|
HC CREATININE
|
Facility
|
IP
|
$98.00
|
|
|
Service Code
|
CPT 82565
|
| Hospital Charge Code |
900910247
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$19.60 |
| Max. Negotiated Rate |
$88.20 |
| Rate for Payer: Adventist Health Commercial |
$19.60
|
| Rate for Payer: Cash Price |
$44.10
|
| Rate for Payer: Central Health Plan Commercial |
$78.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$68.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$39.20
|
| Rate for Payer: EPIC Health Plan Senior |
$39.20
|
| Rate for Payer: Galaxy Health WC |
$83.30
|
| Rate for Payer: Global Benefits Group Commercial |
$58.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$88.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$62.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$57.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.60
|
| Rate for Payer: Multiplan Commercial |
$73.50
|
| Rate for Payer: Networks By Design Commercial |
$63.70
|
| Rate for Payer: Prime Health Services Commercial |
$83.30
|
|
|
HC CREATININE
|
Facility
|
OP
|
$34.00
|
|
|
Service Code
|
CPT 82565
|
| Hospital Charge Code |
900910247
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.15 |
| Max. Negotiated Rate |
$51.75 |
| Rate for Payer: Adventist Health Commercial |
$6.80
|
| Rate for Payer: Adventist Health Commercial |
$19.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$5.12
|
| Rate for Payer: Adventist Health Medi-Cal |
$5.12
|
| Rate for Payer: Aetna of CA HMO/PPO |
$37.67
|
| Rate for Payer: Aetna of CA HMO/PPO |
$37.67
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.68
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.63
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.63
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.12
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$37.22
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$37.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$51.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$51.75
|
| Rate for Payer: Blue Shield of California Commercial |
$61.74
|
| Rate for Payer: Blue Shield of California Commercial |
$21.42
|
| Rate for Payer: Blue Shield of California EPN |
$38.91
|
| Rate for Payer: Blue Shield of California EPN |
$13.50
|
| Rate for Payer: Cash Price |
$44.10
|
| Rate for Payer: Cash Price |
$44.10
|
| 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: Central Health Plan Commercial |
$78.40
|
| Rate for Payer: Cigna of CA HMO |
$62.72
|
| Rate for Payer: Cigna of CA HMO |
$21.76
|
| Rate for Payer: Cigna of CA PPO |
$72.52
|
| Rate for Payer: Cigna of CA PPO |
$25.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.63
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.63
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.12
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$23.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$68.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.45
|
| Rate for Payer: EPIC Health Plan Senior |
$5.63
|
| Rate for Payer: EPIC Health Plan Senior |
$5.63
|
| Rate for Payer: Galaxy Health WC |
$83.30
|
| Rate for Payer: Galaxy Health WC |
$28.90
|
| Rate for Payer: Global Benefits Group Commercial |
$58.80
|
| Rate for Payer: Global Benefits Group Commercial |
$20.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$88.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$30.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$8.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$8.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$7.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$7.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.12
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$21.59
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$62.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$6.86
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$6.86
|
| Rate for Payer: Multiplan Commercial |
$73.50
|
| Rate for Payer: Multiplan Commercial |
$25.50
|
| Rate for Payer: Networks By Design Commercial |
$22.10
|
| Rate for Payer: Networks By Design Commercial |
$63.70
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$5.12
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$5.12
|
| Rate for Payer: Prime Health Services Commercial |
$83.30
|
| Rate for Payer: Prime Health Services Commercial |
$28.90
|
| Rate for Payer: Prime Health Services Medicare |
$5.43
|
| Rate for Payer: Prime Health Services Medicare |
$5.43
|
| Rate for Payer: Riverside University Health System MISP |
$5.63
|
| Rate for Payer: Riverside University Health System MISP |
$5.63
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$20.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$58.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$58.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$20.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.15
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.15
|
| Rate for Payer: United Healthcare All Other HMO |
$4.15
|
| Rate for Payer: United Healthcare All Other HMO |
$4.15
|
| Rate for Payer: United Healthcare HMO Rider |
$4.15
|
| Rate for Payer: United Healthcare HMO Rider |
$4.15
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.15
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.15
|
| Rate for Payer: Upland Medical Group Pediatric |
$5.12
|
| Rate for Payer: Upland Medical Group Pediatric |
$5.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.68
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.63
|
| Rate for Payer: Vantage Medical Group Senior |
$5.12
|
| Rate for Payer: Vantage Medical Group Senior |
$5.12
|
|
|
HC CREATININE BODY FLUID
|
Facility
|
OP
|
$127.00
|
|
|
Service Code
|
CPT 82570
|
| Hospital Charge Code |
900910377
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.19 |
| Max. Negotiated Rate |
$114.30 |
| Rate for Payer: Adventist Health Commercial |
$25.40
|
| Rate for Payer: Adventist Health Commercial |
$10.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$5.18
|
| Rate for Payer: Adventist Health Medi-Cal |
$5.18
|
| Rate for Payer: Aetna of CA HMO/PPO |
$37.98
|
| Rate for Payer: Aetna of CA HMO/PPO |
$37.98
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.77
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.77
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.18
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$37.61
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$37.61
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$52.29
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$52.29
|
| Rate for Payer: Blue Shield of California Commercial |
$31.50
|
| Rate for Payer: Blue Shield of California Commercial |
$80.01
|
| Rate for Payer: Blue Shield of California EPN |
$19.85
|
| Rate for Payer: Blue Shield of California EPN |
$50.42
|
| Rate for Payer: Cash Price |
$22.50
|
| Rate for Payer: Cash Price |
$22.50
|
| Rate for Payer: Cash Price |
$57.15
|
| Rate for Payer: Cash Price |
$57.15
|
| Rate for Payer: Central Health Plan Commercial |
$101.60
|
| Rate for Payer: Central Health Plan Commercial |
$40.00
|
| Rate for Payer: Cigna of CA HMO |
$32.00
|
| Rate for Payer: Cigna of CA HMO |
$81.28
|
| Rate for Payer: Cigna of CA PPO |
$37.00
|
| Rate for Payer: Cigna of CA PPO |
$93.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.77
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.77
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.18
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.18
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$88.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$35.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.55
|
| Rate for Payer: EPIC Health Plan Senior |
$5.70
|
| Rate for Payer: EPIC Health Plan Senior |
$5.70
|
| Rate for Payer: Galaxy Health WC |
$42.50
|
| Rate for Payer: Galaxy Health WC |
$107.95
|
| Rate for Payer: Global Benefits Group Commercial |
$30.00
|
| Rate for Payer: Global Benefits Group Commercial |
$76.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$45.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$114.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$8.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$8.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$7.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$7.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.18
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$80.64
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$31.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$6.94
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$6.94
|
| Rate for Payer: Multiplan Commercial |
$37.50
|
| Rate for Payer: Multiplan Commercial |
$95.25
|
| Rate for Payer: Networks By Design Commercial |
$82.55
|
| Rate for Payer: Networks By Design Commercial |
$32.50
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$5.18
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$5.18
|
| Rate for Payer: Prime Health Services Commercial |
$42.50
|
| Rate for Payer: Prime Health Services Commercial |
$107.95
|
| Rate for Payer: Prime Health Services Medicare |
$5.49
|
| Rate for Payer: Prime Health Services Medicare |
$5.49
|
| Rate for Payer: Riverside University Health System MISP |
$5.70
|
| Rate for Payer: Riverside University Health System MISP |
$5.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$76.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$30.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$30.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$76.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.19
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.19
|
| Rate for Payer: United Healthcare All Other HMO |
$4.19
|
| Rate for Payer: United Healthcare All Other HMO |
$4.19
|
| Rate for Payer: United Healthcare HMO Rider |
$4.19
|
| Rate for Payer: United Healthcare HMO Rider |
$4.19
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.19
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.19
|
| Rate for Payer: Upland Medical Group Pediatric |
$5.18
|
| Rate for Payer: Upland Medical Group Pediatric |
$5.18
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.77
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.77
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.70
|
| Rate for Payer: Vantage Medical Group Senior |
$5.18
|
| Rate for Payer: Vantage Medical Group Senior |
$5.18
|
|
|
HC CREATININE BODY FLUID
|
Facility
|
IP
|
$127.00
|
|
|
Service Code
|
CPT 82570
|
| Hospital Charge Code |
900910377
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$25.40 |
| Max. Negotiated Rate |
$114.30 |
| Rate for Payer: Adventist Health Commercial |
$25.40
|
| Rate for Payer: Cash Price |
$57.15
|
| Rate for Payer: Central Health Plan Commercial |
$101.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$88.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$50.80
|
| Rate for Payer: EPIC Health Plan Senior |
$50.80
|
| Rate for Payer: Galaxy Health WC |
$107.95
|
| Rate for Payer: Global Benefits Group Commercial |
$76.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$114.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$80.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$74.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.40
|
| Rate for Payer: Multiplan Commercial |
$95.25
|
| Rate for Payer: Networks By Design Commercial |
$82.55
|
| Rate for Payer: Prime Health Services Commercial |
$107.95
|
|
|
HC CREATININE CLEARAN
|
Facility
|
IP
|
$261.00
|
|
|
Service Code
|
CPT 82575
|
| Hospital Charge Code |
900910260
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$52.20 |
| Max. Negotiated Rate |
$234.90 |
| Rate for Payer: Adventist Health Commercial |
$52.20
|
| Rate for Payer: Cash Price |
$117.45
|
| Rate for Payer: Central Health Plan Commercial |
$208.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$182.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$104.40
|
| Rate for Payer: EPIC Health Plan Senior |
$104.40
|
| Rate for Payer: Galaxy Health WC |
$221.85
|
| Rate for Payer: Global Benefits Group Commercial |
$156.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$234.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$165.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$153.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$52.20
|
| Rate for Payer: Multiplan Commercial |
$195.75
|
| Rate for Payer: Networks By Design Commercial |
$169.65
|
| Rate for Payer: Prime Health Services Commercial |
$221.85
|
|
|
HC CREATININE CLEARAN
|
Facility
|
OP
|
$261.00
|
|
|
Service Code
|
CPT 82575
|
| Hospital Charge Code |
900910260
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.66 |
| Max. Negotiated Rate |
$234.90 |
| Rate for Payer: Adventist Health Commercial |
$52.20
|
| Rate for Payer: Adventist Health Commercial |
$18.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$9.46
|
| Rate for Payer: Adventist Health Medi-Cal |
$9.46
|
| Rate for Payer: Aetna of CA HMO/PPO |
$69.39
|
| Rate for Payer: Aetna of CA HMO/PPO |
$69.39
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$14.19
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$14.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10.41
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10.41
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9.46
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9.46
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$68.62
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$68.62
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$95.39
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$95.39
|
| Rate for Payer: Blue Shield of California Commercial |
$57.96
|
| Rate for Payer: Blue Shield of California Commercial |
$164.43
|
| Rate for Payer: Blue Shield of California EPN |
$36.52
|
| Rate for Payer: Blue Shield of California EPN |
$103.62
|
| Rate for Payer: Cash Price |
$41.40
|
| Rate for Payer: Cash Price |
$41.40
|
| Rate for Payer: Cash Price |
$117.45
|
| Rate for Payer: Cash Price |
$117.45
|
| Rate for Payer: Central Health Plan Commercial |
$208.80
|
| Rate for Payer: Central Health Plan Commercial |
$73.60
|
| Rate for Payer: Cigna of CA HMO |
$58.88
|
| Rate for Payer: Cigna of CA HMO |
$167.04
|
| Rate for Payer: Cigna of CA PPO |
$68.08
|
| Rate for Payer: Cigna of CA PPO |
$193.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$14.19
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$14.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$10.41
|
| Rate for Payer: Dignity Health Medi-Cal |
$10.41
|
| Rate for Payer: Dignity Health Medicare Advantage |
$9.46
|
| Rate for Payer: Dignity Health Medicare Advantage |
$9.46
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$182.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$64.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.61
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.61
|
| Rate for Payer: EPIC Health Plan Senior |
$10.41
|
| Rate for Payer: EPIC Health Plan Senior |
$10.41
|
| Rate for Payer: Galaxy Health WC |
$78.20
|
| Rate for Payer: Galaxy Health WC |
$221.85
|
| Rate for Payer: Global Benefits Group Commercial |
$55.20
|
| Rate for Payer: Global Benefits Group Commercial |
$156.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$82.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$234.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$15.51
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$15.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$14.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$14.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$9.46
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$9.46
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$165.74
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$58.42
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$15.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$15.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$13.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$13.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$52.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$12.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$12.68
|
| Rate for Payer: Multiplan Commercial |
$69.00
|
| Rate for Payer: Multiplan Commercial |
$195.75
|
| Rate for Payer: Networks By Design Commercial |
$169.65
|
| Rate for Payer: Networks By Design Commercial |
$59.80
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$9.46
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$9.46
|
| Rate for Payer: Prime Health Services Commercial |
$78.20
|
| Rate for Payer: Prime Health Services Commercial |
$221.85
|
| Rate for Payer: Prime Health Services Medicare |
$10.03
|
| Rate for Payer: Prime Health Services Medicare |
$10.03
|
| Rate for Payer: Riverside University Health System MISP |
$10.41
|
| Rate for Payer: Riverside University Health System MISP |
$10.41
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$156.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$55.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$55.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$156.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.66
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.66
|
| Rate for Payer: United Healthcare All Other HMO |
$7.66
|
| Rate for Payer: United Healthcare All Other HMO |
$7.66
|
| Rate for Payer: United Healthcare HMO Rider |
$7.66
|
| Rate for Payer: United Healthcare HMO Rider |
$7.66
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.66
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.66
|
| Rate for Payer: Upland Medical Group Pediatric |
$9.46
|
| Rate for Payer: Upland Medical Group Pediatric |
$9.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$14.19
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$14.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.41
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.41
|
| Rate for Payer: Vantage Medical Group Senior |
$9.46
|
| Rate for Payer: Vantage Medical Group Senior |
$9.46
|
|
|
HC CREATININE INDIVIDUAL
|
Facility
|
IP
|
$98.00
|
|
|
Service Code
|
CPT 82565
|
| Hospital Charge Code |
900910493
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$19.60 |
| Max. Negotiated Rate |
$88.20 |
| Rate for Payer: Adventist Health Commercial |
$19.60
|
| Rate for Payer: Cash Price |
$44.10
|
| Rate for Payer: Central Health Plan Commercial |
$78.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$68.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$39.20
|
| Rate for Payer: EPIC Health Plan Senior |
$39.20
|
| Rate for Payer: Galaxy Health WC |
$83.30
|
| Rate for Payer: Global Benefits Group Commercial |
$58.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$88.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$62.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$57.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.60
|
| Rate for Payer: Multiplan Commercial |
$73.50
|
| Rate for Payer: Networks By Design Commercial |
$63.70
|
| Rate for Payer: Prime Health Services Commercial |
$83.30
|
|
|
HC CREATININE INDIVIDUAL
|
Facility
|
OP
|
$34.00
|
|
|
Service Code
|
CPT 82565
|
| Hospital Charge Code |
900910493
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.15 |
| Max. Negotiated Rate |
$51.75 |
| Rate for Payer: Adventist Health Commercial |
$6.80
|
| Rate for Payer: Adventist Health Commercial |
$19.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$5.12
|
| Rate for Payer: Adventist Health Medi-Cal |
$5.12
|
| Rate for Payer: Aetna of CA HMO/PPO |
$37.67
|
| Rate for Payer: Aetna of CA HMO/PPO |
$37.67
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.68
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.63
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.63
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.12
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$37.22
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$37.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$51.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$51.75
|
| Rate for Payer: Blue Shield of California Commercial |
$61.74
|
| Rate for Payer: Blue Shield of California Commercial |
$21.42
|
| Rate for Payer: Blue Shield of California EPN |
$38.91
|
| Rate for Payer: Blue Shield of California EPN |
$13.50
|
| Rate for Payer: Cash Price |
$44.10
|
| Rate for Payer: Cash Price |
$44.10
|
| 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: Central Health Plan Commercial |
$78.40
|
| Rate for Payer: Cigna of CA HMO |
$62.72
|
| Rate for Payer: Cigna of CA HMO |
$21.76
|
| Rate for Payer: Cigna of CA PPO |
$72.52
|
| Rate for Payer: Cigna of CA PPO |
$25.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.63
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.63
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.12
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$23.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$68.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.45
|
| Rate for Payer: EPIC Health Plan Senior |
$5.63
|
| Rate for Payer: EPIC Health Plan Senior |
$5.63
|
| Rate for Payer: Galaxy Health WC |
$83.30
|
| Rate for Payer: Galaxy Health WC |
$28.90
|
| Rate for Payer: Global Benefits Group Commercial |
$58.80
|
| Rate for Payer: Global Benefits Group Commercial |
$20.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$88.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$30.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$8.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$8.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$7.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$7.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.12
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$21.59
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$62.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$6.86
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$6.86
|
| Rate for Payer: Multiplan Commercial |
$73.50
|
| Rate for Payer: Multiplan Commercial |
$25.50
|
| Rate for Payer: Networks By Design Commercial |
$22.10
|
| Rate for Payer: Networks By Design Commercial |
$63.70
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$5.12
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$5.12
|
| Rate for Payer: Prime Health Services Commercial |
$83.30
|
| Rate for Payer: Prime Health Services Commercial |
$28.90
|
| Rate for Payer: Prime Health Services Medicare |
$5.43
|
| Rate for Payer: Prime Health Services Medicare |
$5.43
|
| Rate for Payer: Riverside University Health System MISP |
$5.63
|
| Rate for Payer: Riverside University Health System MISP |
$5.63
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$20.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$58.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$58.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$20.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.15
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.15
|
| Rate for Payer: United Healthcare All Other HMO |
$4.15
|
| Rate for Payer: United Healthcare All Other HMO |
$4.15
|
| Rate for Payer: United Healthcare HMO Rider |
$4.15
|
| Rate for Payer: United Healthcare HMO Rider |
$4.15
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.15
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.15
|
| Rate for Payer: Upland Medical Group Pediatric |
$5.12
|
| Rate for Payer: Upland Medical Group Pediatric |
$5.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.68
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.63
|
| Rate for Payer: Vantage Medical Group Senior |
$5.12
|
| Rate for Payer: Vantage Medical Group Senior |
$5.12
|
|
|
HC CREATININE URINE 24 HOURS
|
Facility
|
OP
|
$127.00
|
|
|
Service Code
|
CPT 82570
|
| Hospital Charge Code |
900912203
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.19 |
| Max. Negotiated Rate |
$114.30 |
| Rate for Payer: Adventist Health Commercial |
$25.40
|
| Rate for Payer: Adventist Health Commercial |
$10.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$5.18
|
| Rate for Payer: Adventist Health Medi-Cal |
$5.18
|
| Rate for Payer: Aetna of CA HMO/PPO |
$37.98
|
| Rate for Payer: Aetna of CA HMO/PPO |
$37.98
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.77
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.77
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.18
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$37.61
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$37.61
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$52.29
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$52.29
|
| Rate for Payer: Blue Shield of California Commercial |
$31.50
|
| Rate for Payer: Blue Shield of California Commercial |
$80.01
|
| Rate for Payer: Blue Shield of California EPN |
$19.85
|
| Rate for Payer: Blue Shield of California EPN |
$50.42
|
| Rate for Payer: Cash Price |
$22.50
|
| Rate for Payer: Cash Price |
$22.50
|
| Rate for Payer: Cash Price |
$57.15
|
| Rate for Payer: Cash Price |
$57.15
|
| Rate for Payer: Central Health Plan Commercial |
$101.60
|
| Rate for Payer: Central Health Plan Commercial |
$40.00
|
| Rate for Payer: Cigna of CA HMO |
$32.00
|
| Rate for Payer: Cigna of CA HMO |
$81.28
|
| Rate for Payer: Cigna of CA PPO |
$37.00
|
| Rate for Payer: Cigna of CA PPO |
$93.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.77
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.77
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.18
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.18
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$88.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$35.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.55
|
| Rate for Payer: EPIC Health Plan Senior |
$5.70
|
| Rate for Payer: EPIC Health Plan Senior |
$5.70
|
| Rate for Payer: Galaxy Health WC |
$42.50
|
| Rate for Payer: Galaxy Health WC |
$107.95
|
| Rate for Payer: Global Benefits Group Commercial |
$30.00
|
| Rate for Payer: Global Benefits Group Commercial |
$76.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$45.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$114.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$8.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$8.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$7.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$7.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.18
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$80.64
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$31.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$6.94
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$6.94
|
| Rate for Payer: Multiplan Commercial |
$37.50
|
| Rate for Payer: Multiplan Commercial |
$95.25
|
| Rate for Payer: Networks By Design Commercial |
$82.55
|
| Rate for Payer: Networks By Design Commercial |
$32.50
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$5.18
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$5.18
|
| Rate for Payer: Prime Health Services Commercial |
$42.50
|
| Rate for Payer: Prime Health Services Commercial |
$107.95
|
| Rate for Payer: Prime Health Services Medicare |
$5.49
|
| Rate for Payer: Prime Health Services Medicare |
$5.49
|
| Rate for Payer: Riverside University Health System MISP |
$5.70
|
| Rate for Payer: Riverside University Health System MISP |
$5.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$76.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$30.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$30.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$76.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.19
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.19
|
| Rate for Payer: United Healthcare All Other HMO |
$4.19
|
| Rate for Payer: United Healthcare All Other HMO |
$4.19
|
| Rate for Payer: United Healthcare HMO Rider |
$4.19
|
| Rate for Payer: United Healthcare HMO Rider |
$4.19
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.19
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.19
|
| Rate for Payer: Upland Medical Group Pediatric |
$5.18
|
| Rate for Payer: Upland Medical Group Pediatric |
$5.18
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.77
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.77
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.70
|
| Rate for Payer: Vantage Medical Group Senior |
$5.18
|
| Rate for Payer: Vantage Medical Group Senior |
$5.18
|
|
|
HC CREATININE URINE 24 HOURS
|
Facility
|
IP
|
$127.00
|
|
|
Service Code
|
CPT 82570
|
| Hospital Charge Code |
900912203
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$25.40 |
| Max. Negotiated Rate |
$114.30 |
| Rate for Payer: Adventist Health Commercial |
$25.40
|
| Rate for Payer: Cash Price |
$57.15
|
| Rate for Payer: Central Health Plan Commercial |
$101.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$88.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$50.80
|
| Rate for Payer: EPIC Health Plan Senior |
$50.80
|
| Rate for Payer: Galaxy Health WC |
$107.95
|
| Rate for Payer: Global Benefits Group Commercial |
$76.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$114.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$80.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$74.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.40
|
| Rate for Payer: Multiplan Commercial |
$95.25
|
| Rate for Payer: Networks By Design Commercial |
$82.55
|
| Rate for Payer: Prime Health Services Commercial |
$107.95
|
|
|
HC CREATININE URINE RANDOM
|
Facility
|
IP
|
$127.00
|
|
|
Service Code
|
CPT 82570
|
| Hospital Charge Code |
900912202
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$25.40 |
| Max. Negotiated Rate |
$114.30 |
| Rate for Payer: Adventist Health Commercial |
$25.40
|
| Rate for Payer: Cash Price |
$57.15
|
| Rate for Payer: Central Health Plan Commercial |
$101.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$88.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$50.80
|
| Rate for Payer: EPIC Health Plan Senior |
$50.80
|
| Rate for Payer: Galaxy Health WC |
$107.95
|
| Rate for Payer: Global Benefits Group Commercial |
$76.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$114.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$80.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$74.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.40
|
| Rate for Payer: Multiplan Commercial |
$95.25
|
| Rate for Payer: Networks By Design Commercial |
$82.55
|
| Rate for Payer: Prime Health Services Commercial |
$107.95
|
|
|
HC CREATININE URINE RANDOM
|
Facility
|
OP
|
$127.00
|
|
|
Service Code
|
CPT 82570
|
| Hospital Charge Code |
900912202
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.19 |
| Max. Negotiated Rate |
$114.30 |
| Rate for Payer: Adventist Health Commercial |
$25.40
|
| Rate for Payer: Adventist Health Commercial |
$9.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$5.18
|
| Rate for Payer: Adventist Health Medi-Cal |
$5.18
|
| Rate for Payer: Aetna of CA HMO/PPO |
$37.98
|
| Rate for Payer: Aetna of CA HMO/PPO |
$37.98
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.77
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.77
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.18
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$37.61
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$37.61
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$52.29
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$52.29
|
| Rate for Payer: Blue Shield of California Commercial |
$28.35
|
| Rate for Payer: Blue Shield of California Commercial |
$80.01
|
| Rate for Payer: Blue Shield of California EPN |
$17.86
|
| Rate for Payer: Blue Shield of California EPN |
$50.42
|
| Rate for Payer: Cash Price |
$20.25
|
| Rate for Payer: Cash Price |
$20.25
|
| Rate for Payer: Cash Price |
$57.15
|
| Rate for Payer: Cash Price |
$57.15
|
| Rate for Payer: Central Health Plan Commercial |
$101.60
|
| Rate for Payer: Central Health Plan Commercial |
$36.00
|
| Rate for Payer: Cigna of CA HMO |
$28.80
|
| Rate for Payer: Cigna of CA HMO |
$81.28
|
| Rate for Payer: Cigna of CA PPO |
$33.30
|
| Rate for Payer: Cigna of CA PPO |
$93.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.77
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.77
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.18
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.18
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$88.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$31.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.55
|
| Rate for Payer: EPIC Health Plan Senior |
$5.70
|
| Rate for Payer: EPIC Health Plan Senior |
$5.70
|
| Rate for Payer: Galaxy Health WC |
$38.25
|
| Rate for Payer: Galaxy Health WC |
$107.95
|
| Rate for Payer: Global Benefits Group Commercial |
$27.00
|
| Rate for Payer: Global Benefits Group Commercial |
$76.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$40.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$114.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$8.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$8.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$7.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$7.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.18
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$80.64
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$28.57
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$6.94
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$6.94
|
| Rate for Payer: Multiplan Commercial |
$33.75
|
| Rate for Payer: Multiplan Commercial |
$95.25
|
| Rate for Payer: Networks By Design Commercial |
$82.55
|
| Rate for Payer: Networks By Design Commercial |
$29.25
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$5.18
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$5.18
|
| Rate for Payer: Prime Health Services Commercial |
$38.25
|
| Rate for Payer: Prime Health Services Commercial |
$107.95
|
| Rate for Payer: Prime Health Services Medicare |
$5.49
|
| Rate for Payer: Prime Health Services Medicare |
$5.49
|
| Rate for Payer: Riverside University Health System MISP |
$5.70
|
| Rate for Payer: Riverside University Health System MISP |
$5.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$76.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$27.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$27.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$76.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.19
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.19
|
| Rate for Payer: United Healthcare All Other HMO |
$4.19
|
| Rate for Payer: United Healthcare All Other HMO |
$4.19
|
| Rate for Payer: United Healthcare HMO Rider |
$4.19
|
| Rate for Payer: United Healthcare HMO Rider |
$4.19
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.19
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.19
|
| Rate for Payer: Upland Medical Group Pediatric |
$5.18
|
| Rate for Payer: Upland Medical Group Pediatric |
$5.18
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.77
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.77
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.70
|
| Rate for Payer: Vantage Medical Group Senior |
$5.18
|
| Rate for Payer: Vantage Medical Group Senior |
$5.18
|
|
|
HC CRITICAL CARE ADDL 30 MIN
|
Facility
|
OP
|
$8,331.00
|
|
|
Service Code
|
CPT 99292
|
| Hospital Charge Code |
900501641
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$111.91 |
| Max. Negotiated Rate |
$7,497.90 |
| Rate for Payer: Adventist Health Commercial |
$3,415.71
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$591.67
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,081.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,582.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6,248.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.14
|
| Rate for Payer: Cash Price |
$3,748.95
|
| Rate for Payer: Cash Price |
$3,748.95
|
| Rate for Payer: Cash Price |
$3,748.95
|
| Rate for Payer: Cash Price |
$3,748.95
|
| Rate for Payer: Central Health Plan Commercial |
$6,664.80
|
| Rate for Payer: Cigna of CA HMO |
$5,331.84
|
| Rate for Payer: Cigna of CA PPO |
$6,164.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,081.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,081.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7,081.35
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,831.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,332.40
|
| Rate for Payer: EPIC Health Plan Senior |
$3,332.40
|
| Rate for Payer: Galaxy Health WC |
$7,081.35
|
| Rate for Payer: Global Benefits Group Commercial |
$4,998.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,497.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,290.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$111.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,915.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,666.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5,831.70
|
| Rate for Payer: Multiplan Commercial |
$6,248.25
|
| Rate for Payer: Networks By Design Commercial |
$5,415.15
|
| Rate for Payer: Prime Health Services Commercial |
$7,081.35
|
| Rate for Payer: Riverside University Health System MISP |
$3,332.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,998.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,998.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,081.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,081.35
|
| Rate for Payer: Vantage Medical Group Senior |
$7,081.35
|
|
|
HC CRITICAL CARE ADDL 30 MIN
|
Facility
|
IP
|
$8,331.00
|
|
|
Service Code
|
CPT 99292
|
| Hospital Charge Code |
900501641
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,666.20 |
| Max. Negotiated Rate |
$7,497.90 |
| Rate for Payer: Adventist Health Commercial |
$1,666.20
|
| Rate for Payer: Cash Price |
$3,748.95
|
| Rate for Payer: Central Health Plan Commercial |
$6,664.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,831.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,332.40
|
| Rate for Payer: EPIC Health Plan Senior |
$3,332.40
|
| Rate for Payer: Galaxy Health WC |
$7,081.35
|
| Rate for Payer: Global Benefits Group Commercial |
$4,998.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,497.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,290.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,915.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,666.20
|
| Rate for Payer: Multiplan Commercial |
$6,248.25
|
| Rate for Payer: Networks By Design Commercial |
$5,415.15
|
| Rate for Payer: Prime Health Services Commercial |
$7,081.35
|
|
|
HC CRITICAL CARE ADDL 30 MIN
|
Facility
|
OP
|
$8,331.00
|
|
|
Service Code
|
CPT 99292
|
| Hospital Charge Code |
900501641
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$111.91 |
| Max. Negotiated Rate |
$7,497.90 |
| Rate for Payer: Adventist Health Commercial |
$1,666.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,081.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,582.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6,248.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,685.00
|
| Rate for Payer: Cash Price |
$3,748.95
|
| Rate for Payer: Cash Price |
$3,748.95
|
| Rate for Payer: Cash Price |
$3,748.95
|
| Rate for Payer: Cash Price |
$3,748.95
|
| Rate for Payer: Central Health Plan Commercial |
$6,664.80
|
| Rate for Payer: Cigna of CA HMO |
$5,331.84
|
| Rate for Payer: Cigna of CA PPO |
$6,164.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,081.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,081.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7,081.35
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,831.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,332.40
|
| Rate for Payer: EPIC Health Plan Senior |
$3,332.40
|
| Rate for Payer: Galaxy Health WC |
$7,081.35
|
| Rate for Payer: Global Benefits Group Commercial |
$4,998.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,497.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,290.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$111.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,915.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,666.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5,831.70
|
| Rate for Payer: Multiplan Commercial |
$6,248.25
|
| Rate for Payer: Networks By Design Commercial |
$5,415.15
|
| Rate for Payer: Prime Health Services Commercial |
$7,081.35
|
| Rate for Payer: Riverside University Health System MISP |
$3,332.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,998.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,165.50
|
| Rate for Payer: United Healthcare All Other HMO |
$4,165.50
|
| Rate for Payer: United Healthcare HMO Rider |
$4,165.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,165.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,081.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,081.35
|
| Rate for Payer: Vantage Medical Group Senior |
$7,081.35
|
|
|
HC CRITICAL CARE ADDL 30 MIN
|
Facility
|
IP
|
$8,331.00
|
|
|
Service Code
|
CPT 99292
|
| Hospital Charge Code |
900501641
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$1,666.20 |
| Max. Negotiated Rate |
$7,497.90 |
| Rate for Payer: Adventist Health Commercial |
$1,666.20
|
| Rate for Payer: Cash Price |
$3,748.95
|
| Rate for Payer: Central Health Plan Commercial |
$6,664.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,831.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,332.40
|
| Rate for Payer: EPIC Health Plan Senior |
$3,332.40
|
| Rate for Payer: Galaxy Health WC |
$7,081.35
|
| Rate for Payer: Global Benefits Group Commercial |
$4,998.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,497.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,290.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,915.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,666.20
|
| Rate for Payer: Multiplan Commercial |
$6,248.25
|
| Rate for Payer: Networks By Design Commercial |
$5,415.15
|
| Rate for Payer: Prime Health Services Commercial |
$7,081.35
|
|
|
HC CRITICAL CARE E&M 30-74 MIN
|
Facility
|
OP
|
$16,671.00
|
|
|
Service Code
|
CPT 99291
|
| Hospital Charge Code |
900509291
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$231.04 |
| Max. Negotiated Rate |
$15,003.90 |
| Rate for Payer: Adventist Health Commercial |
$3,334.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,593.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,168.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,062.41
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,685.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$1,705.85
|
| Rate for Payer: Cash Price |
$7,501.95
|
| Rate for Payer: Cash Price |
$7,501.95
|
| Rate for Payer: Cash Price |
$7,501.95
|
| Rate for Payer: Cash Price |
$7,501.95
|
| Rate for Payer: Central Health Plan Commercial |
$13,336.80
|
| Rate for Payer: Cigna of CA HMO |
$10,669.44
|
| Rate for Payer: Cigna of CA PPO |
$12,336.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,593.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,168.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,062.41
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$11,669.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,752.98
|
| Rate for Payer: EPIC Health Plan Senior |
$1,168.65
|
| Rate for Payer: Galaxy Health WC |
$14,170.35
|
| Rate for Payer: Global Benefits Group Commercial |
$10,002.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$15,003.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,742.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,062.41
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$10,586.08
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$231.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,142.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,334.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,423.63
|
| Rate for Payer: Multiplan Commercial |
$12,503.25
|
| Rate for Payer: Multiplan WC |
$1,705.85
|
| Rate for Payer: Networks By Design Commercial |
$10,836.15
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,062.41
|
| Rate for Payer: Preferred Health Network WC |
$1,740.66
|
| Rate for Payer: Prime Health Services Commercial |
$14,170.35
|
| Rate for Payer: Prime Health Services Medicare |
$1,126.15
|
| Rate for Payer: Prime Health Services WC |
$1,688.44
|
| Rate for Payer: Riverside University Health System MISP |
$1,168.65
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10,002.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$8,039.00
|
| Rate for Payer: United Healthcare All Other HMO |
$8,075.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,391.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,770.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,062.41
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,593.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,168.65
|
| Rate for Payer: Vantage Medical Group Senior |
$1,062.41
|
|
|
HC CRITICAL CARE E&M 30-74 MIN
|
Facility
|
IP
|
$16,671.00
|
|
|
Service Code
|
CPT 99291
|
| Hospital Charge Code |
900509291
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$3,334.20 |
| Max. Negotiated Rate |
$15,003.90 |
| Rate for Payer: Adventist Health Commercial |
$3,334.20
|
| Rate for Payer: Cash Price |
$7,501.95
|
| Rate for Payer: Central Health Plan Commercial |
$13,336.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$11,669.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,668.40
|
| Rate for Payer: EPIC Health Plan Senior |
$6,668.40
|
| Rate for Payer: Galaxy Health WC |
$14,170.35
|
| Rate for Payer: Global Benefits Group Commercial |
$10,002.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$15,003.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$10,586.08
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9,835.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,334.20
|
| Rate for Payer: Multiplan Commercial |
$12,503.25
|
| Rate for Payer: Networks By Design Commercial |
$10,836.15
|
| Rate for Payer: Prime Health Services Commercial |
$14,170.35
|
|
|
HC CRITICAL CARE E&M 30-74 MIN
|
Facility
|
OP
|
$16,671.00
|
|
|
Service Code
|
CPT 99291
|
| Hospital Charge Code |
900509291
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$231.04 |
| Max. Negotiated Rate |
$15,003.90 |
| Rate for Payer: Adventist Health Commercial |
$6,835.11
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,178.67
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,593.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,168.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,062.41
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,697.52
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$1,705.85
|
| Rate for Payer: Cash Price |
$7,501.95
|
| Rate for Payer: Cash Price |
$7,501.95
|
| Rate for Payer: Cash Price |
$7,501.95
|
| Rate for Payer: Cash Price |
$7,501.95
|
| Rate for Payer: Central Health Plan Commercial |
$13,336.80
|
| Rate for Payer: Cigna of CA HMO |
$10,669.44
|
| Rate for Payer: Cigna of CA PPO |
$12,336.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,593.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,168.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,062.41
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$11,669.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,752.98
|
| Rate for Payer: EPIC Health Plan Senior |
$1,168.65
|
| Rate for Payer: Galaxy Health WC |
$14,170.35
|
| Rate for Payer: Global Benefits Group Commercial |
$10,002.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$15,003.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,742.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,062.41
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$10,586.08
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$231.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,142.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,334.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,423.63
|
| Rate for Payer: Multiplan Commercial |
$12,503.25
|
| Rate for Payer: Multiplan WC |
$1,705.85
|
| Rate for Payer: Networks By Design Commercial |
$10,836.15
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,062.41
|
| Rate for Payer: Preferred Health Network WC |
$1,740.66
|
| Rate for Payer: Prime Health Services Commercial |
$14,170.35
|
| Rate for Payer: Prime Health Services Medicare |
$1,126.15
|
| Rate for Payer: Prime Health Services WC |
$1,688.44
|
| Rate for Payer: Riverside University Health System MISP |
$1,168.65
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10,002.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$10,002.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,062.41
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,593.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,168.65
|
| Rate for Payer: Vantage Medical Group Senior |
$1,062.41
|
|
|
HC CRITICAL CARE E&M 30-74 MIN
|
Facility
|
IP
|
$16,671.00
|
|
|
Service Code
|
CPT 99291
|
| Hospital Charge Code |
900509291
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$3,334.20 |
| Max. Negotiated Rate |
$15,003.90 |
| Rate for Payer: Adventist Health Commercial |
$3,334.20
|
| Rate for Payer: Cash Price |
$7,501.95
|
| Rate for Payer: Central Health Plan Commercial |
$13,336.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$11,669.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,668.40
|
| Rate for Payer: EPIC Health Plan Senior |
$6,668.40
|
| Rate for Payer: Galaxy Health WC |
$14,170.35
|
| Rate for Payer: Global Benefits Group Commercial |
$10,002.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$15,003.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$10,586.08
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9,835.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,334.20
|
| Rate for Payer: Multiplan Commercial |
$12,503.25
|
| Rate for Payer: Networks By Design Commercial |
$10,836.15
|
| Rate for Payer: Prime Health Services Commercial |
$14,170.35
|
|
|
HC CROSSMATCH COMP
|
Facility
|
OP
|
$269.00
|
|
|
Service Code
|
CPT 86923
|
| Hospital Charge Code |
900904766
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$53.80 |
| Max. Negotiated Rate |
$361.55 |
| Rate for Payer: Adventist Health Commercial |
$53.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$219.12
|
| Rate for Payer: Aetna of CA HMO/PPO |
$118.91
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$328.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$241.03
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$219.12
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$61.71
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$85.79
|
| Rate for Payer: Blue Shield of California Commercial |
$169.47
|
| Rate for Payer: Blue Shield of California EPN |
$106.79
|
| Rate for Payer: Cash Price |
$121.05
|
| Rate for Payer: Cash Price |
$121.05
|
| Rate for Payer: Central Health Plan Commercial |
$215.20
|
| Rate for Payer: Cigna of CA HMO |
$172.16
|
| Rate for Payer: Cigna of CA PPO |
$199.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$328.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$241.03
|
| Rate for Payer: Dignity Health Medicare Advantage |
$219.12
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$188.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$361.55
|
| Rate for Payer: EPIC Health Plan Senior |
$241.03
|
| Rate for Payer: Galaxy Health WC |
$228.65
|
| Rate for Payer: Global Benefits Group Commercial |
$161.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$242.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$359.36
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$219.12
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$170.81
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$306.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$53.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$293.62
|
| Rate for Payer: Multiplan Commercial |
$201.75
|
| Rate for Payer: Networks By Design Commercial |
$174.85
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$219.12
|
| Rate for Payer: Prime Health Services Commercial |
$228.65
|
| Rate for Payer: Prime Health Services Medicare |
$232.27
|
| Rate for Payer: Riverside University Health System MISP |
$241.03
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$161.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$161.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$123.38
|
| Rate for Payer: United Healthcare All Other HMO |
$123.38
|
| Rate for Payer: United Healthcare HMO Rider |
$123.38
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$123.38
|
| Rate for Payer: Upland Medical Group Pediatric |
$219.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$328.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$241.03
|
| Rate for Payer: Vantage Medical Group Senior |
$219.12
|
|
|
HC CROSSMATCH COMP
|
Facility
|
IP
|
$269.00
|
|
|
Service Code
|
CPT 86923
|
| Hospital Charge Code |
900904766
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$53.80 |
| Max. Negotiated Rate |
$242.10 |
| Rate for Payer: Adventist Health Commercial |
$53.80
|
| Rate for Payer: Cash Price |
$121.05
|
| Rate for Payer: Central Health Plan Commercial |
$215.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$188.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$107.60
|
| Rate for Payer: EPIC Health Plan Senior |
$107.60
|
| Rate for Payer: Galaxy Health WC |
$228.65
|
| Rate for Payer: Global Benefits Group Commercial |
$161.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$242.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$170.81
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$158.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$53.80
|
| Rate for Payer: Multiplan Commercial |
$201.75
|
| Rate for Payer: Networks By Design Commercial |
$174.85
|
| Rate for Payer: Prime Health Services Commercial |
$228.65
|
|
|
HC CROSSMATCH IS
|
Facility
|
IP
|
$686.00
|
|
|
Service Code
|
CPT 86920
|
| Hospital Charge Code |
900904577
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$137.20 |
| Max. Negotiated Rate |
$617.40 |
| Rate for Payer: Adventist Health Commercial |
$137.20
|
| Rate for Payer: Cash Price |
$308.70
|
| Rate for Payer: Central Health Plan Commercial |
$548.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$480.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$274.40
|
| Rate for Payer: EPIC Health Plan Senior |
$274.40
|
| Rate for Payer: Galaxy Health WC |
$583.10
|
| Rate for Payer: Global Benefits Group Commercial |
$411.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$617.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$435.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$404.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$137.20
|
| Rate for Payer: Multiplan Commercial |
$514.50
|
| Rate for Payer: Networks By Design Commercial |
$445.90
|
| Rate for Payer: Prime Health Services Commercial |
$583.10
|
|
|
HC CROSSMATCH IS
|
Facility
|
OP
|
$686.00
|
|
|
Service Code
|
CPT 86920
|
| Hospital Charge Code |
900904577
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$123.38 |
| Max. Negotiated Rate |
$617.40 |
| Rate for Payer: Adventist Health Commercial |
$137.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$219.12
|
| Rate for Payer: Aetna of CA HMO/PPO |
$149.16
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$328.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$241.03
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$219.12
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$261.83
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$364.01
|
| Rate for Payer: Blue Shield of California Commercial |
$432.18
|
| Rate for Payer: Blue Shield of California EPN |
$272.34
|
| Rate for Payer: Cash Price |
$308.70
|
| Rate for Payer: Cash Price |
$308.70
|
| Rate for Payer: Central Health Plan Commercial |
$548.80
|
| Rate for Payer: Cigna of CA HMO |
$439.04
|
| Rate for Payer: Cigna of CA PPO |
$507.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$328.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$241.03
|
| Rate for Payer: Dignity Health Medicare Advantage |
$219.12
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$480.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$361.55
|
| Rate for Payer: EPIC Health Plan Senior |
$241.03
|
| Rate for Payer: Galaxy Health WC |
$583.10
|
| Rate for Payer: Global Benefits Group Commercial |
$411.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$617.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$359.36
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$219.12
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$435.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$306.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$137.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$293.62
|
| Rate for Payer: Multiplan Commercial |
$514.50
|
| Rate for Payer: Networks By Design Commercial |
$445.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$219.12
|
| Rate for Payer: Prime Health Services Commercial |
$583.10
|
| Rate for Payer: Prime Health Services Medicare |
$232.27
|
| Rate for Payer: Riverside University Health System MISP |
$241.03
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$411.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$411.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$123.38
|
| Rate for Payer: United Healthcare All Other HMO |
$123.38
|
| Rate for Payer: United Healthcare HMO Rider |
$123.38
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$123.38
|
| Rate for Payer: Upland Medical Group Pediatric |
$219.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$328.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$241.03
|
| Rate for Payer: Vantage Medical Group Senior |
$219.12
|
|
|
HC CROSSMATCH XM
|
Facility
|
OP
|
$761.00
|
|
|
Service Code
|
CPT 86922
|
| Hospital Charge Code |
900904551
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$123.38 |
| Max. Negotiated Rate |
$684.90 |
| Rate for Payer: Adventist Health Commercial |
$152.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$219.12
|
| Rate for Payer: Aetna of CA HMO/PPO |
$159.96
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$328.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$241.03
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$219.12
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$261.83
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$364.01
|
| Rate for Payer: Blue Shield of California Commercial |
$479.43
|
| Rate for Payer: Blue Shield of California EPN |
$302.12
|
| Rate for Payer: Cash Price |
$342.45
|
| Rate for Payer: Cash Price |
$342.45
|
| Rate for Payer: Central Health Plan Commercial |
$608.80
|
| Rate for Payer: Cigna of CA HMO |
$487.04
|
| Rate for Payer: Cigna of CA PPO |
$563.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$328.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$241.03
|
| Rate for Payer: Dignity Health Medicare Advantage |
$219.12
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$532.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$361.55
|
| Rate for Payer: EPIC Health Plan Senior |
$241.03
|
| Rate for Payer: Galaxy Health WC |
$646.85
|
| Rate for Payer: Global Benefits Group Commercial |
$456.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$684.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$359.36
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$219.12
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$483.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$306.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$152.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$293.62
|
| Rate for Payer: Multiplan Commercial |
$570.75
|
| Rate for Payer: Networks By Design Commercial |
$494.65
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$219.12
|
| Rate for Payer: Prime Health Services Commercial |
$646.85
|
| Rate for Payer: Prime Health Services Medicare |
$232.27
|
| Rate for Payer: Riverside University Health System MISP |
$241.03
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$456.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$456.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$123.38
|
| Rate for Payer: United Healthcare All Other HMO |
$123.38
|
| Rate for Payer: United Healthcare HMO Rider |
$123.38
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$123.38
|
| Rate for Payer: Upland Medical Group Pediatric |
$219.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$328.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$241.03
|
| Rate for Payer: Vantage Medical Group Senior |
$219.12
|
|
