|
HC CULTURE BORDATELLA PERTUSS
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
900911521
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$78.00 |
| Max. Negotiated Rate |
$351.00 |
| Rate for Payer: Adventist Health Commercial |
$78.00
|
| Rate for Payer: Cash Price |
$175.50
|
| Rate for Payer: Central Health Plan Commercial |
$312.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$273.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$156.00
|
| Rate for Payer: EPIC Health Plan Senior |
$156.00
|
| Rate for Payer: Galaxy Health WC |
$331.50
|
| Rate for Payer: Global Benefits Group Commercial |
$234.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$351.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$247.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$230.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$78.00
|
| Rate for Payer: Multiplan Commercial |
$292.50
|
| Rate for Payer: Networks By Design Commercial |
$253.50
|
| Rate for Payer: Prime Health Services Commercial |
$331.50
|
|
|
HC CULTURE BRONCHIAL WASH/BRUSH
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
900911504
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.98 |
| Max. Negotiated Rate |
$351.00 |
| Rate for Payer: Adventist Health Commercial |
$78.00
|
| Rate for Payer: Adventist Health Commercial |
$16.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$8.62
|
| Rate for Payer: Adventist Health Medi-Cal |
$8.62
|
| Rate for Payer: Aetna of CA HMO/PPO |
$63.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$63.20
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.93
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9.48
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9.48
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.62
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.62
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$62.59
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$62.59
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$87.02
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$87.02
|
| Rate for Payer: Blue Shield of California Commercial |
$245.70
|
| Rate for Payer: Blue Shield of California Commercial |
$52.92
|
| Rate for Payer: Blue Shield of California EPN |
$33.35
|
| Rate for Payer: Blue Shield of California EPN |
$154.83
|
| Rate for Payer: Cash Price |
$175.50
|
| Rate for Payer: Cash Price |
$37.80
|
| Rate for Payer: Cash Price |
$37.80
|
| Rate for Payer: Cash Price |
$175.50
|
| Rate for Payer: Cash Price |
$175.50
|
| Rate for Payer: Cash Price |
$37.80
|
| Rate for Payer: Central Health Plan Commercial |
$67.20
|
| Rate for Payer: Central Health Plan Commercial |
$312.00
|
| Rate for Payer: Cigna of CA HMO |
$249.60
|
| Rate for Payer: Cigna of CA HMO |
$53.76
|
| Rate for Payer: Cigna of CA PPO |
$288.60
|
| Rate for Payer: Cigna of CA PPO |
$62.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.93
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.48
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.48
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8.62
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8.62
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$58.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$273.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.22
|
| Rate for Payer: EPIC Health Plan Senior |
$9.48
|
| Rate for Payer: EPIC Health Plan Senior |
$9.48
|
| Rate for Payer: Galaxy Health WC |
$71.40
|
| Rate for Payer: Galaxy Health WC |
$331.50
|
| Rate for Payer: Global Benefits Group Commercial |
$50.40
|
| Rate for Payer: Global Benefits Group Commercial |
$234.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$75.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$351.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$14.14
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$14.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$12.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$12.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.62
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$247.65
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$53.34
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$14.27
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$14.27
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$12.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$12.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$78.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$11.55
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$11.55
|
| Rate for Payer: Multiplan Commercial |
$63.00
|
| Rate for Payer: Multiplan Commercial |
$292.50
|
| Rate for Payer: Networks By Design Commercial |
$253.50
|
| Rate for Payer: Networks By Design Commercial |
$54.60
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$8.62
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$8.62
|
| Rate for Payer: Prime Health Services Commercial |
$331.50
|
| Rate for Payer: Prime Health Services Commercial |
$71.40
|
| Rate for Payer: Prime Health Services Medicare |
$9.14
|
| Rate for Payer: Prime Health Services Medicare |
$9.14
|
| Rate for Payer: Riverside University Health System MISP |
$9.48
|
| Rate for Payer: Riverside University Health System MISP |
$9.48
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$234.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$50.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$225.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$225.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.98
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.98
|
| Rate for Payer: United Healthcare All Other HMO |
$6.98
|
| Rate for Payer: United Healthcare All Other HMO |
$6.98
|
| Rate for Payer: United Healthcare HMO Rider |
$6.98
|
| Rate for Payer: United Healthcare HMO Rider |
$6.98
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.98
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.98
|
| Rate for Payer: Upland Medical Group Pediatric |
$8.62
|
| Rate for Payer: Upland Medical Group Pediatric |
$8.62
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.93
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.48
|
| Rate for Payer: Vantage Medical Group Senior |
$8.62
|
| Rate for Payer: Vantage Medical Group Senior |
$8.62
|
|
|
HC CULTURE BRONCHIAL WASH/BRUSH
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
900911504
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$78.00 |
| Max. Negotiated Rate |
$351.00 |
| Rate for Payer: Adventist Health Commercial |
$78.00
|
| Rate for Payer: Cash Price |
$175.50
|
| Rate for Payer: Central Health Plan Commercial |
$312.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$273.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$156.00
|
| Rate for Payer: EPIC Health Plan Senior |
$156.00
|
| Rate for Payer: Galaxy Health WC |
$331.50
|
| Rate for Payer: Global Benefits Group Commercial |
$234.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$351.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$247.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$230.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$78.00
|
| Rate for Payer: Multiplan Commercial |
$292.50
|
| Rate for Payer: Networks By Design Commercial |
$253.50
|
| Rate for Payer: Prime Health Services Commercial |
$331.50
|
|
|
HC CULTURE CATHETER TIP
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
900912437
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.98 |
| Max. Negotiated Rate |
$351.00 |
| Rate for Payer: Adventist Health Commercial |
$78.00
|
| Rate for Payer: Adventist Health Commercial |
$16.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$8.62
|
| Rate for Payer: Adventist Health Medi-Cal |
$8.62
|
| Rate for Payer: Aetna of CA HMO/PPO |
$63.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$63.20
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.93
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9.48
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9.48
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.62
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.62
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$62.59
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$62.59
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$87.02
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$87.02
|
| Rate for Payer: Blue Shield of California Commercial |
$245.70
|
| Rate for Payer: Blue Shield of California Commercial |
$52.92
|
| Rate for Payer: Blue Shield of California EPN |
$33.35
|
| Rate for Payer: Blue Shield of California EPN |
$154.83
|
| Rate for Payer: Cash Price |
$175.50
|
| Rate for Payer: Cash Price |
$37.80
|
| Rate for Payer: Cash Price |
$37.80
|
| Rate for Payer: Cash Price |
$175.50
|
| Rate for Payer: Cash Price |
$175.50
|
| Rate for Payer: Cash Price |
$37.80
|
| Rate for Payer: Central Health Plan Commercial |
$67.20
|
| Rate for Payer: Central Health Plan Commercial |
$312.00
|
| Rate for Payer: Cigna of CA HMO |
$249.60
|
| Rate for Payer: Cigna of CA HMO |
$53.76
|
| Rate for Payer: Cigna of CA PPO |
$288.60
|
| Rate for Payer: Cigna of CA PPO |
$62.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.93
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.48
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.48
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8.62
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8.62
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$58.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$273.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.22
|
| Rate for Payer: EPIC Health Plan Senior |
$9.48
|
| Rate for Payer: EPIC Health Plan Senior |
$9.48
|
| Rate for Payer: Galaxy Health WC |
$71.40
|
| Rate for Payer: Galaxy Health WC |
$331.50
|
| Rate for Payer: Global Benefits Group Commercial |
$50.40
|
| Rate for Payer: Global Benefits Group Commercial |
$234.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$75.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$351.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$14.14
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$14.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$12.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$12.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.62
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$247.65
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$53.34
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$14.27
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$14.27
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$12.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$12.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$78.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$11.55
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$11.55
|
| Rate for Payer: Multiplan Commercial |
$63.00
|
| Rate for Payer: Multiplan Commercial |
$292.50
|
| Rate for Payer: Networks By Design Commercial |
$253.50
|
| Rate for Payer: Networks By Design Commercial |
$54.60
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$8.62
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$8.62
|
| Rate for Payer: Prime Health Services Commercial |
$331.50
|
| Rate for Payer: Prime Health Services Commercial |
$71.40
|
| Rate for Payer: Prime Health Services Medicare |
$9.14
|
| Rate for Payer: Prime Health Services Medicare |
$9.14
|
| Rate for Payer: Riverside University Health System MISP |
$9.48
|
| Rate for Payer: Riverside University Health System MISP |
$9.48
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$234.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$50.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$225.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$225.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.98
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.98
|
| Rate for Payer: United Healthcare All Other HMO |
$6.98
|
| Rate for Payer: United Healthcare All Other HMO |
$6.98
|
| Rate for Payer: United Healthcare HMO Rider |
$6.98
|
| Rate for Payer: United Healthcare HMO Rider |
$6.98
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.98
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.98
|
| Rate for Payer: Upland Medical Group Pediatric |
$8.62
|
| Rate for Payer: Upland Medical Group Pediatric |
$8.62
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.93
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.48
|
| Rate for Payer: Vantage Medical Group Senior |
$8.62
|
| Rate for Payer: Vantage Medical Group Senior |
$8.62
|
|
|
HC CULTURE CATHETER TIP
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
900912437
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$78.00 |
| Max. Negotiated Rate |
$351.00 |
| Rate for Payer: Adventist Health Commercial |
$78.00
|
| Rate for Payer: Cash Price |
$175.50
|
| Rate for Payer: Central Health Plan Commercial |
$312.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$273.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$156.00
|
| Rate for Payer: EPIC Health Plan Senior |
$156.00
|
| Rate for Payer: Galaxy Health WC |
$331.50
|
| Rate for Payer: Global Benefits Group Commercial |
$234.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$351.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$247.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$230.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$78.00
|
| Rate for Payer: Multiplan Commercial |
$292.50
|
| Rate for Payer: Networks By Design Commercial |
$253.50
|
| Rate for Payer: Prime Health Services Commercial |
$331.50
|
|
|
HC CULTURE CLO TEST
|
Facility
|
IP
|
$133.00
|
|
|
Service Code
|
CPT 87077
|
| Hospital Charge Code |
900910670
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$26.60 |
| Max. Negotiated Rate |
$119.70 |
| Rate for Payer: Adventist Health Commercial |
$26.60
|
| Rate for Payer: Cash Price |
$59.85
|
| Rate for Payer: Central Health Plan Commercial |
$106.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$93.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$53.20
|
| Rate for Payer: EPIC Health Plan Senior |
$53.20
|
| Rate for Payer: Galaxy Health WC |
$113.05
|
| Rate for Payer: Global Benefits Group Commercial |
$79.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$119.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$84.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$78.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$26.60
|
| Rate for Payer: Multiplan Commercial |
$99.75
|
| Rate for Payer: Networks By Design Commercial |
$86.45
|
| Rate for Payer: Prime Health Services Commercial |
$113.05
|
|
|
HC CULTURE CLO TEST
|
Facility
|
OP
|
$133.00
|
|
|
Service Code
|
CPT 87077
|
| Hospital Charge Code |
900910670
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.54 |
| Max. Negotiated Rate |
$225.00 |
| Rate for Payer: Adventist Health Commercial |
$26.60
|
| Rate for Payer: Adventist Health Commercial |
$14.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$8.08
|
| Rate for Payer: Adventist Health Medi-Cal |
$8.08
|
| Rate for Payer: Aetna of CA HMO/PPO |
$59.27
|
| Rate for Payer: Aetna of CA HMO/PPO |
$59.27
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.12
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.12
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.89
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.08
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$58.72
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$58.72
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$81.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$81.64
|
| Rate for Payer: Blue Shield of California Commercial |
$83.79
|
| Rate for Payer: Blue Shield of California Commercial |
$45.36
|
| Rate for Payer: Blue Shield of California EPN |
$28.58
|
| Rate for Payer: Blue Shield of California EPN |
$52.80
|
| Rate for Payer: Cash Price |
$59.85
|
| Rate for Payer: Cash Price |
$32.40
|
| Rate for Payer: Cash Price |
$32.40
|
| Rate for Payer: Cash Price |
$59.85
|
| Rate for Payer: Cash Price |
$59.85
|
| Rate for Payer: Cash Price |
$32.40
|
| Rate for Payer: Central Health Plan Commercial |
$57.60
|
| Rate for Payer: Central Health Plan Commercial |
$106.40
|
| Rate for Payer: Cigna of CA HMO |
$85.12
|
| Rate for Payer: Cigna of CA HMO |
$46.08
|
| Rate for Payer: Cigna of CA PPO |
$98.42
|
| Rate for Payer: Cigna of CA PPO |
$53.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$8.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$8.89
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8.08
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8.08
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$50.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$93.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.33
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.33
|
| Rate for Payer: EPIC Health Plan Senior |
$8.89
|
| Rate for Payer: EPIC Health Plan Senior |
$8.89
|
| Rate for Payer: Galaxy Health WC |
$61.20
|
| Rate for Payer: Galaxy Health WC |
$113.05
|
| Rate for Payer: Global Benefits Group Commercial |
$43.20
|
| Rate for Payer: Global Benefits Group Commercial |
$79.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$64.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$119.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$13.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$13.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$11.44
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$11.44
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$84.45
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$45.72
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$12.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$12.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$11.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$11.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$26.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$10.83
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$10.83
|
| Rate for Payer: Multiplan Commercial |
$54.00
|
| Rate for Payer: Multiplan Commercial |
$99.75
|
| Rate for Payer: Networks By Design Commercial |
$86.45
|
| Rate for Payer: Networks By Design Commercial |
$46.80
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$8.08
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$8.08
|
| Rate for Payer: Prime Health Services Commercial |
$113.05
|
| Rate for Payer: Prime Health Services Commercial |
$61.20
|
| Rate for Payer: Prime Health Services Medicare |
$8.56
|
| Rate for Payer: Prime Health Services Medicare |
$8.56
|
| Rate for Payer: Riverside University Health System MISP |
$8.89
|
| Rate for Payer: Riverside University Health System MISP |
$8.89
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$79.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$43.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$225.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$225.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.54
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.54
|
| Rate for Payer: United Healthcare All Other HMO |
$6.54
|
| Rate for Payer: United Healthcare All Other HMO |
$6.54
|
| Rate for Payer: United Healthcare HMO Rider |
$6.54
|
| Rate for Payer: United Healthcare HMO Rider |
$6.54
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.54
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.54
|
| Rate for Payer: Upland Medical Group Pediatric |
$8.08
|
| Rate for Payer: Upland Medical Group Pediatric |
$8.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.89
|
| Rate for Payer: Vantage Medical Group Senior |
$8.08
|
| Rate for Payer: Vantage Medical Group Senior |
$8.08
|
|
|
HC CULTURE CRYPTOCOCCUS SCREEN
|
Facility
|
OP
|
$132.00
|
|
|
Service Code
|
CPT 87147
|
| Hospital Charge Code |
900911610
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$4.19 |
| Max. Negotiated Rate |
$118.80 |
| Rate for Payer: Adventist Health Commercial |
$26.40
|
| Rate for Payer: Adventist Health Commercial |
$9.20
|
| 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 |
$36.02
|
| Rate for Payer: Aetna of CA HMO/PPO |
$36.02
|
| 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 |
$34.04
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$34.04
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$47.32
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$47.32
|
| Rate for Payer: Blue Shield of California Commercial |
$28.98
|
| Rate for Payer: Blue Shield of California Commercial |
$83.16
|
| Rate for Payer: Blue Shield of California EPN |
$18.26
|
| Rate for Payer: Blue Shield of California EPN |
$52.40
|
| Rate for Payer: Cash Price |
$20.70
|
| Rate for Payer: Cash Price |
$20.70
|
| Rate for Payer: Cash Price |
$59.40
|
| Rate for Payer: Cash Price |
$59.40
|
| Rate for Payer: Central Health Plan Commercial |
$105.60
|
| Rate for Payer: Central Health Plan Commercial |
$36.80
|
| Rate for Payer: Cigna of CA HMO |
$29.44
|
| Rate for Payer: Cigna of CA HMO |
$84.48
|
| Rate for Payer: Cigna of CA PPO |
$34.04
|
| Rate for Payer: Cigna of CA PPO |
$97.68
|
| 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 |
$92.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$32.20
|
| 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 |
$39.10
|
| Rate for Payer: Galaxy Health WC |
$112.20
|
| Rate for Payer: Global Benefits Group Commercial |
$27.60
|
| Rate for Payer: Global Benefits Group Commercial |
$79.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$41.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$118.80
|
| 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 |
$6.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$6.24
|
| 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 |
$83.82
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$29.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$6.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$6.90
|
| 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 |
$26.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.20
|
| 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 |
$34.50
|
| Rate for Payer: Multiplan Commercial |
$99.00
|
| Rate for Payer: Networks By Design Commercial |
$85.80
|
| Rate for Payer: Networks By Design Commercial |
$29.90
|
| 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 |
$39.10
|
| Rate for Payer: Prime Health Services Commercial |
$112.20
|
| 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 |
$79.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$27.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$27.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$79.20
|
| 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 CULTURE CRYPTOCOCCUS SCREEN
|
Facility
|
IP
|
$132.00
|
|
|
Service Code
|
CPT 87147
|
| Hospital Charge Code |
900911610
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$26.40 |
| Max. Negotiated Rate |
$118.80 |
| Rate for Payer: Adventist Health Commercial |
$26.40
|
| Rate for Payer: Cash Price |
$59.40
|
| Rate for Payer: Central Health Plan Commercial |
$105.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$92.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$52.80
|
| Rate for Payer: EPIC Health Plan Senior |
$52.80
|
| Rate for Payer: Galaxy Health WC |
$112.20
|
| Rate for Payer: Global Benefits Group Commercial |
$79.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$118.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$83.82
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$77.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$26.40
|
| Rate for Payer: Multiplan Commercial |
$99.00
|
| Rate for Payer: Networks By Design Commercial |
$85.80
|
| Rate for Payer: Prime Health Services Commercial |
$112.20
|
|
|
HC CULTURE CSF
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
900911505
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$78.00 |
| Max. Negotiated Rate |
$351.00 |
| Rate for Payer: Adventist Health Commercial |
$78.00
|
| Rate for Payer: Cash Price |
$175.50
|
| Rate for Payer: Central Health Plan Commercial |
$312.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$273.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$156.00
|
| Rate for Payer: EPIC Health Plan Senior |
$156.00
|
| Rate for Payer: Galaxy Health WC |
$331.50
|
| Rate for Payer: Global Benefits Group Commercial |
$234.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$351.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$247.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$230.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$78.00
|
| Rate for Payer: Multiplan Commercial |
$292.50
|
| Rate for Payer: Networks By Design Commercial |
$253.50
|
| Rate for Payer: Prime Health Services Commercial |
$331.50
|
|
|
HC CULTURE CSF
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
900911505
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.98 |
| Max. Negotiated Rate |
$351.00 |
| Rate for Payer: Adventist Health Commercial |
$78.00
|
| Rate for Payer: Adventist Health Commercial |
$16.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$8.62
|
| Rate for Payer: Adventist Health Medi-Cal |
$8.62
|
| Rate for Payer: Aetna of CA HMO/PPO |
$63.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$63.20
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.93
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9.48
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9.48
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.62
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.62
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$62.59
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$62.59
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$87.02
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$87.02
|
| Rate for Payer: Blue Shield of California Commercial |
$245.70
|
| Rate for Payer: Blue Shield of California Commercial |
$52.92
|
| Rate for Payer: Blue Shield of California EPN |
$33.35
|
| Rate for Payer: Blue Shield of California EPN |
$154.83
|
| Rate for Payer: Cash Price |
$175.50
|
| Rate for Payer: Cash Price |
$37.80
|
| Rate for Payer: Cash Price |
$37.80
|
| Rate for Payer: Cash Price |
$175.50
|
| Rate for Payer: Cash Price |
$175.50
|
| Rate for Payer: Cash Price |
$37.80
|
| Rate for Payer: Central Health Plan Commercial |
$67.20
|
| Rate for Payer: Central Health Plan Commercial |
$312.00
|
| Rate for Payer: Cigna of CA HMO |
$249.60
|
| Rate for Payer: Cigna of CA HMO |
$53.76
|
| Rate for Payer: Cigna of CA PPO |
$288.60
|
| Rate for Payer: Cigna of CA PPO |
$62.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.93
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.48
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.48
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8.62
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8.62
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$58.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$273.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.22
|
| Rate for Payer: EPIC Health Plan Senior |
$9.48
|
| Rate for Payer: EPIC Health Plan Senior |
$9.48
|
| Rate for Payer: Galaxy Health WC |
$71.40
|
| Rate for Payer: Galaxy Health WC |
$331.50
|
| Rate for Payer: Global Benefits Group Commercial |
$50.40
|
| Rate for Payer: Global Benefits Group Commercial |
$234.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$75.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$351.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$14.14
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$14.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$12.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$12.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.62
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$247.65
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$53.34
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$14.27
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$14.27
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$12.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$12.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$78.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$11.55
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$11.55
|
| Rate for Payer: Multiplan Commercial |
$63.00
|
| Rate for Payer: Multiplan Commercial |
$292.50
|
| Rate for Payer: Networks By Design Commercial |
$253.50
|
| Rate for Payer: Networks By Design Commercial |
$54.60
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$8.62
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$8.62
|
| Rate for Payer: Prime Health Services Commercial |
$331.50
|
| Rate for Payer: Prime Health Services Commercial |
$71.40
|
| Rate for Payer: Prime Health Services Medicare |
$9.14
|
| Rate for Payer: Prime Health Services Medicare |
$9.14
|
| Rate for Payer: Riverside University Health System MISP |
$9.48
|
| Rate for Payer: Riverside University Health System MISP |
$9.48
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$234.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$50.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$225.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$225.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.98
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.98
|
| Rate for Payer: United Healthcare All Other HMO |
$6.98
|
| Rate for Payer: United Healthcare All Other HMO |
$6.98
|
| Rate for Payer: United Healthcare HMO Rider |
$6.98
|
| Rate for Payer: United Healthcare HMO Rider |
$6.98
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.98
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.98
|
| Rate for Payer: Upland Medical Group Pediatric |
$8.62
|
| Rate for Payer: Upland Medical Group Pediatric |
$8.62
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.93
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.48
|
| Rate for Payer: Vantage Medical Group Senior |
$8.62
|
| Rate for Payer: Vantage Medical Group Senior |
$8.62
|
|
|
HC CULTURE CYSTIC FIBROSIS
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
900911533
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$78.00 |
| Max. Negotiated Rate |
$351.00 |
| Rate for Payer: Adventist Health Commercial |
$78.00
|
| Rate for Payer: Cash Price |
$175.50
|
| Rate for Payer: Central Health Plan Commercial |
$312.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$273.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$156.00
|
| Rate for Payer: EPIC Health Plan Senior |
$156.00
|
| Rate for Payer: Galaxy Health WC |
$331.50
|
| Rate for Payer: Global Benefits Group Commercial |
$234.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$351.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$247.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$230.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$78.00
|
| Rate for Payer: Multiplan Commercial |
$292.50
|
| Rate for Payer: Networks By Design Commercial |
$253.50
|
| Rate for Payer: Prime Health Services Commercial |
$331.50
|
|
|
HC CULTURE CYSTIC FIBROSIS
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
900911533
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.98 |
| Max. Negotiated Rate |
$351.00 |
| Rate for Payer: Adventist Health Commercial |
$78.00
|
| Rate for Payer: Adventist Health Commercial |
$16.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$8.62
|
| Rate for Payer: Adventist Health Medi-Cal |
$8.62
|
| Rate for Payer: Aetna of CA HMO/PPO |
$63.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$63.20
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.93
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9.48
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9.48
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.62
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.62
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$62.59
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$62.59
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$87.02
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$87.02
|
| Rate for Payer: Blue Shield of California Commercial |
$245.70
|
| Rate for Payer: Blue Shield of California Commercial |
$52.92
|
| Rate for Payer: Blue Shield of California EPN |
$33.35
|
| Rate for Payer: Blue Shield of California EPN |
$154.83
|
| Rate for Payer: Cash Price |
$175.50
|
| Rate for Payer: Cash Price |
$37.80
|
| Rate for Payer: Cash Price |
$37.80
|
| Rate for Payer: Cash Price |
$175.50
|
| Rate for Payer: Cash Price |
$175.50
|
| Rate for Payer: Cash Price |
$37.80
|
| Rate for Payer: Central Health Plan Commercial |
$67.20
|
| Rate for Payer: Central Health Plan Commercial |
$312.00
|
| Rate for Payer: Cigna of CA HMO |
$249.60
|
| Rate for Payer: Cigna of CA HMO |
$53.76
|
| Rate for Payer: Cigna of CA PPO |
$288.60
|
| Rate for Payer: Cigna of CA PPO |
$62.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.93
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.48
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.48
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8.62
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8.62
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$58.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$273.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.22
|
| Rate for Payer: EPIC Health Plan Senior |
$9.48
|
| Rate for Payer: EPIC Health Plan Senior |
$9.48
|
| Rate for Payer: Galaxy Health WC |
$71.40
|
| Rate for Payer: Galaxy Health WC |
$331.50
|
| Rate for Payer: Global Benefits Group Commercial |
$50.40
|
| Rate for Payer: Global Benefits Group Commercial |
$234.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$75.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$351.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$14.14
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$14.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$12.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$12.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.62
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$247.65
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$53.34
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$14.27
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$14.27
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$12.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$12.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$78.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$11.55
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$11.55
|
| Rate for Payer: Multiplan Commercial |
$63.00
|
| Rate for Payer: Multiplan Commercial |
$292.50
|
| Rate for Payer: Networks By Design Commercial |
$253.50
|
| Rate for Payer: Networks By Design Commercial |
$54.60
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$8.62
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$8.62
|
| Rate for Payer: Prime Health Services Commercial |
$331.50
|
| Rate for Payer: Prime Health Services Commercial |
$71.40
|
| Rate for Payer: Prime Health Services Medicare |
$9.14
|
| Rate for Payer: Prime Health Services Medicare |
$9.14
|
| Rate for Payer: Riverside University Health System MISP |
$9.48
|
| Rate for Payer: Riverside University Health System MISP |
$9.48
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$234.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$50.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$225.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$225.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.98
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.98
|
| Rate for Payer: United Healthcare All Other HMO |
$6.98
|
| Rate for Payer: United Healthcare All Other HMO |
$6.98
|
| Rate for Payer: United Healthcare HMO Rider |
$6.98
|
| Rate for Payer: United Healthcare HMO Rider |
$6.98
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.98
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.98
|
| Rate for Payer: Upland Medical Group Pediatric |
$8.62
|
| Rate for Payer: Upland Medical Group Pediatric |
$8.62
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.93
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.48
|
| Rate for Payer: Vantage Medical Group Senior |
$8.62
|
| Rate for Payer: Vantage Medical Group Senior |
$8.62
|
|
|
HC CULTURE ENVIORNMENTAL
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
900911532
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.98 |
| Max. Negotiated Rate |
$351.00 |
| Rate for Payer: Adventist Health Commercial |
$78.00
|
| Rate for Payer: Adventist Health Commercial |
$16.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$8.62
|
| Rate for Payer: Adventist Health Medi-Cal |
$8.62
|
| Rate for Payer: Aetna of CA HMO/PPO |
$63.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$63.20
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.93
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9.48
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9.48
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.62
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.62
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$62.59
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$62.59
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$87.02
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$87.02
|
| Rate for Payer: Blue Shield of California Commercial |
$245.70
|
| Rate for Payer: Blue Shield of California Commercial |
$52.92
|
| Rate for Payer: Blue Shield of California EPN |
$33.35
|
| Rate for Payer: Blue Shield of California EPN |
$154.83
|
| Rate for Payer: Cash Price |
$175.50
|
| Rate for Payer: Cash Price |
$37.80
|
| Rate for Payer: Cash Price |
$37.80
|
| Rate for Payer: Cash Price |
$175.50
|
| Rate for Payer: Cash Price |
$175.50
|
| Rate for Payer: Cash Price |
$37.80
|
| Rate for Payer: Central Health Plan Commercial |
$67.20
|
| Rate for Payer: Central Health Plan Commercial |
$312.00
|
| Rate for Payer: Cigna of CA HMO |
$249.60
|
| Rate for Payer: Cigna of CA HMO |
$53.76
|
| Rate for Payer: Cigna of CA PPO |
$288.60
|
| Rate for Payer: Cigna of CA PPO |
$62.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.93
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.48
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.48
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8.62
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8.62
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$58.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$273.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.22
|
| Rate for Payer: EPIC Health Plan Senior |
$9.48
|
| Rate for Payer: EPIC Health Plan Senior |
$9.48
|
| Rate for Payer: Galaxy Health WC |
$71.40
|
| Rate for Payer: Galaxy Health WC |
$331.50
|
| Rate for Payer: Global Benefits Group Commercial |
$50.40
|
| Rate for Payer: Global Benefits Group Commercial |
$234.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$75.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$351.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$14.14
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$14.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$12.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$12.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.62
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$247.65
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$53.34
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$14.27
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$14.27
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$12.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$12.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$78.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$11.55
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$11.55
|
| Rate for Payer: Multiplan Commercial |
$63.00
|
| Rate for Payer: Multiplan Commercial |
$292.50
|
| Rate for Payer: Networks By Design Commercial |
$253.50
|
| Rate for Payer: Networks By Design Commercial |
$54.60
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$8.62
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$8.62
|
| Rate for Payer: Prime Health Services Commercial |
$331.50
|
| Rate for Payer: Prime Health Services Commercial |
$71.40
|
| Rate for Payer: Prime Health Services Medicare |
$9.14
|
| Rate for Payer: Prime Health Services Medicare |
$9.14
|
| Rate for Payer: Riverside University Health System MISP |
$9.48
|
| Rate for Payer: Riverside University Health System MISP |
$9.48
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$234.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$50.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$225.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$225.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.98
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.98
|
| Rate for Payer: United Healthcare All Other HMO |
$6.98
|
| Rate for Payer: United Healthcare All Other HMO |
$6.98
|
| Rate for Payer: United Healthcare HMO Rider |
$6.98
|
| Rate for Payer: United Healthcare HMO Rider |
$6.98
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.98
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.98
|
| Rate for Payer: Upland Medical Group Pediatric |
$8.62
|
| Rate for Payer: Upland Medical Group Pediatric |
$8.62
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.93
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.48
|
| Rate for Payer: Vantage Medical Group Senior |
$8.62
|
| Rate for Payer: Vantage Medical Group Senior |
$8.62
|
|
|
HC CULTURE ENVIORNMENTAL
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
900911532
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$78.00 |
| Max. Negotiated Rate |
$351.00 |
| Rate for Payer: Adventist Health Commercial |
$78.00
|
| Rate for Payer: Cash Price |
$175.50
|
| Rate for Payer: Central Health Plan Commercial |
$312.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$273.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$156.00
|
| Rate for Payer: EPIC Health Plan Senior |
$156.00
|
| Rate for Payer: Galaxy Health WC |
$331.50
|
| Rate for Payer: Global Benefits Group Commercial |
$234.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$351.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$247.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$230.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$78.00
|
| Rate for Payer: Multiplan Commercial |
$292.50
|
| Rate for Payer: Networks By Design Commercial |
$253.50
|
| Rate for Payer: Prime Health Services Commercial |
$331.50
|
|
|
HC CULTURE ENVIRONMENTAL
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
900912439
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$78.00 |
| Max. Negotiated Rate |
$351.00 |
| Rate for Payer: Adventist Health Commercial |
$78.00
|
| Rate for Payer: Cash Price |
$175.50
|
| Rate for Payer: Central Health Plan Commercial |
$312.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$273.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$156.00
|
| Rate for Payer: EPIC Health Plan Senior |
$156.00
|
| Rate for Payer: Galaxy Health WC |
$331.50
|
| Rate for Payer: Global Benefits Group Commercial |
$234.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$351.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$247.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$230.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$78.00
|
| Rate for Payer: Multiplan Commercial |
$292.50
|
| Rate for Payer: Networks By Design Commercial |
$253.50
|
| Rate for Payer: Prime Health Services Commercial |
$331.50
|
|
|
HC CULTURE ENVIRONMENTAL
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
900912439
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.98 |
| Max. Negotiated Rate |
$351.00 |
| Rate for Payer: Adventist Health Commercial |
$78.00
|
| Rate for Payer: Adventist Health Commercial |
$16.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$8.62
|
| Rate for Payer: Adventist Health Medi-Cal |
$8.62
|
| Rate for Payer: Aetna of CA HMO/PPO |
$63.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$63.20
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.93
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9.48
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9.48
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.62
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.62
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$62.59
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$62.59
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$87.02
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$87.02
|
| Rate for Payer: Blue Shield of California Commercial |
$245.70
|
| Rate for Payer: Blue Shield of California Commercial |
$52.92
|
| Rate for Payer: Blue Shield of California EPN |
$33.35
|
| Rate for Payer: Blue Shield of California EPN |
$154.83
|
| Rate for Payer: Cash Price |
$175.50
|
| Rate for Payer: Cash Price |
$37.80
|
| Rate for Payer: Cash Price |
$37.80
|
| Rate for Payer: Cash Price |
$175.50
|
| Rate for Payer: Cash Price |
$175.50
|
| Rate for Payer: Cash Price |
$37.80
|
| Rate for Payer: Central Health Plan Commercial |
$67.20
|
| Rate for Payer: Central Health Plan Commercial |
$312.00
|
| Rate for Payer: Cigna of CA HMO |
$249.60
|
| Rate for Payer: Cigna of CA HMO |
$53.76
|
| Rate for Payer: Cigna of CA PPO |
$288.60
|
| Rate for Payer: Cigna of CA PPO |
$62.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.93
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.48
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.48
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8.62
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8.62
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$58.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$273.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.22
|
| Rate for Payer: EPIC Health Plan Senior |
$9.48
|
| Rate for Payer: EPIC Health Plan Senior |
$9.48
|
| Rate for Payer: Galaxy Health WC |
$71.40
|
| Rate for Payer: Galaxy Health WC |
$331.50
|
| Rate for Payer: Global Benefits Group Commercial |
$50.40
|
| Rate for Payer: Global Benefits Group Commercial |
$234.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$75.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$351.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$14.14
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$14.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$12.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$12.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.62
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$247.65
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$53.34
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$14.27
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$14.27
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$12.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$12.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$78.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$11.55
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$11.55
|
| Rate for Payer: Multiplan Commercial |
$63.00
|
| Rate for Payer: Multiplan Commercial |
$292.50
|
| Rate for Payer: Networks By Design Commercial |
$253.50
|
| Rate for Payer: Networks By Design Commercial |
$54.60
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$8.62
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$8.62
|
| Rate for Payer: Prime Health Services Commercial |
$331.50
|
| Rate for Payer: Prime Health Services Commercial |
$71.40
|
| Rate for Payer: Prime Health Services Medicare |
$9.14
|
| Rate for Payer: Prime Health Services Medicare |
$9.14
|
| Rate for Payer: Riverside University Health System MISP |
$9.48
|
| Rate for Payer: Riverside University Health System MISP |
$9.48
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$234.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$50.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$225.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$225.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.98
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.98
|
| Rate for Payer: United Healthcare All Other HMO |
$6.98
|
| Rate for Payer: United Healthcare All Other HMO |
$6.98
|
| Rate for Payer: United Healthcare HMO Rider |
$6.98
|
| Rate for Payer: United Healthcare HMO Rider |
$6.98
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.98
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.98
|
| Rate for Payer: Upland Medical Group Pediatric |
$8.62
|
| Rate for Payer: Upland Medical Group Pediatric |
$8.62
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.93
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.48
|
| Rate for Payer: Vantage Medical Group Senior |
$8.62
|
| Rate for Payer: Vantage Medical Group Senior |
$8.62
|
|
|
HC CULTURE FOR TB
|
Facility
|
OP
|
$459.00
|
|
|
Service Code
|
CPT 87116
|
| Hospital Charge Code |
900911526
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$8.75 |
| Max. Negotiated Rate |
$413.10 |
| Rate for Payer: Adventist Health Commercial |
$91.80
|
| Rate for Payer: Adventist Health Commercial |
$18.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$10.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$10.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$72.16
|
| Rate for Payer: Aetna of CA HMO/PPO |
$72.16
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$16.20
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$16.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11.88
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10.80
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$78.46
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$78.46
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$109.08
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$109.08
|
| Rate for Payer: Blue Shield of California Commercial |
$59.22
|
| Rate for Payer: Blue Shield of California Commercial |
$289.17
|
| Rate for Payer: Blue Shield of California EPN |
$37.32
|
| Rate for Payer: Blue Shield of California EPN |
$182.22
|
| Rate for Payer: Cash Price |
$42.30
|
| Rate for Payer: Cash Price |
$42.30
|
| Rate for Payer: Cash Price |
$206.55
|
| Rate for Payer: Cash Price |
$206.55
|
| Rate for Payer: Central Health Plan Commercial |
$367.20
|
| Rate for Payer: Central Health Plan Commercial |
$75.20
|
| Rate for Payer: Cigna of CA HMO |
$60.16
|
| Rate for Payer: Cigna of CA HMO |
$293.76
|
| Rate for Payer: Cigna of CA PPO |
$69.56
|
| Rate for Payer: Cigna of CA PPO |
$339.66
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$16.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$16.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$11.88
|
| Rate for Payer: Dignity Health Medi-Cal |
$11.88
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10.80
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$321.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$65.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$17.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$17.82
|
| Rate for Payer: EPIC Health Plan Senior |
$11.88
|
| Rate for Payer: EPIC Health Plan Senior |
$11.88
|
| Rate for Payer: Galaxy Health WC |
$79.90
|
| Rate for Payer: Galaxy Health WC |
$390.15
|
| Rate for Payer: Global Benefits Group Commercial |
$56.40
|
| Rate for Payer: Global Benefits Group Commercial |
$275.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$84.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$413.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$17.71
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$17.71
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$15.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$15.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$291.46
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$59.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$17.33
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$17.33
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$15.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$15.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$91.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$14.47
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$14.47
|
| Rate for Payer: Multiplan Commercial |
$70.50
|
| Rate for Payer: Multiplan Commercial |
$344.25
|
| Rate for Payer: Networks By Design Commercial |
$298.35
|
| Rate for Payer: Networks By Design Commercial |
$61.10
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$10.80
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$10.80
|
| Rate for Payer: Prime Health Services Commercial |
$79.90
|
| Rate for Payer: Prime Health Services Commercial |
$390.15
|
| Rate for Payer: Prime Health Services Medicare |
$11.45
|
| Rate for Payer: Prime Health Services Medicare |
$11.45
|
| Rate for Payer: Riverside University Health System MISP |
$11.88
|
| Rate for Payer: Riverside University Health System MISP |
$11.88
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$275.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$56.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$56.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$275.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$8.75
|
| Rate for Payer: United Healthcare All Other Commercial |
$8.75
|
| Rate for Payer: United Healthcare All Other HMO |
$8.75
|
| Rate for Payer: United Healthcare All Other HMO |
$8.75
|
| Rate for Payer: United Healthcare HMO Rider |
$8.75
|
| Rate for Payer: United Healthcare HMO Rider |
$8.75
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8.75
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8.75
|
| Rate for Payer: Upland Medical Group Pediatric |
$10.80
|
| Rate for Payer: Upland Medical Group Pediatric |
$10.80
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$16.20
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$16.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11.88
|
| Rate for Payer: Vantage Medical Group Senior |
$10.80
|
| Rate for Payer: Vantage Medical Group Senior |
$10.80
|
|
|
HC CULTURE FOR TB
|
Facility
|
IP
|
$459.00
|
|
|
Service Code
|
CPT 87116
|
| Hospital Charge Code |
900911526
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$91.80 |
| Max. Negotiated Rate |
$413.10 |
| Rate for Payer: Adventist Health Commercial |
$91.80
|
| Rate for Payer: Cash Price |
$206.55
|
| Rate for Payer: Central Health Plan Commercial |
$367.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$321.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$183.60
|
| Rate for Payer: EPIC Health Plan Senior |
$183.60
|
| Rate for Payer: Galaxy Health WC |
$390.15
|
| Rate for Payer: Global Benefits Group Commercial |
$275.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$413.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$291.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$270.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$91.80
|
| Rate for Payer: Multiplan Commercial |
$344.25
|
| Rate for Payer: Networks By Design Commercial |
$298.35
|
| Rate for Payer: Prime Health Services Commercial |
$390.15
|
|
|
HC CULTURE FOR VIROLOGY
|
Facility
|
OP
|
$165.00
|
|
|
Service Code
|
CPT 87252
|
| Hospital Charge Code |
900911528
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$21.11 |
| Max. Negotiated Rate |
$263.64 |
| Rate for Payer: Adventist Health Commercial |
$33.00
|
| Rate for Payer: Adventist Health Commercial |
$18.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$26.07
|
| Rate for Payer: Adventist Health Medi-Cal |
$26.07
|
| Rate for Payer: Aetna of CA HMO/PPO |
$191.31
|
| Rate for Payer: Aetna of CA HMO/PPO |
$191.31
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$39.10
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$39.10
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$28.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$28.68
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$26.07
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$26.07
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$189.64
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$189.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$263.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$263.64
|
| Rate for Payer: Blue Shield of California Commercial |
$56.70
|
| Rate for Payer: Blue Shield of California Commercial |
$103.95
|
| Rate for Payer: Blue Shield of California EPN |
$35.73
|
| Rate for Payer: Blue Shield of California EPN |
$65.50
|
| Rate for Payer: Cash Price |
$40.50
|
| Rate for Payer: Cash Price |
$40.50
|
| Rate for Payer: Cash Price |
$74.25
|
| Rate for Payer: Cash Price |
$74.25
|
| Rate for Payer: Central Health Plan Commercial |
$132.00
|
| Rate for Payer: Central Health Plan Commercial |
$72.00
|
| Rate for Payer: Cigna of CA HMO |
$57.60
|
| Rate for Payer: Cigna of CA HMO |
$105.60
|
| Rate for Payer: Cigna of CA PPO |
$66.60
|
| Rate for Payer: Cigna of CA PPO |
$122.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$39.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$39.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$28.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$28.68
|
| Rate for Payer: Dignity Health Medicare Advantage |
$26.07
|
| Rate for Payer: Dignity Health Medicare Advantage |
$26.07
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$115.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$63.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$43.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$43.02
|
| Rate for Payer: EPIC Health Plan Senior |
$28.68
|
| Rate for Payer: EPIC Health Plan Senior |
$28.68
|
| Rate for Payer: Galaxy Health WC |
$76.50
|
| Rate for Payer: Galaxy Health WC |
$140.25
|
| Rate for Payer: Global Benefits Group Commercial |
$54.00
|
| Rate for Payer: Global Benefits Group Commercial |
$99.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$81.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$148.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$42.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$42.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$36.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$36.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$26.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$26.07
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$104.78
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$57.15
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$40.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$40.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$36.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$36.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$33.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$34.93
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$34.93
|
| Rate for Payer: Multiplan Commercial |
$67.50
|
| Rate for Payer: Multiplan Commercial |
$123.75
|
| Rate for Payer: Networks By Design Commercial |
$107.25
|
| Rate for Payer: Networks By Design Commercial |
$58.50
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$26.07
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$26.07
|
| Rate for Payer: Prime Health Services Commercial |
$76.50
|
| Rate for Payer: Prime Health Services Commercial |
$140.25
|
| Rate for Payer: Prime Health Services Medicare |
$27.63
|
| Rate for Payer: Prime Health Services Medicare |
$27.63
|
| Rate for Payer: Riverside University Health System MISP |
$28.68
|
| Rate for Payer: Riverside University Health System MISP |
$28.68
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$99.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$54.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$54.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$99.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$21.11
|
| Rate for Payer: United Healthcare All Other Commercial |
$21.11
|
| Rate for Payer: United Healthcare All Other HMO |
$21.11
|
| Rate for Payer: United Healthcare All Other HMO |
$21.11
|
| Rate for Payer: United Healthcare HMO Rider |
$21.11
|
| Rate for Payer: United Healthcare HMO Rider |
$21.11
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$21.11
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$21.11
|
| Rate for Payer: Upland Medical Group Pediatric |
$26.07
|
| Rate for Payer: Upland Medical Group Pediatric |
$26.07
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$39.10
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$39.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$28.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$28.68
|
| Rate for Payer: Vantage Medical Group Senior |
$26.07
|
| Rate for Payer: Vantage Medical Group Senior |
$26.07
|
|
|
HC CULTURE FOR VIROLOGY
|
Facility
|
IP
|
$165.00
|
|
|
Service Code
|
CPT 87252
|
| Hospital Charge Code |
900911528
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$33.00 |
| Max. Negotiated Rate |
$148.50 |
| Rate for Payer: Adventist Health Commercial |
$33.00
|
| Rate for Payer: Cash Price |
$74.25
|
| Rate for Payer: Central Health Plan Commercial |
$132.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$115.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$66.00
|
| Rate for Payer: EPIC Health Plan Senior |
$66.00
|
| Rate for Payer: Galaxy Health WC |
$140.25
|
| Rate for Payer: Global Benefits Group Commercial |
$99.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$148.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$104.78
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$97.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$33.00
|
| Rate for Payer: Multiplan Commercial |
$123.75
|
| Rate for Payer: Networks By Design Commercial |
$107.25
|
| Rate for Payer: Prime Health Services Commercial |
$140.25
|
|
|
HC CULTURE FUNGUS (BLOOD)
|
Facility
|
IP
|
$264.00
|
|
|
Service Code
|
CPT 87103
|
| Hospital Charge Code |
900912430
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$52.80 |
| Max. Negotiated Rate |
$237.60 |
| Rate for Payer: Adventist Health Commercial |
$52.80
|
| Rate for Payer: Cash Price |
$118.80
|
| Rate for Payer: Central Health Plan Commercial |
$211.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$184.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$105.60
|
| Rate for Payer: EPIC Health Plan Senior |
$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 Foundation Hospitals Commercial/Self Funded |
$167.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$155.76
|
| 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 CULTURE FUNGUS (BLOOD)
|
Facility
|
OP
|
$264.00
|
|
|
Service Code
|
CPT 87103
|
| Hospital Charge Code |
900912430
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$13.78 |
| Max. Negotiated Rate |
$237.60 |
| Rate for Payer: Adventist Health Commercial |
$52.80
|
| Rate for Payer: Adventist Health Commercial |
$10.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$20.46
|
| Rate for Payer: Adventist Health Medi-Cal |
$20.46
|
| Rate for Payer: Aetna of CA HMO/PPO |
$66.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$66.20
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$30.69
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$30.69
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$22.51
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$22.51
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$20.46
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$20.46
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$65.58
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$65.58
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$91.17
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$91.17
|
| Rate for Payer: Blue Shield of California Commercial |
$33.39
|
| Rate for Payer: Blue Shield of California Commercial |
$166.32
|
| Rate for Payer: Blue Shield of California EPN |
$21.04
|
| Rate for Payer: Blue Shield of California EPN |
$104.81
|
| Rate for Payer: Cash Price |
$23.85
|
| Rate for Payer: Cash Price |
$23.85
|
| Rate for Payer: Cash Price |
$118.80
|
| Rate for Payer: Cash Price |
$118.80
|
| Rate for Payer: Central Health Plan Commercial |
$211.20
|
| Rate for Payer: Central Health Plan Commercial |
$42.40
|
| Rate for Payer: Cigna of CA HMO |
$33.92
|
| Rate for Payer: Cigna of CA HMO |
$168.96
|
| Rate for Payer: Cigna of CA PPO |
$39.22
|
| Rate for Payer: Cigna of CA PPO |
$195.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$30.69
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$30.69
|
| Rate for Payer: Dignity Health Medi-Cal |
$22.51
|
| Rate for Payer: Dignity Health Medi-Cal |
$22.51
|
| Rate for Payer: Dignity Health Medicare Advantage |
$20.46
|
| Rate for Payer: Dignity Health Medicare Advantage |
$20.46
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$184.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$37.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$33.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$33.76
|
| Rate for Payer: EPIC Health Plan Senior |
$22.51
|
| Rate for Payer: EPIC Health Plan Senior |
$22.51
|
| Rate for Payer: Galaxy Health WC |
$45.05
|
| Rate for Payer: Galaxy Health WC |
$224.40
|
| Rate for Payer: Global Benefits Group Commercial |
$31.80
|
| Rate for Payer: Global Benefits Group Commercial |
$158.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$47.70
|
| Rate for Payer: Health Management Network EPO/PPO |
$237.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$33.55
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$33.55
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$13.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$13.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$20.46
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$20.46
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$167.64
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$33.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$15.22
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$15.22
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$28.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$28.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$52.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$27.42
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$27.42
|
| Rate for Payer: Multiplan Commercial |
$39.75
|
| Rate for Payer: Multiplan Commercial |
$198.00
|
| Rate for Payer: Networks By Design Commercial |
$171.60
|
| Rate for Payer: Networks By Design Commercial |
$34.45
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$20.46
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$20.46
|
| Rate for Payer: Prime Health Services Commercial |
$45.05
|
| Rate for Payer: Prime Health Services Commercial |
$224.40
|
| Rate for Payer: Prime Health Services Medicare |
$21.69
|
| Rate for Payer: Prime Health Services Medicare |
$21.69
|
| Rate for Payer: Riverside University Health System MISP |
$22.51
|
| Rate for Payer: Riverside University Health System MISP |
$22.51
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$158.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$31.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$31.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$158.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$16.57
|
| Rate for Payer: United Healthcare All Other Commercial |
$16.57
|
| Rate for Payer: United Healthcare All Other HMO |
$16.57
|
| Rate for Payer: United Healthcare All Other HMO |
$16.57
|
| Rate for Payer: United Healthcare HMO Rider |
$16.57
|
| Rate for Payer: United Healthcare HMO Rider |
$16.57
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16.57
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16.57
|
| Rate for Payer: Upland Medical Group Pediatric |
$20.46
|
| Rate for Payer: Upland Medical Group Pediatric |
$20.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$30.69
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$30.69
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$22.51
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$22.51
|
| Rate for Payer: Vantage Medical Group Senior |
$20.46
|
| Rate for Payer: Vantage Medical Group Senior |
$20.46
|
|
|
HC CULTURE FUNGUS OTHER
|
Facility
|
OP
|
$353.00
|
|
|
Service Code
|
CPT 87102
|
| Hospital Charge Code |
900911523
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.81 |
| Max. Negotiated Rate |
$317.70 |
| Rate for Payer: Adventist Health Commercial |
$70.60
|
| Rate for Payer: Adventist Health Commercial |
$16.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$8.41
|
| Rate for Payer: Adventist Health Medi-Cal |
$8.41
|
| Rate for Payer: Aetna of CA HMO/PPO |
$61.73
|
| Rate for Payer: Aetna of CA HMO/PPO |
$61.73
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.62
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.41
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.41
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$61.12
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$61.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$84.98
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$84.98
|
| Rate for Payer: Blue Shield of California Commercial |
$52.92
|
| Rate for Payer: Blue Shield of California Commercial |
$222.39
|
| Rate for Payer: Blue Shield of California EPN |
$33.35
|
| Rate for Payer: Blue Shield of California EPN |
$140.14
|
| Rate for Payer: Cash Price |
$37.80
|
| Rate for Payer: Cash Price |
$37.80
|
| Rate for Payer: Cash Price |
$158.85
|
| Rate for Payer: Cash Price |
$158.85
|
| Rate for Payer: Central Health Plan Commercial |
$282.40
|
| Rate for Payer: Central Health Plan Commercial |
$67.20
|
| Rate for Payer: Cigna of CA HMO |
$53.76
|
| Rate for Payer: Cigna of CA HMO |
$225.92
|
| Rate for Payer: Cigna of CA PPO |
$62.16
|
| Rate for Payer: Cigna of CA PPO |
$261.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.25
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8.41
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8.41
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$247.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$58.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.88
|
| Rate for Payer: EPIC Health Plan Senior |
$9.25
|
| Rate for Payer: EPIC Health Plan Senior |
$9.25
|
| Rate for Payer: Galaxy Health WC |
$71.40
|
| Rate for Payer: Galaxy Health WC |
$300.05
|
| Rate for Payer: Global Benefits Group Commercial |
$50.40
|
| Rate for Payer: Global Benefits Group Commercial |
$211.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$75.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$317.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$13.79
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$13.79
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$12.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$12.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.41
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$224.16
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$53.34
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$14.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$14.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$11.77
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$11.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$70.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$11.27
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$11.27
|
| Rate for Payer: Multiplan Commercial |
$63.00
|
| Rate for Payer: Multiplan Commercial |
$264.75
|
| Rate for Payer: Networks By Design Commercial |
$229.45
|
| Rate for Payer: Networks By Design Commercial |
$54.60
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$8.41
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$8.41
|
| Rate for Payer: Prime Health Services Commercial |
$71.40
|
| Rate for Payer: Prime Health Services Commercial |
$300.05
|
| Rate for Payer: Prime Health Services Medicare |
$8.91
|
| Rate for Payer: Prime Health Services Medicare |
$8.91
|
| Rate for Payer: Riverside University Health System MISP |
$9.25
|
| Rate for Payer: Riverside University Health System MISP |
$9.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$211.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$50.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$50.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$211.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.81
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.81
|
| Rate for Payer: United Healthcare All Other HMO |
$6.81
|
| Rate for Payer: United Healthcare All Other HMO |
$6.81
|
| Rate for Payer: United Healthcare HMO Rider |
$6.81
|
| Rate for Payer: United Healthcare HMO Rider |
$6.81
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.81
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.81
|
| Rate for Payer: Upland Medical Group Pediatric |
$8.41
|
| Rate for Payer: Upland Medical Group Pediatric |
$8.41
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.62
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.25
|
| Rate for Payer: Vantage Medical Group Senior |
$8.41
|
| Rate for Payer: Vantage Medical Group Senior |
$8.41
|
|
|
HC CULTURE FUNGUS OTHER
|
Facility
|
IP
|
$353.00
|
|
|
Service Code
|
CPT 87102
|
| Hospital Charge Code |
900911523
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$70.60 |
| Max. Negotiated Rate |
$317.70 |
| Rate for Payer: Adventist Health Commercial |
$70.60
|
| Rate for Payer: Cash Price |
$158.85
|
| Rate for Payer: Central Health Plan Commercial |
$282.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$247.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$141.20
|
| Rate for Payer: EPIC Health Plan Senior |
$141.20
|
| Rate for Payer: Galaxy Health WC |
$300.05
|
| Rate for Payer: Global Benefits Group Commercial |
$211.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$317.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$224.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$208.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$70.60
|
| Rate for Payer: Multiplan Commercial |
$264.75
|
| Rate for Payer: Networks By Design Commercial |
$229.45
|
| Rate for Payer: Prime Health Services Commercial |
$300.05
|
|
