash Price |
$152.55
|
| Rate for Payer: Central Health Plan Commercial |
$271.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$135.60
|
| Rate for Payer: EPIC Health Plan Senior |
$135.60
|
| Rate for Payer: Galaxy Health WC |
$288.15
|
| Rate for Payer: Global Benefits Group Commercial |
$203.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$305.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$226.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$129.16
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$209.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$67.80
|
| Rate for Payer: Multiplan Commercial |
$254.25
|
| Rate for Payer: Networks By Design Commercial |
$220.35
|
| Rate for Payer: Prime Health Services Commercial |
$288.15
|
|
|
HC CHROM AMNIO 6-12 COLN 1 KARYO
|
Facility
|
OP
|
$230.00
|
|
|
Service Code
|
CPT 88269
|
| Hospital Charge Code |
900918014
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$46.00 |
| Max. Negotiated Rate |
$1,209.88 |
| Rate for Payer: Adventist Health Commercial |
$46.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$173.66
|
| Rate for Payer: Aetna of CA HMO/PPO |
$139.68
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$260.49
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$191.03
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$173.66
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,209.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$245.55
|
| Rate for Payer: Blue Shield of California Commercial |
$139.61
|
| Rate for Payer: Blue Shield of California EPN |
$91.31
|
| Rate for Payer: Cash Price |
$103.50
|
| Rate for Payer: Cash Price |
$103.50
|
| Rate for Payer: Central Health Plan Commercial |
$184.00
|
| Rate for Payer: Cigna of CA HMO |
$147.20
|
| Rate for Payer: Cigna of CA PPO |
$170.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$260.49
|
| Rate for Payer: Dignity Health Medi-Cal |
$191.03
|
| Rate for Payer: Dignity Health Medicare Advantage |
$173.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$234.44
|
| Rate for Payer: EPIC Health Plan Senior |
$173.66
|
| Rate for Payer: Galaxy Health WC |
$195.50
|
| Rate for Payer: Global Benefits Group Commercial |
$138.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$207.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$284.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$254.28
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$173.66
|
| Rate for Payer: InnovAge PACE Commercial |
$260.49
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$153.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$280.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$173.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$46.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$232.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$232.70
|
| Rate for Payer: Multiplan Commercial |
$172.50
|
| Rate for Payer: Networks By Design Commercial |
$149.50
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$173.66
|
| Rate for Payer: Prime Health Services Commercial |
$195.50
|
| Rate for Payer: Prime Health Services Medicare |
$184.08
|
| Rate for Payer: Riverside University Health System MISP |
$191.03
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$138.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$138.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$140.66
|
| Rate for Payer: United Healthcare All Other HMO |
$140.66
|
| Rate for Payer: United Healthcare HMO Rider |
$140.66
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$140.66
|
| Rate for Payer: Upland Medical Group Pediatric |
$173.66
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$260.49
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$191.03
|
| Rate for Payer: Vantage Medical Group Senior |
$173.66
|
|
|
HC CHROM AMNIO 6-12 COLN 1 KARYO
|
Facility
|
IP
|
$321.00
|
|
|
Service Code
|
CPT 88269
|
| Hospital Charge Code |
900918014
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$64.20 |
| Max. Negotiated Rate |
$288.90 |
| Rate for Payer: Adventist Health Commercial |
$64.20
|
| Rate for Payer: Cash Price |
$144.45
|
| Rate for Payer: Central Health Plan Commercial |
$256.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$128.40
|
| Rate for Payer: EPIC Health Plan Senior |
$128.40
|
| Rate for Payer: Galaxy Health WC |
$272.85
|
| Rate for Payer: Global Benefits Group Commercial |
$192.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$288.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$214.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$122.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$198.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$64.20
|
| Rate for Payer: Multiplan Commercial |
$240.75
|
| Rate for Payer: Networks By Design Commercial |
$208.65
|
| Rate for Payer: Prime Health Services Commercial |
$272.85
|
|
|
HC CHROM ANLZ 15-20 CELLS 2 KARYO
|
Facility
|
IP
|
$564.00
|
|
|
Service Code
|
CPT 88262
|
| Hospital Charge Code |
900918020
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$112.80 |
| Max. Negotiated Rate |
$507.60 |
| Rate for Payer: Adventist Health Commercial |
$112.80
|
| Rate for Payer: Cash Price |
$253.80
|
| Rate for Payer: Central Health Plan Commercial |
$451.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$225.60
|
| Rate for Payer: EPIC Health Plan Senior |
$225.60
|
| Rate for Payer: Galaxy Health WC |
$479.40
|
| Rate for Payer: Global Benefits Group Commercial |
$338.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$507.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$376.19
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$214.88
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$349.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$112.80
|
| Rate for Payer: Multiplan Commercial |
$423.00
|
| Rate for Payer: Networks By Design Commercial |
$366.60
|
| Rate for Payer: Prime Health Services Commercial |
$479.40
|
|
|
HC CHROM ANLZ 15-20 CELLS 2 KARYO
|
Facility
|
OP
|
$400.00
|
|
|
Service Code
|
CPT 88262
|
| Hospital Charge Code |
900918020
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$80.00 |
| Max. Negotiated Rate |
$906.71 |
| Rate for Payer: Adventist Health Commercial |
$80.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$125.49
|
| Rate for Payer: Aetna of CA HMO/PPO |
$242.92
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$188.24
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$138.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$125.49
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$906.71
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$184.02
|
| Rate for Payer: Blue Shield of California Commercial |
$242.80
|
| Rate for Payer: Blue Shield of California EPN |
$158.80
|
| Rate for Payer: Cash Price |
$180.00
|
| Rate for Payer: Cash Price |
$180.00
|
| Rate for Payer: Central Health Plan Commercial |
$320.00
|
| Rate for Payer: Cigna of CA HMO |
$256.00
|
| Rate for Payer: Cigna of CA PPO |
$296.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$188.24
|
| Rate for Payer: Dignity Health Medi-Cal |
$138.04
|
| Rate for Payer: Dignity Health Medicare Advantage |
$125.49
|
| Rate for Payer: EPIC Health Plan Commercial |
$169.41
|
| Rate for Payer: EPIC Health Plan Senior |
$125.49
|
| Rate for Payer: Galaxy Health WC |
$340.00
|
| Rate for Payer: Global Benefits Group Commercial |
$240.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$360.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$205.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$185.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$125.49
|
| Rate for Payer: InnovAge PACE Commercial |
$188.24
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$266.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$204.84
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$125.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$80.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$168.16
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$168.16
|
| Rate for Payer: Multiplan Commercial |
$300.00
|
| Rate for Payer: Networks By Design Commercial |
$260.00
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$125.49
|
| Rate for Payer: Prime Health Services Commercial |
$340.00
|
| Rate for Payer: Prime Health Services Medicare |
$133.02
|
| Rate for Payer: Riverside University Health System MISP |
$138.04
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$240.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$240.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$101.65
|
| Rate for Payer: United Healthcare All Other HMO |
$101.65
|
| Rate for Payer: United Healthcare HMO Rider |
$101.65
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$101.65
|
| Rate for Payer: Upland Medical Group Pediatric |
$125.49
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$188.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$138.04
|
| Rate for Payer: Vantage Medical Group Senior |
$125.49
|
|
|
HC CHROM ANLZ 20-25 CELLS
|
Facility
|
IP
|
$564.00
|
|
|
Service Code
|
CPT 88264
|
| Hospital Charge Code |
900918016
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$112.80 |
| Max. Negotiated Rate |
$507.60 |
| Rate for Payer: Adventist Health Commercial |
$112.80
|
| Rate for Payer: Cash Price |
$253.80
|
| Rate for Payer: Central Health Plan Commercial |
$451.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$225.60
|
| Rate for Payer: EPIC Health Plan Senior |
$225.60
|
| Rate for Payer: Galaxy Health WC |
$479.40
|
| Rate for Payer: Global Benefits Group Commercial |
$338.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$507.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$376.19
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$214.88
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$349.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$112.80
|
| Rate for Payer: Multiplan Commercial |
$423.00
|
| Rate for Payer: Networks By Design Commercial |
$366.60
|
| Rate for Payer: Prime Health Services Commercial |
$479.40
|
|
|
HC CHROM ANLZ 20-25 CELLS
|
Facility
|
OP
|
$400.00
|
|
|
Service Code
|
CPT 88264
|
| Hospital Charge Code |
900918016
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$80.00 |
| Max. Negotiated Rate |
$902.70 |
| Rate for Payer: Adventist Health Commercial |
$80.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$144.61
|
| Rate for Payer: Aetna of CA HMO/PPO |
$242.92
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$216.91
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$159.07
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$144.61
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$902.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$183.20
|
| Rate for Payer: Blue Shield of California Commercial |
$242.80
|
| Rate for Payer: Blue Shield of California EPN |
$158.80
|
| Rate for Payer: Cash Price |
$180.00
|
| Rate for Payer: Cash Price |
$180.00
|
| Rate for Payer: Central Health Plan Commercial |
$320.00
|
| Rate for Payer: Cigna of CA HMO |
$256.00
|
| Rate for Payer: Cigna of CA PPO |
$296.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$216.91
|
| Rate for Payer: Dignity Health Medi-Cal |
$159.07
|
| Rate for Payer: Dignity Health Medicare Advantage |
$144.61
|
| Rate for Payer: EPIC Health Plan Commercial |
$195.22
|
| Rate for Payer: EPIC Health Plan Senior |
$144.61
|
| Rate for Payer: Galaxy Health WC |
$340.00
|
| Rate for Payer: Global Benefits Group Commercial |
$240.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$360.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$237.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$198.97
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$144.61
|
| Rate for Payer: InnovAge PACE Commercial |
$216.91
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$266.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$219.79
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$144.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$80.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$193.78
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$193.78
|
| Rate for Payer: Multiplan Commercial |
$300.00
|
| Rate for Payer: Networks By Design Commercial |
$260.00
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$144.61
|
| Rate for Payer: Prime Health Services Commercial |
$340.00
|
| Rate for Payer: Prime Health Services Medicare |
$153.29
|
| Rate for Payer: Riverside University Health System MISP |
$159.07
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$240.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$240.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$117.14
|
| Rate for Payer: United Healthcare All Other HMO |
$117.14
|
| Rate for Payer: United Healthcare HMO Rider |
$117.14
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$117.14
|
| Rate for Payer: Upland Medical Group Pediatric |
$144.61
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$216.91
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$159.07
|
| Rate for Payer: Vantage Medical Group Senior |
$144.61
|
|
|
HC CHROM ANLZ 45 CEL MSAIC 2 KRYO
|
Facility
|
IP
|
$291.00
|
|
|
Service Code
|
CPT 88263
|
| Hospital Charge Code |
900918017
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$58.20 |
| Max. Negotiated Rate |
$261.90 |
| Rate for Payer: Adventist Health Commercial |
$58.20
|
| Rate for Payer: Cash Price |
$130.95
|
| Rate for Payer: Central Health Plan Commercial |
$232.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$116.40
|
| Rate for Payer: EPIC Health Plan Senior |
$116.40
|
| Rate for Payer: Galaxy Health WC |
$247.35
|
| Rate for Payer: Global Benefits Group Commercial |
$174.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$261.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$194.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$110.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$180.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$58.20
|
| Rate for Payer: Multiplan Commercial |
$218.25
|
| Rate for Payer: Networks By Design Commercial |
$189.15
|
| Rate for Payer: Prime Health Services Commercial |
$247.35
|
|
|
HC CHROM ANLZ 45 CEL MSAIC 2 KRYO
|
Facility
|
OP
|
$208.00
|
|
|
Service Code
|
CPT 88263
|
| Hospital Charge Code |
900918017
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$41.60 |
| Max. Negotiated Rate |
$1,057.81 |
| Rate for Payer: Adventist Health Commercial |
$41.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$150.29
|
| Rate for Payer: Aetna of CA HMO/PPO |
$126.32
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$225.44
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$165.32
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$150.29
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,057.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$214.68
|
| Rate for Payer: Blue Shield of California Commercial |
$126.26
|
| Rate for Payer: Blue Shield of California EPN |
$82.58
|
| Rate for Payer: Cash Price |
$93.60
|
| Rate for Payer: Cash Price |
$93.60
|
| Rate for Payer: Central Health Plan Commercial |
$166.40
|
| Rate for Payer: Cigna of CA HMO |
$133.12
|
| Rate for Payer: Cigna of CA PPO |
$153.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$225.44
|
| Rate for Payer: Dignity Health Medi-Cal |
$165.32
|
| Rate for Payer: Dignity Health Medicare Advantage |
$150.29
|
| Rate for Payer: EPIC Health Plan Commercial |
$202.89
|
| Rate for Payer: EPIC Health Plan Senior |
$150.29
|
| Rate for Payer: Galaxy Health WC |
$176.80
|
| Rate for Payer: Global Benefits Group Commercial |
$124.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$187.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$246.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$229.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$150.29
|
| Rate for Payer: InnovAge PACE Commercial |
$225.44
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$138.74
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$253.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$150.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$41.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$201.39
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$201.39
|
| Rate for Payer: Multiplan Commercial |
$156.00
|
| Rate for Payer: Networks By Design Commercial |
$135.20
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$150.29
|
| Rate for Payer: Prime Health Services Commercial |
$176.80
|
| Rate for Payer: Prime Health Services Medicare |
$159.31
|
| Rate for Payer: Riverside University Health System MISP |
$165.32
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$124.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$124.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$121.73
|
| Rate for Payer: United Healthcare All Other HMO |
$121.73
|
| Rate for Payer: United Healthcare HMO Rider |
$121.73
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$121.73
|
| Rate for Payer: Upland Medical Group Pediatric |
$150.29
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$225.44
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$165.32
|
| Rate for Payer: Vantage Medical Group Senior |
$150.29
|
|
|
HC CHROM ANLZ 5 CELLS 1 KARYO
|
Facility
|
OP
|
$291.00
|
|
|
Service Code
|
CPT 88261
|
| Hospital Charge Code |
900918019
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$58.20 |
| Max. Negotiated Rate |
$1,091.45 |
| Rate for Payer: Adventist Health Commercial |
$58.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$264.34
|
| Rate for Payer: Aetna of CA HMO/PPO |
$176.72
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$396.51
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$290.77
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$264.34
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,091.45
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$221.51
|
| Rate for Payer: Blue Shield of California Commercial |
$176.64
|
| Rate for Payer: Blue Shield of California EPN |
$115.53
|
| Rate for Payer: Cash Price |
$130.95
|
| Rate for Payer: Cash Price |
$130.95
|
| Rate for Payer: Central Health Plan Commercial |
$232.80
|
| Rate for Payer: Cigna of CA HMO |
$186.24
|
| Rate for Payer: Cigna of CA PPO |
$215.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$396.51
|
| Rate for Payer: Dignity Health Medi-Cal |
$290.77
|
| Rate for Payer: Dignity Health Medicare Advantage |
$264.34
|
| Rate for Payer: EPIC Health Plan Commercial |
$356.86
|
| Rate for Payer: EPIC Health Plan Senior |
$264.34
|
| Rate for Payer: Galaxy Health WC |
$247.35
|
| Rate for Payer: Global Benefits Group Commercial |
$174.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$261.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$433.52
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$326.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$264.34
|
| Rate for Payer: InnovAge PACE Commercial |
$396.51
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$194.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$361.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$264.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$58.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$354.22
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$354.22
|
| Rate for Payer: Multiplan Commercial |
$218.25
|
| Rate for Payer: Networks By Design Commercial |
$189.15
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$264.34
|
| Rate for Payer: Prime Health Services Commercial |
$247.35
|
| Rate for Payer: Prime Health Services Medicare |
$280.20
|
| Rate for Payer: Riverside University Health System MISP |
$290.77
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$174.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$174.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$214.12
|
| Rate for Payer: United Healthcare All Other HMO |
$214.12
|
| Rate for Payer: United Healthcare HMO Rider |
$214.12
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$214.12
|
| Rate for Payer: Upland Medical Group Pediatric |
$264.34
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$396.51
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$290.77
|
| Rate for Payer: Vantage Medical Group Senior |
$264.34
|
|
|
HC CHROM ANLZ 5 CELLS 1 KARYO
|
Facility
|
IP
|
$403.00
|
|
|
Service Code
|
CPT 88261
|
| Hospital Charge Code |
900918019
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$80.60 |
| Max. Negotiated Rate |
$362.70 |
| Rate for Payer: Adventist Health Commercial |
$80.60
|
| Rate for Payer: Cash Price |
$181.35
|
| Rate for Payer: Central Health Plan Commercial |
$322.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$161.20
|
| Rate for Payer: EPIC Health Plan Senior |
$161.20
|
| Rate for Payer: Galaxy Health WC |
$342.55
|
| Rate for Payer: Global Benefits Group Commercial |
$241.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$362.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$268.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$153.54
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$249.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$80.60
|
| Rate for Payer: Multiplan Commercial |
$302.25
|
| Rate for Payer: Networks By Design Commercial |
$261.95
|
| Rate for Payer: Prime Health Services Commercial |
$342.55
|
|
|
HC CHROM ANLZ ADDL KARYO
|
Facility
|
OP
|
$42.00
|
|
|
Service Code
|
CPT 88280
|
| Hospital Charge Code |
900918018
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$8.40 |
| Max. Negotiated Rate |
$182.59 |
| Rate for Payer: Adventist Health Commercial |
$8.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$33.47
|
| Rate for Payer: Aetna of CA HMO/PPO |
$25.51
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$50.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$36.82
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$33.47
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$182.59
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$37.06
|
| Rate for Payer: Blue Shield of California Commercial |
$25.49
|
| Rate for Payer: Blue Shield of California EPN |
$16.67
|
| Rate for Payer: Cash Price |
$18.90
|
| Rate for Payer: Cash Price |
$18.90
|
| Rate for Payer: Central Health Plan Commercial |
$33.60
|
| Rate for Payer: Cigna of CA HMO |
$26.88
|
| Rate for Payer: Cigna of CA PPO |
$31.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$50.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$36.82
|
| Rate for Payer: Dignity Health Medicare Advantage |
$33.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$45.18
|
| Rate for Payer: EPIC Health Plan Senior |
$33.47
|
| Rate for Payer: Galaxy Health WC |
$35.70
|
| Rate for Payer: Global Benefits Group Commercial |
$25.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$37.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$54.89
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$32.97
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$33.47
|
| Rate for Payer: InnovAge PACE Commercial |
$50.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$28.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$36.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$33.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$44.85
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$44.85
|
| Rate for Payer: Multiplan Commercial |
$31.50
|
| Rate for Payer: Networks By Design Commercial |
$27.30
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$33.47
|
| Rate for Payer: Prime Health Services Commercial |
$35.70
|
| Rate for Payer: Prime Health Services Medicare |
$35.48
|
| Rate for Payer: Riverside University Health System MISP |
$36.82
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$25.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$25.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$27.11
|
| Rate for Payer: United Healthcare All Other HMO |
$27.11
|
| Rate for Payer: United Healthcare HMO Rider |
$27.11
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$27.11
|
| Rate for Payer: Upland Medical Group Pediatric |
$33.47
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$50.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$36.82
|
| Rate for Payer: Vantage Medical Group Senior |
$33.47
|
|
|
HC CHROM ANLZ ADDL KARYO
|
Facility
|
IP
|
$57.00
|
|
|
Service Code
|
CPT 88280
|
| Hospital Charge Code |
900918018
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$11.40 |
| Max. Negotiated Rate |
$51.30 |
| Rate for Payer: Adventist Health Commercial |
$11.40
|
| Rate for Payer: Cash Price |
$25.65
|
| Rate for Payer: Central Health Plan Commercial |
$45.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$22.80
|
| Rate for Payer: EPIC Health Plan Senior |
$22.80
|
| Rate for Payer: Galaxy Health WC |
$48.45
|
| Rate for Payer: Global Benefits Group Commercial |
$34.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$51.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$38.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$21.72
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$35.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.40
|
| Rate for Payer: Multiplan Commercial |
$42.75
|
| Rate for Payer: Networks By Design Commercial |
$37.05
|
| Rate for Payer: Prime Health Services Commercial |
$48.45
|
|
|
HC CHROMOSOME ANALYSIS; CNT 15-20
|
Facility
|
IP
|
$625.52
|
|
|
Service Code
|
CPT 88262
|
| Hospital Charge Code |
903800162
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$125.10 |
| Max. Negotiated Rate |
$562.97 |
| Rate for Payer: Adventist Health Commercial |
$125.10
|
| Rate for Payer: Cash Price |
$281.48
|
| Rate for Payer: Central Health Plan Commercial |
$500.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$250.21
|
| Rate for Payer: EPIC Health Plan Senior |
$250.21
|
| Rate for Payer: Galaxy Health WC |
$531.69
|
| Rate for Payer: Global Benefits Group Commercial |
$375.31
|
| Rate for Payer: Health Management Network EPO/PPO |
$562.97
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$417.22
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$238.32
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$387.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$125.10
|
| Rate for Payer: Multiplan Commercial |
$469.14
|
| Rate for Payer: Networks By Design Commercial |
$406.59
|
| Rate for Payer: Prime Health Services Commercial |
$531.69
|
|
|
HC CHROMOSOME ANALYSIS; CNT 15-20
|
Facility
|
OP
|
$625.52
|
|
|
Service Code
|
CPT 88262
|
| Hospital Charge Code |
903800162
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$101.65 |
| Max. Negotiated Rate |
$906.71 |
| Rate for Payer: Adventist Health Commercial |
$125.10
|
| Rate for Payer: Adventist Health Medi-Cal |
$125.49
|
| Rate for Payer: Aetna of CA HMO/PPO |
$379.88
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$188.24
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$138.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$125.49
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$906.71
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$184.02
|
| Rate for Payer: Blue Shield of California Commercial |
$379.69
|
| Rate for Payer: Blue Shield of California EPN |
$248.33
|
| Rate for Payer: Cash Price |
$281.48
|
| Rate for Payer: Cash Price |
$281.48
|
| Rate for Payer: Central Health Plan Commercial |
$500.42
|
| Rate for Payer: Cigna of CA HMO |
$400.33
|
| Rate for Payer: Cigna of CA PPO |
$462.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$188.24
|
| Rate for Payer: Dignity Health Medi-Cal |
$138.04
|
| Rate for Payer: Dignity Health Medicare Advantage |
$125.49
|
| Rate for Payer: EPIC Health Plan Commercial |
$169.41
|
| Rate for Payer: EPIC Health Plan Senior |
$125.49
|
| Rate for Payer: Galaxy Health WC |
$531.69
|
| Rate for Payer: Global Benefits Group Commercial |
$375.31
|
| Rate for Payer: Health Management Network EPO/PPO |
$562.97
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$205.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$185.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$125.49
|
| Rate for Payer: InnovAge PACE Commercial |
$188.24
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$417.22
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$204.84
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$125.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$125.10
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$168.16
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$168.16
|
| Rate for Payer: Multiplan Commercial |
$469.14
|
| Rate for Payer: Networks By Design Commercial |
$406.59
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$125.49
|
| Rate for Payer: Prime Health Services Commercial |
$531.69
|
| Rate for Payer: Prime Health Services Medicare |
$133.02
|
| Rate for Payer: Riverside University Health System MISP |
$138.04
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$375.31
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$375.31
|
| Rate for Payer: United Healthcare All Other Commercial |
$101.65
|
| Rate for Payer: United Healthcare All Other HMO |
$101.65
|
| Rate for Payer: United Healthcare HMO Rider |
$101.65
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$101.65
|
| Rate for Payer: Upland Medical Group Pediatric |
$125.49
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$188.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$138.04
|
| Rate for Payer: Vantage Medical Group Senior |
$125.49
|
|
