|
HC AMPUTATION FINGER/THUMB W/V-Y
|
Facility
|
IP
|
$12,530.00
|
|
|
Service Code
|
CPT 26952
|
| Hospital Charge Code |
900501462
|
|
Hospital Revenue Code
|
490
|
| Min. Negotiated Rate |
$2,506.00 |
| Max. Negotiated Rate |
$11,277.00 |
| Rate for Payer: Cash Price |
$5,638.50
|
| Rate for Payer: Central Health Plan Commercial |
$10,024.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,012.00
|
| Rate for Payer: Galaxy Health WC |
$10,650.50
|
| Rate for Payer: Global Benefits Group Commercial |
$7,518.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,277.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,357.51
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,773.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,506.00
|
| Rate for Payer: Multiplan Commercial |
$9,397.50
|
| Rate for Payer: Networks By Design Commercial |
$8,144.50
|
| Rate for Payer: Prime Health Services Commercial |
$10,650.50
|
|
|
HC AMPUTATION OF TOE
|
Facility
|
IP
|
$10,007.00
|
|
|
Service Code
|
CPT 28820
|
| Hospital Charge Code |
900501402
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,001.40 |
| Max. Negotiated Rate |
$9,006.30 |
| Rate for Payer: Cash Price |
$4,503.15
|
| Rate for Payer: Central Health Plan Commercial |
$8,005.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,002.80
|
| Rate for Payer: Galaxy Health WC |
$8,505.95
|
| Rate for Payer: Global Benefits Group Commercial |
$6,004.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,006.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,674.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,812.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,001.40
|
| Rate for Payer: Multiplan Commercial |
$7,505.25
|
| Rate for Payer: Networks By Design Commercial |
$6,504.55
|
| Rate for Payer: Prime Health Services Commercial |
$8,505.95
|
|
|
HC AMPUTATION OF TOE
|
Facility
|
OP
|
$10,007.00
|
|
|
Service Code
|
CPT 28820
|
| Hospital Charge Code |
900501402
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$9,006.30 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,066.32
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,448.63
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,044.21
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
| Rate for Payer: Blue Distinction Transplant |
$6,004.20
|
| Rate for Payer: Caremore Medicare Advantage |
$4,044.21
|
| Rate for Payer: Cash Price |
$4,503.15
|
| Rate for Payer: Cash Price |
$4,503.15
|
| Rate for Payer: Cash Price |
$4,503.15
|
| Rate for Payer: Cash Price |
$4,503.15
|
| Rate for Payer: Central Health Plan Commercial |
$8,005.60
|
| Rate for Payer: Cigna of CA PPO |
$7,405.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,066.32
|
| Rate for Payer: Dignity Health Media |
$4,044.21
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,448.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,459.68
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4,044.21
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,044.21
|
| Rate for Payer: Galaxy Health WC |
$8,505.95
|
| Rate for Payer: Global Benefits Group Commercial |
$6,004.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,006.30
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$7,505.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,632.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,044.21
|
| Rate for Payer: InnovAge PACE Commercial |
$6,066.32
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,674.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$433.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,044.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,001.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,419.24
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,419.24
|
| Rate for Payer: Multiplan Commercial |
$7,505.25
|
| Rate for Payer: Networks By Design Commercial |
$6,504.55
|
| Rate for Payer: Prime Health Services Commercial |
$8,505.95
|
| Rate for Payer: Prime Health Services Medicare |
$4,286.86
|
| Rate for Payer: Riverside University Health System MISP |
$4,448.63
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,004.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,003.50
|
| Rate for Payer: United Healthcare All Other HMO |
$5,003.50
|
| Rate for Payer: United Healthcare HMO Rider |
$5,003.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,003.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,066.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,448.63
|
| Rate for Payer: Vantage Medical Group Senior |
$4,044.21
|
|
|
HC AMYLASE
|
Facility
|
OP
|
$17.00
|
|
|
Service Code
|
CPT 82150
|
| Hospital Charge Code |
900910236
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.40 |
| Max. Negotiated Rate |
$57.59 |
| Rate for Payer: Adventist Health Medi-Cal |
$6.48
|
| Rate for Payer: Aetna of CA HMO/PPO |
$47.55
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$9.72
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6.48
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$47.21
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$57.59
|
| Rate for Payer: Blue Distinction Transplant |
$10.20
|
| Rate for Payer: Blue Shield of California Commercial |
$10.51
|
| Rate for Payer: Blue Shield of California EPN |
$8.26
|
| Rate for Payer: Caremore Medicare Advantage |
$6.48
|
| 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 |
$9.72
|
| Rate for Payer: Dignity Health Media |
$6.48
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.13
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.75
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$6.48
|
| Rate for Payer: EPIC Health Plan Transplant |
$6.48
|
| 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: Health Plan of Nevada (Sierra) Other |
$12.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$10.63
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$10.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6.48
|
| Rate for Payer: InnovAge PACE Commercial |
$9.72
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10.89
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8.68
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8.68
|
| Rate for Payer: Multiplan Commercial |
$12.75
|
| Rate for Payer: Networks By Design Commercial |
$11.05
|
| Rate for Payer: Prime Health Services Commercial |
$14.45
|
| Rate for Payer: Prime Health Services Medicare |
$6.87
|
| Rate for Payer: Riverside University Health System MISP |
$7.13
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$10.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.25
|
| Rate for Payer: United Healthcare All Other HMO |
$5.25
|
| Rate for Payer: United Healthcare HMO Rider |
$5.25
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$9.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.13
|
| Rate for Payer: Vantage Medical Group Senior |
$6.48
|
|
|
HC AMYLASE
|
Facility
|
IP
|
$233.00
|
|
|
Service Code
|
CPT 82150
|
| Hospital Charge Code |
900910236
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$46.60 |
| Max. Negotiated Rate |
$209.70 |
| Rate for Payer: Cash Price |
$104.85
|
| Rate for Payer: Central Health Plan Commercial |
$186.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$93.20
|
| Rate for Payer: Galaxy Health WC |
$198.05
|
| Rate for Payer: Global Benefits Group Commercial |
$139.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$209.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$155.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$88.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$46.60
|
| Rate for Payer: Multiplan Commercial |
$174.75
|
| Rate for Payer: Networks By Design Commercial |
$151.45
|
| Rate for Payer: Prime Health Services Commercial |
$198.05
|
|
|
HC AMYLASE BODY FLUID
|
Facility
|
OP
|
$17.00
|
|
|
Service Code
|
CPT 82150
|
| Hospital Charge Code |
900910242
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.40 |
| Max. Negotiated Rate |
$57.59 |
| Rate for Payer: Adventist Health Medi-Cal |
$6.48
|
| Rate for Payer: Aetna of CA HMO/PPO |
$47.55
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$9.72
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6.48
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$47.21
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$57.59
|
| Rate for Payer: Blue Distinction Transplant |
$10.20
|
| Rate for Payer: Blue Shield of California Commercial |
$10.51
|
| Rate for Payer: Blue Shield of California EPN |
$8.26
|
| Rate for Payer: Caremore Medicare Advantage |
$6.48
|
| 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 |
$9.72
|
| Rate for Payer: Dignity Health Media |
$6.48
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.13
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.75
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$6.48
|
| Rate for Payer: EPIC Health Plan Transplant |
$6.48
|
| 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: Health Plan of Nevada (Sierra) Other |
$12.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$10.63
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$10.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6.48
|
| Rate for Payer: InnovAge PACE Commercial |
$9.72
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10.89
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8.68
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8.68
|
| Rate for Payer: Multiplan Commercial |
$12.75
|
| Rate for Payer: Networks By Design Commercial |
$11.05
|
| Rate for Payer: Prime Health Services Commercial |
$14.45
|
| Rate for Payer: Prime Health Services Medicare |
$6.87
|
| Rate for Payer: Riverside University Health System MISP |
$7.13
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$10.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.25
|
| Rate for Payer: United Healthcare All Other HMO |
$5.25
|
| Rate for Payer: United Healthcare HMO Rider |
$5.25
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$9.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.13
|
| Rate for Payer: Vantage Medical Group Senior |
$6.48
|
|
|
HC AMYLASE BODY FLUID
|
Facility
|
IP
|
$25.00
|
|
|
Service Code
|
CPT 82150
|
| Hospital Charge Code |
900910242
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.00 |
| Max. Negotiated Rate |
$22.50 |
| Rate for Payer: Cash Price |
$11.25
|
| Rate for Payer: Central Health Plan Commercial |
$20.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.00
|
| Rate for Payer: Galaxy Health WC |
$21.25
|
| Rate for Payer: Global Benefits Group Commercial |
$15.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$22.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.00
|
| Rate for Payer: Multiplan Commercial |
$18.75
|
| Rate for Payer: Networks By Design Commercial |
$16.25
|
| Rate for Payer: Prime Health Services Commercial |
$21.25
|
|
|
HC AMYLASE URINE
|
Facility
|
OP
|
$25.00
|
|
|
Service Code
|
CPT 82150
|
| Hospital Charge Code |
900910237
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.00 |
| Max. Negotiated Rate |
$57.59 |
| Rate for Payer: Adventist Health Medi-Cal |
$6.48
|
| Rate for Payer: Aetna of CA HMO/PPO |
$47.55
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$9.72
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6.48
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$47.21
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$57.59
|
| Rate for Payer: Blue Distinction Transplant |
$15.00
|
| Rate for Payer: Blue Shield of California Commercial |
$15.45
|
| Rate for Payer: Blue Shield of California EPN |
$12.15
|
| Rate for Payer: Caremore Medicare Advantage |
$6.48
|
| Rate for Payer: Cash Price |
$11.25
|
| Rate for Payer: Cash Price |
$11.25
|
| Rate for Payer: Central Health Plan Commercial |
$20.00
|
| Rate for Payer: Cigna of CA HMO |
$16.00
|
| Rate for Payer: Cigna of CA PPO |
$18.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9.72
|
| Rate for Payer: Dignity Health Media |
$6.48
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.13
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.75
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$6.48
|
| Rate for Payer: EPIC Health Plan Transplant |
$6.48
|
| Rate for Payer: Galaxy Health WC |
$21.25
|
| Rate for Payer: Global Benefits Group Commercial |
$15.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$22.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$18.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$10.63
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$10.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6.48
|
| Rate for Payer: InnovAge PACE Commercial |
$9.72
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10.89
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8.68
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8.68
|
| Rate for Payer: Multiplan Commercial |
$18.75
|
| Rate for Payer: Networks By Design Commercial |
$16.25
|
| Rate for Payer: Prime Health Services Commercial |
$21.25
|
| Rate for Payer: Prime Health Services Medicare |
$6.87
|
| Rate for Payer: Riverside University Health System MISP |
$7.13
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$15.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.25
|
| Rate for Payer: United Healthcare All Other HMO |
$5.25
|
| Rate for Payer: United Healthcare HMO Rider |
$5.25
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$9.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.13
|
| Rate for Payer: Vantage Medical Group Senior |
$6.48
|
|
|
HC AMYLASE URINE
|
Facility
|
IP
|
$233.00
|
|
|
Service Code
|
CPT 82150
|
| Hospital Charge Code |
900910237
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$46.60 |
| Max. Negotiated Rate |
$209.70 |
| Rate for Payer: Cash Price |
$104.85
|
| Rate for Payer: Central Health Plan Commercial |
$186.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$93.20
|
| Rate for Payer: Galaxy Health WC |
$198.05
|
| Rate for Payer: Global Benefits Group Commercial |
$139.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$209.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$155.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$88.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$46.60
|
| Rate for Payer: Multiplan Commercial |
$174.75
|
| Rate for Payer: Networks By Design Commercial |
$151.45
|
| Rate for Payer: Prime Health Services Commercial |
$198.05
|
|
|
HC AMYLASE URINE 24 HOURS
|
Facility
|
OP
|
$25.00
|
|
|
Service Code
|
CPT 82150
|
| Hospital Charge Code |
900912194
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.00 |
| Max. Negotiated Rate |
$57.59 |
| Rate for Payer: Adventist Health Medi-Cal |
$6.48
|
| Rate for Payer: Aetna of CA HMO/PPO |
$47.55
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$9.72
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6.48
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$47.21
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$57.59
|
| Rate for Payer: Blue Distinction Transplant |
$15.00
|
| Rate for Payer: Blue Shield of California Commercial |
$15.45
|
| Rate for Payer: Blue Shield of California EPN |
$12.15
|
| Rate for Payer: Caremore Medicare Advantage |
$6.48
|
| Rate for Payer: Cash Price |
$11.25
|
| Rate for Payer: Cash Price |
$11.25
|
| Rate for Payer: Central Health Plan Commercial |
$20.00
|
| Rate for Payer: Cigna of CA HMO |
$16.00
|
| Rate for Payer: Cigna of CA PPO |
$18.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9.72
|
| Rate for Payer: Dignity Health Media |
$6.48
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.13
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.75
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$6.48
|
| Rate for Payer: EPIC Health Plan Transplant |
$6.48
|
| Rate for Payer: Galaxy Health WC |
$21.25
|
| Rate for Payer: Global Benefits Group Commercial |
$15.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$22.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$18.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$10.63
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$10.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6.48
|
| Rate for Payer: InnovAge PACE Commercial |
$9.72
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10.89
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8.68
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8.68
|
| Rate for Payer: Multiplan Commercial |
$18.75
|
| Rate for Payer: Networks By Design Commercial |
$16.25
|
| Rate for Payer: Prime Health Services Commercial |
$21.25
|
| Rate for Payer: Prime Health Services Medicare |
$6.87
|
| Rate for Payer: Riverside University Health System MISP |
$7.13
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$15.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.25
|
| Rate for Payer: United Healthcare All Other HMO |
$5.25
|
| Rate for Payer: United Healthcare HMO Rider |
$5.25
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$9.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.13
|
| Rate for Payer: Vantage Medical Group Senior |
$6.48
|
|
|
HC AMYLASE URINE 24 HOURS
|
Facility
|
IP
|
$233.00
|
|
|
Service Code
|
CPT 82150
|
| Hospital Charge Code |
900912194
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$46.60 |
| Max. Negotiated Rate |
$209.70 |
| Rate for Payer: Cash Price |
$104.85
|
| Rate for Payer: Central Health Plan Commercial |
$186.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$93.20
|
| Rate for Payer: Galaxy Health WC |
$198.05
|
| Rate for Payer: Global Benefits Group Commercial |
$139.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$209.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$155.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$88.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$46.60
|
| Rate for Payer: Multiplan Commercial |
$174.75
|
| Rate for Payer: Networks By Design Commercial |
$151.45
|
| Rate for Payer: Prime Health Services Commercial |
$198.05
|
|
|
HC AMYLASE URINE RANDOM
|
Facility
|
IP
|
$233.00
|
|
|
Service Code
|
CPT 82150
|
| Hospital Charge Code |
900912193
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$46.60 |
| Max. Negotiated Rate |
$209.70 |
| Rate for Payer: Cash Price |
$104.85
|
| Rate for Payer: Central Health Plan Commercial |
$186.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$93.20
|
| Rate for Payer: Galaxy Health WC |
$198.05
|
| Rate for Payer: Global Benefits Group Commercial |
$139.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$209.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$155.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$88.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$46.60
|
| Rate for Payer: Multiplan Commercial |
$174.75
|
| Rate for Payer: Networks By Design Commercial |
$151.45
|
| Rate for Payer: Prime Health Services Commercial |
$198.05
|
|
|
HC AMYLASE URINE RANDOM
|
Facility
|
OP
|
$25.00
|
|
|
Service Code
|
CPT 82150
|
| Hospital Charge Code |
900912193
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.00 |
| Max. Negotiated Rate |
$57.59 |
| Rate for Payer: Adventist Health Medi-Cal |
$6.48
|
| Rate for Payer: Aetna of CA HMO/PPO |
$47.55
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$9.72
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6.48
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$47.21
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$57.59
|
| Rate for Payer: Blue Distinction Transplant |
$15.00
|
| Rate for Payer: Blue Shield of California Commercial |
$15.45
|
| Rate for Payer: Blue Shield of California EPN |
$12.15
|
| Rate for Payer: Caremore Medicare Advantage |
$6.48
|
| Rate for Payer: Cash Price |
$11.25
|
| Rate for Payer: Cash Price |
$11.25
|
| Rate for Payer: Central Health Plan Commercial |
$20.00
|
| Rate for Payer: Cigna of CA HMO |
$16.00
|
| Rate for Payer: Cigna of CA PPO |
$18.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9.72
|
| Rate for Payer: Dignity Health Media |
$6.48
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.13
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.75
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$6.48
|
| Rate for Payer: EPIC Health Plan Transplant |
$6.48
|
| Rate for Payer: Galaxy Health WC |
$21.25
|
| Rate for Payer: Global Benefits Group Commercial |
$15.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$22.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$18.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$10.63
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$10.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6.48
|
| Rate for Payer: InnovAge PACE Commercial |
$9.72
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10.89
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8.68
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8.68
|
| Rate for Payer: Multiplan Commercial |
$18.75
|
| Rate for Payer: Networks By Design Commercial |
$16.25
|
| Rate for Payer: Prime Health Services Commercial |
$21.25
|
| Rate for Payer: Prime Health Services Medicare |
$6.87
|
| Rate for Payer: Riverside University Health System MISP |
$7.13
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$15.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.25
|
| Rate for Payer: United Healthcare All Other HMO |
$5.25
|
| Rate for Payer: United Healthcare HMO Rider |
$5.25
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$9.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.13
|
| Rate for Payer: Vantage Medical Group Senior |
$6.48
|
|
|
HC ANAEROBIC MIC PANEL
|
Facility
|
OP
|
$34.00
|
|
|
Service Code
|
CPT 87186
|
| Hospital Charge Code |
900912405
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.80 |
| Max. Negotiated Rate |
$225.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$8.65
|
| Rate for Payer: Aetna of CA HMO/PPO |
$63.44
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.98
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9.52
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.65
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$62.89
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$76.71
|
| Rate for Payer: Blue Distinction Transplant |
$20.40
|
| Rate for Payer: Blue Shield of California Commercial |
$21.01
|
| Rate for Payer: Blue Shield of California EPN |
$16.52
|
| Rate for Payer: Caremore Medicare Advantage |
$8.65
|
| Rate for Payer: Cash Price |
$15.30
|
| 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 |
$12.98
|
| Rate for Payer: Dignity Health Media |
$8.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.68
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$8.65
|
| Rate for Payer: EPIC Health Plan Transplant |
$8.65
|
| 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: Health Plan of Nevada (Sierra) Other |
$25.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$14.19
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$14.27
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.65
|
| Rate for Payer: InnovAge PACE Commercial |
$12.98
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$22.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14.27
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11.59
|
| Rate for Payer: Multiplan Commercial |
$25.50
|
| Rate for Payer: Networks By Design Commercial |
$22.10
|
| Rate for Payer: Prime Health Services Commercial |
$28.90
|
| Rate for Payer: Prime Health Services Medicare |
$9.17
|
| Rate for Payer: Riverside University Health System MISP |
$9.52
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$20.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$225.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.01
|
| Rate for Payer: United Healthcare All Other HMO |
$7.01
|
| Rate for Payer: United Healthcare HMO Rider |
$7.01
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.01
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.98
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.52
|
| Rate for Payer: Vantage Medical Group Senior |
$8.65
|
|
|
HC ANAEROBIC MIC PANEL
|
Facility
|
IP
|
$320.00
|
|
|
Service Code
|
CPT 87186
|
| Hospital Charge Code |
900912405
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$64.00 |
| Max. Negotiated Rate |
$288.00 |
| Rate for Payer: Cash Price |
$144.00
|
| Rate for Payer: Central Health Plan Commercial |
$256.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$128.00
|
| Rate for Payer: Galaxy Health WC |
$272.00
|
| Rate for Payer: Global Benefits Group Commercial |
$192.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$288.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$213.44
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$121.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$64.00
|
| Rate for Payer: Multiplan Commercial |
$240.00
|
| Rate for Payer: Networks By Design Commercial |
$208.00
|
| Rate for Payer: Prime Health Services Commercial |
$272.00
|
|
|
HC ANALYSIS PROG PUMP
|
Facility
|
IP
|
$1,552.00
|
|
|
Service Code
|
CPT 62367
|
| Hospital Charge Code |
911801005
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$310.40 |
| Max. Negotiated Rate |
$1,396.80 |
| Rate for Payer: Cash Price |
$698.40
|
| Rate for Payer: Central Health Plan Commercial |
$1,241.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$620.80
|
| Rate for Payer: Galaxy Health WC |
$1,319.20
|
| Rate for Payer: Global Benefits Group Commercial |
$931.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,396.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,035.18
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$591.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$310.40
|
| Rate for Payer: Multiplan Commercial |
$1,164.00
|
| Rate for Payer: Networks By Design Commercial |
$1,008.80
|
| Rate for Payer: Prime Health Services Commercial |
$1,319.20
|
|
|
HC ANALYSIS PROG PUMP
|
Facility
|
OP
|
$1,552.00
|
|
|
Service Code
|
CPT 62367
|
| Hospital Charge Code |
911801005
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$41.74 |
| Max. Negotiated Rate |
$6,248.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$373.19
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$559.78
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$410.51
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$373.19
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
| Rate for Payer: Blue Distinction Transplant |
$931.20
|
| Rate for Payer: Blue Shield of California Commercial |
$959.14
|
| Rate for Payer: Blue Shield of California EPN |
$754.27
|
| Rate for Payer: Caremore Medicare Advantage |
$373.19
|
| Rate for Payer: Cash Price |
$698.40
|
| Rate for Payer: Cash Price |
$698.40
|
| Rate for Payer: Cash Price |
$698.40
|
| Rate for Payer: Central Health Plan Commercial |
$1,241.60
|
| Rate for Payer: Cigna of CA HMO |
$993.28
|
| Rate for Payer: Cigna of CA PPO |
$1,148.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$559.78
|
| Rate for Payer: Dignity Health Media |
$373.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$410.51
|
| Rate for Payer: EPIC Health Plan Commercial |
$503.81
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$373.19
|
| Rate for Payer: EPIC Health Plan Transplant |
$373.19
|
| Rate for Payer: Galaxy Health WC |
$1,319.20
|
| Rate for Payer: Global Benefits Group Commercial |
$931.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,396.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,164.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$612.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$615.76
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$373.19
|
| Rate for Payer: InnovAge PACE Commercial |
$559.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,035.18
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$41.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$373.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$310.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$500.07
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$500.07
|
| Rate for Payer: Multiplan Commercial |
$1,164.00
|
| Rate for Payer: Networks By Design Commercial |
$1,008.80
|
| Rate for Payer: Prime Health Services Commercial |
$1,319.20
|
| Rate for Payer: Prime Health Services Medicare |
$395.58
|
| Rate for Payer: Riverside University Health System MISP |
$410.51
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$931.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$931.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$969.00
|
| Rate for Payer: United Healthcare All Other HMO |
$765.00
|
| Rate for Payer: United Healthcare HMO Rider |
$579.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$530.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$559.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$410.51
|
| Rate for Payer: Vantage Medical Group Senior |
$373.19
|
|
|
HC ANALYSIS PUMP W/REPROGRAM
|
Facility
|
OP
|
$1,382.00
|
|
|
Service Code
|
CPT 62368
|
| Hospital Charge Code |
911801006
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$65.08 |
| Max. Negotiated Rate |
$6,248.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$373.19
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$559.78
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$410.51
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$373.19
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
| Rate for Payer: Blue Distinction Transplant |
$829.20
|
| Rate for Payer: Blue Shield of California Commercial |
$854.08
|
| Rate for Payer: Blue Shield of California EPN |
$671.65
|
| Rate for Payer: Caremore Medicare Advantage |
$373.19
|
| Rate for Payer: Cash Price |
$621.90
|
| Rate for Payer: Cash Price |
$621.90
|
| Rate for Payer: Cash Price |
$621.90
|
| Rate for Payer: Central Health Plan Commercial |
$1,105.60
|
| Rate for Payer: Cigna of CA HMO |
$884.48
|
| Rate for Payer: Cigna of CA PPO |
$1,022.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$559.78
|
| Rate for Payer: Dignity Health Media |
$373.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$410.51
|
| Rate for Payer: EPIC Health Plan Commercial |
$503.81
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$373.19
|
| Rate for Payer: EPIC Health Plan Transplant |
$373.19
|
| Rate for Payer: Galaxy Health WC |
$1,174.70
|
| Rate for Payer: Global Benefits Group Commercial |
$829.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,243.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,036.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$612.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$615.76
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$373.19
|
| Rate for Payer: InnovAge PACE Commercial |
$559.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$921.79
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$65.08
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$373.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$276.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$500.07
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$500.07
|
| Rate for Payer: Multiplan Commercial |
$1,036.50
|
| Rate for Payer: Networks By Design Commercial |
$898.30
|
| Rate for Payer: Prime Health Services Commercial |
$1,174.70
|
| Rate for Payer: Prime Health Services Medicare |
$395.58
|
| Rate for Payer: Riverside University Health System MISP |
$410.51
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$829.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$829.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$969.00
|
| Rate for Payer: United Healthcare All Other HMO |
$765.00
|
| Rate for Payer: United Healthcare HMO Rider |
$579.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$530.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$559.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$410.51
|
| Rate for Payer: Vantage Medical Group Senior |
$373.19
|
|
|
HC ANALYSIS PUMP W/REPROGRAM
|
Facility
|
IP
|
$1,382.00
|
|
|
Service Code
|
CPT 62368
|
| Hospital Charge Code |
911801006
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$276.40 |
| Max. Negotiated Rate |
$1,243.80 |
| Rate for Payer: Cash Price |
$621.90
|
| Rate for Payer: Central Health Plan Commercial |
$1,105.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$552.80
|
| Rate for Payer: Galaxy Health WC |
$1,174.70
|
| Rate for Payer: Global Benefits Group Commercial |
$829.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,243.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$921.79
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$526.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$276.40
|
| Rate for Payer: Multiplan Commercial |
$1,036.50
|
| Rate for Payer: Networks By Design Commercial |
$898.30
|
| Rate for Payer: Prime Health Services Commercial |
$1,174.70
|
|
|
HC ANA PANEL
|
Facility
|
OP
|
$185.00
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
900913646
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$14.53 |
| Max. Negotiated Rate |
$166.50 |
| Rate for Payer: Adventist Health Medi-Cal |
$17.93
|
| Rate for Payer: Aetna of CA HMO/PPO |
$120.14
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$26.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$17.93
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$110.79
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$135.13
|
| Rate for Payer: Blue Distinction Transplant |
$111.00
|
| Rate for Payer: Blue Shield of California Commercial |
$114.33
|
| Rate for Payer: Blue Shield of California EPN |
$89.91
|
| Rate for Payer: Caremore Medicare Advantage |
$17.93
|
| Rate for Payer: Cash Price |
$83.25
|
| Rate for Payer: Cash Price |
$83.25
|
| Rate for Payer: Central Health Plan Commercial |
$148.00
|
| Rate for Payer: Cigna of CA HMO |
$118.40
|
| Rate for Payer: Cigna of CA PPO |
$136.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$26.90
|
| Rate for Payer: Dignity Health Media |
$17.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$19.72
|
| Rate for Payer: EPIC Health Plan Commercial |
$24.21
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$17.93
|
| Rate for Payer: EPIC Health Plan Transplant |
$17.93
|
| Rate for Payer: Galaxy Health WC |
$157.25
|
| Rate for Payer: Global Benefits Group Commercial |
$111.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$166.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$138.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$29.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$29.58
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$17.93
|
| Rate for Payer: InnovAge PACE Commercial |
$26.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$123.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$27.72
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$17.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$37.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$24.03
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$24.03
|
| Rate for Payer: Multiplan Commercial |
$138.75
|
| Rate for Payer: Networks By Design Commercial |
$120.25
|
| Rate for Payer: Prime Health Services Commercial |
$157.25
|
| Rate for Payer: Prime Health Services Medicare |
$19.01
|
| Rate for Payer: Riverside University Health System MISP |
$19.72
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$111.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$111.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.53
|
| Rate for Payer: United Healthcare All Other HMO |
$14.53
|
| Rate for Payer: United Healthcare HMO Rider |
$14.53
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.53
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$26.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Vantage Medical Group Senior |
$17.93
|
|
|
HC ANA PANEL
|
Facility
|
IP
|
$264.00
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
900913646
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$52.80 |
| Max. Negotiated Rate |
$237.60 |
| Rate for Payer: Cash Price |
$118.80
|
| Rate for Payer: Central Health Plan Commercial |
$211.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$105.60
|
| Rate for Payer: Galaxy Health WC |
$224.40
|
| Rate for Payer: Global Benefits Group Commercial |
$158.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$237.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$176.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$100.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$52.80
|
| Rate for Payer: Multiplan Commercial |
$198.00
|
| Rate for Payer: Networks By Design Commercial |
$171.60
|
| Rate for Payer: Prime Health Services Commercial |
$224.40
|
|
|
HC ANCR CATH UMBILICAL UMB-E
|
Facility
|
OP
|
$18.45
|
|
| Hospital Charge Code |
901603825
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$3.69 |
| Max. Negotiated Rate |
$16.60 |
| Rate for Payer: Aetna of CA HMO/PPO |
$11.20
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10.15
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$8.93
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10.90
|
| Rate for Payer: Blue Distinction Transplant |
$11.07
|
| Rate for Payer: Blue Shield of California Commercial |
$11.61
|
| Rate for Payer: Blue Shield of California EPN |
$9.02
|
| Rate for Payer: Cash Price |
$8.30
|
| Rate for Payer: Central Health Plan Commercial |
$14.76
|
| Rate for Payer: Cigna of CA HMO |
$11.81
|
| Rate for Payer: Cigna of CA PPO |
$13.65
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15.68
|
| Rate for Payer: Dignity Health Media |
$15.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$15.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.38
|
| Rate for Payer: EPIC Health Plan Transplant |
$7.38
|
| Rate for Payer: Galaxy Health WC |
$15.68
|
| Rate for Payer: Global Benefits Group Commercial |
$11.07
|
| Rate for Payer: Health Management Network EPO/PPO |
$16.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$13.84
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$6.46
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12.31
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.69
|
| Rate for Payer: Multiplan Commercial |
$13.84
|
| Rate for Payer: Networks By Design Commercial |
$11.99
|
| Rate for Payer: Prime Health Services Commercial |
$15.68
|
| Rate for Payer: Riverside University Health System MISP |
$7.38
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$11.07
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$11.07
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.22
|
| Rate for Payer: United Healthcare All Other HMO |
$9.22
|
| Rate for Payer: United Healthcare HMO Rider |
$9.22
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15.68
|
| Rate for Payer: Vantage Medical Group Senior |
$15.68
|
|
|
HC ANCR CATH UMBILICAL UMB-E
|
Facility
|
IP
|
$18.45
|
|
| Hospital Charge Code |
901603825
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$3.69 |
| Max. Negotiated Rate |
$16.60 |
| Rate for Payer: Cash Price |
$8.30
|
| Rate for Payer: Central Health Plan Commercial |
$14.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.38
|
| Rate for Payer: Galaxy Health WC |
$15.68
|
| Rate for Payer: Global Benefits Group Commercial |
$11.07
|
| Rate for Payer: Health Management Network EPO/PPO |
$16.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12.31
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.69
|
| Rate for Payer: Multiplan Commercial |
$13.84
|
| Rate for Payer: Networks By Design Commercial |
$11.99
|
| Rate for Payer: Prime Health Services Commercial |
$15.68
|
|
|
HC ANESTHESIA LEVEL I 1ST 15MIN
|
Facility
|
IP
|
$822.00
|
|
| Hospital Charge Code |
904900400
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$164.40 |
| Max. Negotiated Rate |
$739.80 |
| Rate for Payer: Cash Price |
$369.90
|
| Rate for Payer: Central Health Plan Commercial |
$657.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$328.80
|
| Rate for Payer: Galaxy Health WC |
$698.70
|
| Rate for Payer: Global Benefits Group Commercial |
$493.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$739.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$548.27
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$313.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$164.40
|
| Rate for Payer: Multiplan Commercial |
$616.50
|
| Rate for Payer: Networks By Design Commercial |
$534.30
|
| Rate for Payer: Prime Health Services Commercial |
$698.70
|
|
|
HC ANESTHESIA LEVEL I 1ST 15MIN
|
Facility
|
OP
|
$822.00
|
|
| Hospital Charge Code |
904900400
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$164.40 |
| Max. Negotiated Rate |
$739.80 |
| Rate for Payer: Aetna of CA HMO/PPO |
$499.20
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$698.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$452.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$452.10
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$398.01
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$485.64
|
| Rate for Payer: Blue Distinction Transplant |
$493.20
|
| Rate for Payer: Blue Shield of California Commercial |
$517.04
|
| Rate for Payer: Blue Shield of California EPN |
$401.96
|
| Rate for Payer: Cash Price |
$369.90
|
| Rate for Payer: Central Health Plan Commercial |
$657.60
|
| Rate for Payer: Cigna of CA HMO |
$526.08
|
| Rate for Payer: Cigna of CA PPO |
$608.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$698.70
|
| Rate for Payer: Dignity Health Media |
$698.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$698.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$328.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$328.80
|
| Rate for Payer: Galaxy Health WC |
$698.70
|
| Rate for Payer: Global Benefits Group Commercial |
$493.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$739.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$616.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$287.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$548.27
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$313.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$164.40
|
| Rate for Payer: Multiplan Commercial |
$616.50
|
| Rate for Payer: Networks By Design Commercial |
$534.30
|
| Rate for Payer: Prime Health Services Commercial |
$698.70
|
| Rate for Payer: Riverside University Health System MISP |
$328.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$493.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$493.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$411.00
|
| Rate for Payer: United Healthcare All Other HMO |
$411.00
|
| Rate for Payer: United Healthcare HMO Rider |
$411.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$411.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$698.70
|
| Rate for Payer: Vantage Medical Group Senior |
$698.70
|
|
