|
HC C-REACTIVE PROTEIN HI SENSITIVITY
|
Facility
|
IP
|
$315.00
|
|
|
Service Code
|
CPT 86141
|
| Hospital Charge Code |
900912102
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$63.00 |
| Max. Negotiated Rate |
$283.50 |
| Rate for Payer: Adventist Health Commercial |
$63.00
|
| Rate for Payer: Cash Price |
$141.75
|
| Rate for Payer: Central Health Plan Commercial |
$252.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$126.00
|
| Rate for Payer: EPIC Health Plan Senior |
$126.00
|
| Rate for Payer: Galaxy Health WC |
$267.75
|
| Rate for Payer: Global Benefits Group Commercial |
$189.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$283.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$210.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$120.02
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$194.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$63.00
|
| Rate for Payer: Multiplan Commercial |
$236.25
|
| Rate for Payer: Networks By Design Commercial |
$204.75
|
| Rate for Payer: Prime Health Services Commercial |
$267.75
|
|
|
HC C-REACTIVE PROTEIN HI SENSITIVITY
|
Facility
|
OP
|
$82.00
|
|
|
Service Code
|
CPT 86141
|
| Hospital Charge Code |
900912102
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.49 |
| Max. Negotiated Rate |
$94.13 |
| Rate for Payer: Adventist Health Commercial |
$16.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$12.95
|
| Rate for Payer: Aetna of CA HMO/PPO |
$49.80
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19.43
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.24
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12.95
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$94.13
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$19.10
|
| Rate for Payer: Blue Shield of California Commercial |
$49.77
|
| Rate for Payer: Blue Shield of California EPN |
$32.55
|
| Rate for Payer: Cash Price |
$36.90
|
| Rate for Payer: Cash Price |
$36.90
|
| Rate for Payer: Central Health Plan Commercial |
$65.60
|
| Rate for Payer: Cigna of CA HMO |
$52.48
|
| Rate for Payer: Cigna of CA PPO |
$60.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.43
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.24
|
| Rate for Payer: Dignity Health Medicare Advantage |
$12.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$17.48
|
| Rate for Payer: EPIC Health Plan Senior |
$12.95
|
| Rate for Payer: Galaxy Health WC |
$69.70
|
| Rate for Payer: Global Benefits Group Commercial |
$49.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$73.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$21.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$19.02
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$12.95
|
| Rate for Payer: InnovAge PACE Commercial |
$19.43
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$54.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$21.01
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17.35
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17.35
|
| Rate for Payer: Multiplan Commercial |
$61.50
|
| Rate for Payer: Networks By Design Commercial |
$53.30
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$12.95
|
| Rate for Payer: Prime Health Services Commercial |
$69.70
|
| Rate for Payer: Prime Health Services Medicare |
$13.73
|
| Rate for Payer: Riverside University Health System MISP |
$14.24
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$49.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$49.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.49
|
| Rate for Payer: United Healthcare All Other HMO |
$10.49
|
| Rate for Payer: United Healthcare HMO Rider |
$10.49
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.49
|
| Rate for Payer: Upland Medical Group Pediatric |
$12.95
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.43
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.24
|
| Rate for Payer: Vantage Medical Group Senior |
$12.95
|
|
|
HC CREAM WOUND CARE ATRACTAIN 2OZ
|
Facility
|
IP
|
$27.88
|
|
| Hospital Charge Code |
901606201
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$5.58 |
| Max. Negotiated Rate |
$25.09 |
| Rate for Payer: Adventist Health Commercial |
$5.58
|
| Rate for Payer: Cash Price |
$12.55
|
| Rate for Payer: Central Health Plan Commercial |
$22.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.15
|
| Rate for Payer: EPIC Health Plan Senior |
$11.15
|
| Rate for Payer: Galaxy Health WC |
$23.70
|
| Rate for Payer: Global Benefits Group Commercial |
$16.73
|
| Rate for Payer: Health Management Network EPO/PPO |
$25.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$18.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$17.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.58
|
| Rate for Payer: Multiplan Commercial |
$20.91
|
| Rate for Payer: Networks By Design Commercial |
$18.12
|
| Rate for Payer: Prime Health Services Commercial |
$23.70
|
|
|
HC CREAM WOUND CARE ATRACTAIN 2OZ
|
Facility
|
OP
|
$27.88
|
|
| Hospital Charge Code |
901606201
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$5.58 |
| Max. Negotiated Rate |
$25.09 |
| Rate for Payer: Adventist Health Commercial |
$5.58
|
| Rate for Payer: Aetna of CA HMO/PPO |
$16.93
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$23.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15.33
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$20.91
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$13.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$16.37
|
| Rate for Payer: Blue Shield of California Commercial |
$17.03
|
| Rate for Payer: Blue Shield of California EPN |
$11.12
|
| Rate for Payer: Cash Price |
$12.55
|
| Rate for Payer: Central Health Plan Commercial |
$22.30
|
| Rate for Payer: Cigna of CA HMO |
$17.84
|
| Rate for Payer: Cigna of CA PPO |
$20.63
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$23.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$23.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$23.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.15
|
| Rate for Payer: EPIC Health Plan Senior |
$11.15
|
| Rate for Payer: Galaxy Health WC |
$23.70
|
| Rate for Payer: Global Benefits Group Commercial |
$16.73
|
| Rate for Payer: Health Management Network EPO/PPO |
$25.09
|
| Rate for Payer: InnovAge PACE Commercial |
$13.94
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$18.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$17.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.58
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$19.52
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$19.52
|
| Rate for Payer: Multiplan Commercial |
$20.91
|
| Rate for Payer: Networks By Design Commercial |
$18.12
|
| Rate for Payer: Prime Health Services Commercial |
$23.70
|
| Rate for Payer: Riverside University Health System MISP |
$11.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$16.73
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$16.73
|
| Rate for Payer: United Healthcare All Other Commercial |
$13.94
|
| Rate for Payer: United Healthcare All Other HMO |
$13.94
|
| Rate for Payer: United Healthcare HMO Rider |
$13.94
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$13.94
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$23.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$23.70
|
| Rate for Payer: Vantage Medical Group Senior |
$23.70
|
|
|
HC CREATINE KINASE
|
Facility
|
OP
|
$55.09
|
|
|
Service Code
|
CPT 82550
|
| Hospital Charge Code |
900910222
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.27 |
| Max. Negotiated Rate |
$49.58 |
| Rate for Payer: Adventist Health Commercial |
$11.02
|
| Rate for Payer: Adventist Health Medi-Cal |
$6.51
|
| Rate for Payer: Aetna of CA HMO/PPO |
$33.46
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$9.77
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6.51
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$47.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9.68
|
| Rate for Payer: Blue Shield of California Commercial |
$33.44
|
| Rate for Payer: Blue Shield of California EPN |
$21.87
|
| Rate for Payer: Cash Price |
$24.79
|
| Rate for Payer: Cash Price |
$24.79
|
| Rate for Payer: Central Health Plan Commercial |
$44.07
|
| Rate for Payer: Cigna of CA HMO |
$35.26
|
| Rate for Payer: Cigna of CA PPO |
$40.77
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9.77
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.16
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6.51
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.79
|
| Rate for Payer: EPIC Health Plan Senior |
$6.51
|
| Rate for Payer: Galaxy Health WC |
$46.83
|
| Rate for Payer: Global Benefits Group Commercial |
$33.05
|
| Rate for Payer: Health Management Network EPO/PPO |
$49.58
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$10.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$9.96
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6.51
|
| Rate for Payer: InnovAge PACE Commercial |
$9.77
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$36.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.02
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8.72
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8.72
|
| Rate for Payer: Multiplan Commercial |
$41.32
|
| Rate for Payer: Networks By Design Commercial |
$35.81
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$6.51
|
| Rate for Payer: Prime Health Services Commercial |
$46.83
|
| Rate for Payer: Prime Health Services Medicare |
$6.90
|
| Rate for Payer: Riverside University Health System MISP |
$7.16
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$33.05
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$33.05
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.27
|
| Rate for Payer: United Healthcare All Other HMO |
$5.27
|
| Rate for Payer: United Healthcare HMO Rider |
$5.27
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.27
|
| Rate for Payer: Upland Medical Group Pediatric |
$6.51
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$9.77
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.16
|
| Rate for Payer: Vantage Medical Group Senior |
$6.51
|
|
|
HC CREATINE KINASE
|
Facility
|
IP
|
$153.00
|
|
|
Service Code
|
CPT 82550
|
| Hospital Charge Code |
900910222
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$30.60 |
| Max. Negotiated Rate |
$137.70 |
| Rate for Payer: Adventist Health Commercial |
$30.60
|
| Rate for Payer: Cash Price |
$68.85
|
| Rate for Payer: Central Health Plan Commercial |
$122.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$61.20
|
| Rate for Payer: EPIC Health Plan Senior |
$61.20
|
| Rate for Payer: Galaxy Health WC |
$130.05
|
| Rate for Payer: Global Benefits Group Commercial |
$91.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$137.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$102.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$58.29
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$94.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$30.60
|
| Rate for Payer: Multiplan Commercial |
$114.75
|
| Rate for Payer: Networks By Design Commercial |
$99.45
|
| Rate for Payer: Prime Health Services Commercial |
$130.05
|
|
|
HC 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 |
$37.22 |
| Rate for Payer: Adventist Health Commercial |
$6.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$5.12
|
| Rate for Payer: Aetna of CA HMO/PPO |
$20.65
|
| 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 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 HMO/PPO |
$7.55
|
| Rate for Payer: Blue Shield of California Commercial |
$20.64
|
| Rate for Payer: Blue Shield of California EPN |
$13.50
|
| Rate for Payer: Cash Price |
$15.30
|
| Rate for Payer: Cash Price |
$15.30
|
| Rate for Payer: Central Health Plan Commercial |
$27.20
|
| Rate for Payer: Cigna of CA HMO |
$21.76
|
| Rate for Payer: Cigna of CA PPO |
$25.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.63
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.91
|
| Rate for Payer: EPIC Health Plan Senior |
$5.12
|
| Rate for Payer: Galaxy Health WC |
$28.90
|
| Rate for Payer: Global Benefits Group Commercial |
$20.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$30.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$8.40
|
| 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: InnovAge PACE Commercial |
$7.68
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$22.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.19
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.86
|
| Rate for Payer: Multiplan Commercial |
$25.50
|
| Rate for Payer: Networks By Design Commercial |
$22.10
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$5.12
|
| Rate for Payer: Prime Health Services Commercial |
$28.90
|
| Rate for Payer: Prime Health Services Medicare |
$5.43
|
| Rate for Payer: Riverside University Health System MISP |
$5.63
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$20.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$20.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.15
|
| Rate for Payer: United Healthcare All Other HMO |
$4.15
|
| Rate for Payer: United Healthcare HMO Rider |
$4.15
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.15
|
| 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 Medi-Cal |
$5.63
|
| Rate for Payer: Vantage Medical Group Senior |
$5.12
|
|
|
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: EPIC Health Plan Commercial |
$39.20
|
| Rate for Payer: EPIC Health Plan Senior |
$39.20
|
| Rate for Payer: Galaxy Health WC |
$83.30
|
| Rate for Payer: Global Benefits Group Commercial |
$58.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$88.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$65.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$37.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$60.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.60
|
| Rate for Payer: Multiplan Commercial |
$73.50
|
| Rate for Payer: Networks By Design Commercial |
$63.70
|
| Rate for Payer: Prime Health Services Commercial |
$83.30
|
|
|
HC 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: 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 Permanente of CA Commercial/Self Funded |
$84.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$48.39
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$78.61
|
| 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 BODY FLUID
|
Facility
|
OP
|
$50.00
|
|
|
Service Code
|
CPT 82570
|
| Hospital Charge Code |
900910377
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.19 |
| Max. Negotiated Rate |
$45.00 |
| Rate for Payer: Adventist Health Commercial |
$10.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$5.18
|
| Rate for Payer: Aetna of CA HMO/PPO |
$30.36
|
| 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 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 HMO/PPO |
$7.63
|
| Rate for Payer: Blue Shield of California Commercial |
$30.35
|
| Rate for Payer: Blue Shield of California EPN |
$19.85
|
| Rate for Payer: Cash Price |
$22.50
|
| Rate for Payer: Cash Price |
$22.50
|
| Rate for Payer: Central Health Plan Commercial |
$40.00
|
| Rate for Payer: Cigna of CA HMO |
$32.00
|
| Rate for Payer: Cigna of CA PPO |
$37.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.77
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.99
|
| Rate for Payer: EPIC Health Plan Senior |
$5.18
|
| Rate for Payer: Galaxy Health WC |
$42.50
|
| Rate for Payer: Global Benefits Group Commercial |
$30.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$45.00
|
| 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) Medicare Advantage |
$5.18
|
| Rate for Payer: InnovAge PACE Commercial |
$7.77
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$33.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.94
|
| Rate for Payer: Multiplan Commercial |
$37.50
|
| Rate for Payer: Networks By Design Commercial |
$32.50
|
| 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 Medicare |
$5.49
|
| Rate for Payer: Riverside University Health System MISP |
$5.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$30.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$30.00
|
| 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 HMO Rider |
$4.19
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.19
|
| 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 Medi-Cal |
$5.70
|
| Rate for Payer: Vantage Medical Group Senior |
$5.18
|
|
|
HC CREATININE CLEARAN
|
Facility
|
OP
|
$92.00
|
|
|
Service Code
|
CPT 82575
|
| Hospital Charge Code |
900910260
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.66 |
| Max. Negotiated Rate |
$82.80 |
| Rate for Payer: Adventist Health Commercial |
$18.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$9.46
|
| Rate for Payer: Aetna of CA HMO/PPO |
$55.87
|
| 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 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 HMO/PPO |
$13.93
|
| Rate for Payer: Blue Shield of California Commercial |
$55.84
|
| Rate for Payer: Blue Shield of California EPN |
$36.52
|
| Rate for Payer: Cash Price |
$41.40
|
| Rate for Payer: Cash Price |
$41.40
|
| Rate for Payer: Central Health Plan Commercial |
$73.60
|
| Rate for Payer: Cigna of CA HMO |
$58.88
|
| Rate for Payer: Cigna of CA PPO |
$68.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$14.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$10.41
|
| Rate for Payer: Dignity Health Medicare Advantage |
$9.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.77
|
| Rate for Payer: EPIC Health Plan Senior |
$9.46
|
| Rate for Payer: Galaxy Health WC |
$78.20
|
| Rate for Payer: Global Benefits Group Commercial |
$55.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$82.80
|
| 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) Medicare Advantage |
$9.46
|
| Rate for Payer: InnovAge PACE Commercial |
$14.19
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$61.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$15.96
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$12.68
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$12.68
|
| Rate for Payer: Multiplan Commercial |
$69.00
|
| Rate for Payer: Networks By Design Commercial |
$59.80
|
| 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 Medicare |
$10.03
|
| Rate for Payer: Riverside University Health System MISP |
$10.41
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$55.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$55.20
|
| 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 HMO Rider |
$7.66
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.66
|
| 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 Medi-Cal |
$10.41
|
| Rate for Payer: Vantage Medical Group Senior |
$9.46
|
|
|
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: 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 Permanente of CA Commercial/Self Funded |
$174.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$99.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$161.56
|
| 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 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 |
$37.22 |
| Rate for Payer: Adventist Health Commercial |
$6.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$5.12
|
| Rate for Payer: Aetna of CA HMO/PPO |
$20.65
|
| 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 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 HMO/PPO |
$7.55
|
| Rate for Payer: Blue Shield of California Commercial |
$20.64
|
| Rate for Payer: Blue Shield of California EPN |
$13.50
|
| Rate for Payer: Cash Price |
$15.30
|
| Rate for Payer: Cash Price |
$15.30
|
| Rate for Payer: Central Health Plan Commercial |
$27.20
|
| Rate for Payer: Cigna of CA HMO |
$21.76
|
| Rate for Payer: Cigna of CA PPO |
$25.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.63
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.91
|
| Rate for Payer: EPIC Health Plan Senior |
$5.12
|
| Rate for Payer: Galaxy Health WC |
$28.90
|
| Rate for Payer: Global Benefits Group Commercial |
$20.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$30.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$8.40
|
| 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: InnovAge PACE Commercial |
$7.68
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$22.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.19
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.86
|
| Rate for Payer: Multiplan Commercial |
$25.50
|
| Rate for Payer: Networks By Design Commercial |
$22.10
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$5.12
|
| Rate for Payer: Prime Health Services Commercial |
$28.90
|
| Rate for Payer: Prime Health Services Medicare |
$5.43
|
| Rate for Payer: Riverside University Health System MISP |
$5.63
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$20.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$20.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.15
|
| Rate for Payer: United Healthcare All Other HMO |
$4.15
|
| Rate for Payer: United Healthcare HMO Rider |
$4.15
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.15
|
| 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 Medi-Cal |
$5.63
|
| Rate for Payer: Vantage Medical Group Senior |
$5.12
|
|
|
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: EPIC Health Plan Commercial |
$39.20
|
| Rate for Payer: EPIC Health Plan Senior |
$39.20
|
| Rate for Payer: Galaxy Health WC |
$83.30
|
| Rate for Payer: Global Benefits Group Commercial |
$58.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$88.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$65.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$37.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$60.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.60
|
| Rate for Payer: Multiplan Commercial |
$73.50
|
| Rate for Payer: Networks By Design Commercial |
$63.70
|
| Rate for Payer: Prime Health Services Commercial |
$83.30
|
|
|
HC CREATININE URINE 24 HOURS
|
Facility
|
OP
|
$50.00
|
|
|
Service Code
|
CPT 82570
|
| Hospital Charge Code |
900912203
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.19 |
| Max. Negotiated Rate |
$45.00 |
| Rate for Payer: Adventist Health Commercial |
$10.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$5.18
|
| Rate for Payer: Aetna of CA HMO/PPO |
$30.36
|
| 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 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 HMO/PPO |
$7.63
|
| Rate for Payer: Blue Shield of California Commercial |
$30.35
|
| Rate for Payer: Blue Shield of California EPN |
$19.85
|
| Rate for Payer: Cash Price |
$22.50
|
| Rate for Payer: Cash Price |
$22.50
|
| Rate for Payer: Central Health Plan Commercial |
$40.00
|
| Rate for Payer: Cigna of CA HMO |
$32.00
|
| Rate for Payer: Cigna of CA PPO |
$37.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.77
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.99
|
| Rate for Payer: EPIC Health Plan Senior |
$5.18
|
| Rate for Payer: Galaxy Health WC |
$42.50
|
| Rate for Payer: Global Benefits Group Commercial |
$30.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$45.00
|
| 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) Medicare Advantage |
$5.18
|
| Rate for Payer: InnovAge PACE Commercial |
$7.77
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$33.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.94
|
| Rate for Payer: Multiplan Commercial |
$37.50
|
| Rate for Payer: Networks By Design Commercial |
$32.50
|
| 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 Medicare |
$5.49
|
| Rate for Payer: Riverside University Health System MISP |
$5.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$30.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$30.00
|
| 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 HMO Rider |
$4.19
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.19
|
| 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 Medi-Cal |
$5.70
|
| 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: 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 Permanente of CA Commercial/Self Funded |
$84.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$48.39
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$78.61
|
| 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
|
$32.93
|
|
|
Service Code
|
CPT 82570
|
| Hospital Charge Code |
900912202
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.19 |
| Max. Negotiated Rate |
$37.61 |
| Rate for Payer: Adventist Health Commercial |
$6.59
|
| Rate for Payer: Adventist Health Medi-Cal |
$5.18
|
| Rate for Payer: Aetna of CA HMO/PPO |
$20.00
|
| 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 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 HMO/PPO |
$7.63
|
| Rate for Payer: Blue Shield of California Commercial |
$19.99
|
| Rate for Payer: Blue Shield of California EPN |
$13.07
|
| Rate for Payer: Cash Price |
$14.82
|
| Rate for Payer: Cash Price |
$14.82
|
| Rate for Payer: Central Health Plan Commercial |
$26.34
|
| Rate for Payer: Cigna of CA HMO |
$21.08
|
| Rate for Payer: Cigna of CA PPO |
$24.37
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.77
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.99
|
| Rate for Payer: EPIC Health Plan Senior |
$5.18
|
| Rate for Payer: Galaxy Health WC |
$27.99
|
| Rate for Payer: Global Benefits Group Commercial |
$19.76
|
| Rate for Payer: Health Management Network EPO/PPO |
$29.64
|
| 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) Medicare Advantage |
$5.18
|
| Rate for Payer: InnovAge PACE Commercial |
$7.77
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$21.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.59
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.94
|
| Rate for Payer: Multiplan Commercial |
$24.70
|
| Rate for Payer: Networks By Design Commercial |
$21.40
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$5.18
|
| Rate for Payer: Prime Health Services Commercial |
$27.99
|
| Rate for Payer: Prime Health Services Medicare |
$5.49
|
| Rate for Payer: Riverside University Health System MISP |
$5.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$19.76
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$19.76
|
| 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 HMO Rider |
$4.19
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.19
|
| 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 Medi-Cal |
$5.70
|
| Rate for Payer: Vantage Medical Group Senior |
$5.18
|
|
|
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: 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 Permanente of CA Commercial/Self Funded |
$84.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$48.39
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$78.61
|
| 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 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 |
$5,059.42
|
| 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 |
$4,892.80
|
| 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: 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: InnovAge PACE Commercial |
$4,165.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,556.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$111.91
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,156.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,666.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,831.70
|
| Rate for Payer: Molina Healthcare of CA 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
|
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: 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 Permanente of CA Commercial/Self Funded |
$5,556.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,174.11
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,156.89
|
| 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 |
$2,582.00
|
| 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: 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: InnovAge PACE Commercial |
$4,165.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,556.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$111.91
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,156.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,666.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,831.70
|
| Rate for Payer: Molina Healthcare of CA 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
|
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: 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 Permanente of CA Commercial/Self Funded |
$5,556.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,174.11
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,156.89
|
| 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
|
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 |
$10,124.30
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,605.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,177.68
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,070.62
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,572.00
|
| 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 |
$1,605.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,177.68
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,070.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,445.34
|
| Rate for Payer: EPIC Health Plan Senior |
$1,070.62
|
| 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 |
$1,755.82
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,070.62
|
| Rate for Payer: InnovAge PACE Commercial |
$1,605.93
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11,119.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$231.04
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,070.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,334.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,434.63
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,434.63
|
| 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 |
$1,070.62
|
| 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 |
$1,134.86
|
| Rate for Payer: Prime Health Services WC |
$1,688.44
|
| Rate for Payer: Riverside University Health System MISP |
$1,177.68
|
| 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 |
$1,070.62
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,605.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,177.68
|
| Rate for Payer: Vantage Medical Group Senior |
$1,070.62
|
|
|
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 |
$1,605.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,177.68
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,070.62
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,582.00
|
| 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 |
$1,605.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,177.68
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,070.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,445.34
|
| Rate for Payer: EPIC Health Plan Senior |
$1,070.62
|
| 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 |
$1,755.82
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,070.62
|
| Rate for Payer: InnovAge PACE Commercial |
$1,605.93
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11,119.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$231.04
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,070.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,334.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,434.63
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,434.63
|
| 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 |
$1,070.62
|
| 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 |
$1,134.86
|
| Rate for Payer: Prime Health Services WC |
$1,688.44
|
| Rate for Payer: Riverside University Health System MISP |
$1,177.68
|
| 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 |
$1,070.62
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,605.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,177.68
|
| Rate for Payer: Vantage Medical Group Senior |
$1,070.62
|
|
|
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: 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 Permanente of CA Commercial/Self Funded |
$11,119.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6,351.65
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10,319.35
|
| 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
|
|
