|
HC BX OF PLEURA PERC NEEDLE
|
Facility
|
OP
|
$4,836.00
|
|
|
Service Code
|
CPT 32400
|
| Hospital Charge Code |
900831706
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$254.66 |
| Max. Negotiated Rate |
$7,027.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$2,025.69
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,038.54
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,228.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,025.69
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: Blue Distinction Transplant |
$2,901.60
|
| Rate for Payer: Blue Shield of California Commercial |
$3,079.84
|
| Rate for Payer: Blue Shield of California EPN |
$2,212.08
|
| Rate for Payer: Caremore Medicare Advantage |
$2,025.69
|
| Rate for Payer: Cash Price |
$2,176.20
|
| Rate for Payer: Cash Price |
$2,176.20
|
| Rate for Payer: Central Health Plan Commercial |
$3,868.80
|
| Rate for Payer: Cigna of CA PPO |
$3,578.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,038.54
|
| Rate for Payer: Dignity Health Media |
$2,025.69
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,228.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,734.68
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,025.69
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,025.69
|
| Rate for Payer: Galaxy Health WC |
$4,110.60
|
| Rate for Payer: Global Benefits Group Commercial |
$2,901.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,352.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$3,627.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,322.13
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3,342.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,025.69
|
| Rate for Payer: InnovAge PACE Commercial |
$3,038.54
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,225.61
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$254.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,025.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$967.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,714.42
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,714.42
|
| Rate for Payer: Multiplan Commercial |
$3,627.00
|
| Rate for Payer: Networks By Design Commercial |
$3,143.40
|
| Rate for Payer: Prime Health Services Commercial |
$4,110.60
|
| Rate for Payer: Prime Health Services Medicare |
$2,147.23
|
| Rate for Payer: Riverside University Health System MISP |
$2,228.26
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,901.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,893.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,027.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,217.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,038.54
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,228.26
|
| Rate for Payer: Vantage Medical Group Senior |
$2,025.69
|
|
|
HC BX SALIVARY GLAND; NEEDLE
|
Facility
|
OP
|
$2,902.00
|
|
|
Service Code
|
CPT 42400
|
| Hospital Charge Code |
900501748
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$95.49 |
| Max. Negotiated Rate |
$4,846.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$879.07
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,318.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$966.98
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$879.07
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: Blue Distinction Transplant |
$1,741.20
|
| Rate for Payer: Blue Shield of California Commercial |
$951.13
|
| Rate for Payer: Blue Shield of California EPN |
$683.14
|
| Rate for Payer: Caremore Medicare Advantage |
$879.07
|
| Rate for Payer: Cash Price |
$1,305.90
|
| Rate for Payer: Cash Price |
$1,305.90
|
| Rate for Payer: Central Health Plan Commercial |
$2,321.60
|
| Rate for Payer: Cigna of CA PPO |
$2,147.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,318.60
|
| Rate for Payer: Dignity Health Media |
$879.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$966.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,186.74
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$879.07
|
| Rate for Payer: EPIC Health Plan Transplant |
$879.07
|
| Rate for Payer: Galaxy Health WC |
$2,466.70
|
| Rate for Payer: Global Benefits Group Commercial |
$1,741.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,611.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$2,176.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,441.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,450.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$879.07
|
| Rate for Payer: InnovAge PACE Commercial |
$1,318.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,935.63
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$95.49
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$879.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$580.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,177.95
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,177.95
|
| Rate for Payer: Multiplan Commercial |
$2,176.50
|
| Rate for Payer: Networks By Design Commercial |
$1,886.30
|
| Rate for Payer: Prime Health Services Commercial |
$2,466.70
|
| Rate for Payer: Prime Health Services Medicare |
$931.81
|
| Rate for Payer: Riverside University Health System MISP |
$966.98
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,741.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,121.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,248.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,468.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,257.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,318.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$966.98
|
| Rate for Payer: Vantage Medical Group Senior |
$879.07
|
|
|
HC BX SALIVARY GLAND; NEEDLE
|
Facility
|
IP
|
$2,902.00
|
|
|
Service Code
|
CPT 42400
|
| Hospital Charge Code |
900501748
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$580.40 |
| Max. Negotiated Rate |
$2,611.80 |
| Rate for Payer: Cash Price |
$1,305.90
|
| Rate for Payer: Central Health Plan Commercial |
$2,321.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,160.80
|
| Rate for Payer: Galaxy Health WC |
$2,466.70
|
| Rate for Payer: Global Benefits Group Commercial |
$1,741.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,611.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,935.63
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,105.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$580.40
|
| Rate for Payer: Multiplan Commercial |
$2,176.50
|
| Rate for Payer: Networks By Design Commercial |
$1,886.30
|
| Rate for Payer: Prime Health Services Commercial |
$2,466.70
|
|
|
HC BX SALIVARY GLAND; NEEDLE
|
Facility
|
IP
|
$2,902.00
|
|
|
Service Code
|
CPT 42400
|
| Hospital Charge Code |
900501748
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$580.40 |
| Max. Negotiated Rate |
$2,611.80 |
| Rate for Payer: Cash Price |
$1,305.90
|
| Rate for Payer: Central Health Plan Commercial |
$2,321.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,160.80
|
| Rate for Payer: Galaxy Health WC |
$2,466.70
|
| Rate for Payer: Global Benefits Group Commercial |
$1,741.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,611.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,935.63
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,105.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$580.40
|
| Rate for Payer: Multiplan Commercial |
$2,176.50
|
| Rate for Payer: Networks By Design Commercial |
$1,886.30
|
| Rate for Payer: Prime Health Services Commercial |
$2,466.70
|
|
|
HC BX SALIVARY GLAND; NEEDLE
|
Facility
|
OP
|
$2,902.00
|
|
|
Service Code
|
CPT 42400
|
| Hospital Charge Code |
900501748
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$95.49 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,318.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$966.98
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$879.07
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: Blue Distinction Transplant |
$1,741.20
|
| Rate for Payer: Caremore Medicare Advantage |
$879.07
|
| Rate for Payer: Cash Price |
$1,305.90
|
| Rate for Payer: Cash Price |
$1,305.90
|
| Rate for Payer: Cash Price |
$1,305.90
|
| Rate for Payer: Cash Price |
$1,305.90
|
| Rate for Payer: Central Health Plan Commercial |
$2,321.60
|
| Rate for Payer: Cigna of CA PPO |
$2,147.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,318.60
|
| Rate for Payer: Dignity Health Media |
$879.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$966.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,186.74
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$879.07
|
| Rate for Payer: EPIC Health Plan Transplant |
$879.07
|
| Rate for Payer: Galaxy Health WC |
$2,466.70
|
| Rate for Payer: Global Benefits Group Commercial |
$1,741.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,611.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$2,176.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,441.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$879.07
|
| Rate for Payer: InnovAge PACE Commercial |
$1,318.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,935.63
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$95.49
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$879.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$580.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,177.95
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,177.95
|
| Rate for Payer: Multiplan Commercial |
$2,176.50
|
| Rate for Payer: Networks By Design Commercial |
$1,886.30
|
| Rate for Payer: Prime Health Services Commercial |
$2,466.70
|
| Rate for Payer: Prime Health Services Medicare |
$931.81
|
| Rate for Payer: Riverside University Health System MISP |
$966.98
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,741.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,451.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,451.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,451.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,451.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,318.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$966.98
|
| Rate for Payer: Vantage Medical Group Senior |
$879.07
|
|
|
HC C-14 UREA BREATH TEST ACQ
|
Facility
|
OP
|
$580.00
|
|
|
Service Code
|
CPT 78267
|
| Hospital Charge Code |
909301257
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$11.06 |
| Max. Negotiated Rate |
$522.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$11.06
|
| Rate for Payer: Aetna of CA HMO/PPO |
$63.01
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$16.59
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$12.17
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11.06
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$56.91
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$342.66
|
| Rate for Payer: Blue Distinction Transplant |
$348.00
|
| Rate for Payer: Blue Shield of California Commercial |
$358.44
|
| Rate for Payer: Blue Shield of California EPN |
$281.88
|
| Rate for Payer: Caremore Medicare Advantage |
$11.06
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Central Health Plan Commercial |
$464.00
|
| Rate for Payer: Cigna of CA HMO |
$371.20
|
| Rate for Payer: Cigna of CA PPO |
$429.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$16.59
|
| Rate for Payer: Dignity Health Media |
$11.06
|
| Rate for Payer: Dignity Health Medi-Cal |
$12.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.93
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$11.06
|
| Rate for Payer: EPIC Health Plan Transplant |
$11.06
|
| Rate for Payer: Galaxy Health WC |
$493.00
|
| Rate for Payer: Global Benefits Group Commercial |
$348.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$522.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$435.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$18.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$18.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$11.06
|
| Rate for Payer: InnovAge PACE Commercial |
$16.59
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$386.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$220.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$11.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$116.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$14.82
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14.82
|
| Rate for Payer: Multiplan Commercial |
$435.00
|
| Rate for Payer: Networks By Design Commercial |
$377.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
| Rate for Payer: Prime Health Services Medicare |
$11.72
|
| Rate for Payer: Riverside University Health System MISP |
$12.17
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$348.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$348.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$28.51
|
| Rate for Payer: United Healthcare All Other HMO |
$28.51
|
| Rate for Payer: United Healthcare HMO Rider |
$28.51
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$28.51
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$16.59
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$12.17
|
| Rate for Payer: Vantage Medical Group Senior |
$11.06
|
|
|
HC C-14 UREA BREATH TEST ACQ
|
Facility
|
IP
|
$580.00
|
|
|
Service Code
|
CPT 78267
|
| Hospital Charge Code |
909301257
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$522.00 |
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Central Health Plan Commercial |
$464.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: Galaxy Health WC |
$493.00
|
| Rate for Payer: Global Benefits Group Commercial |
$348.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$522.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$386.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$220.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$116.00
|
| Rate for Payer: Multiplan Commercial |
$435.00
|
| Rate for Payer: Networks By Design Commercial |
$377.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
|
|
HC C-14 UREA BREATH TEST ANAL
|
Facility
|
OP
|
$562.00
|
|
|
Service Code
|
CPT 78268
|
| Hospital Charge Code |
909301258
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$94.41 |
| Max. Negotiated Rate |
$532.95 |
| Rate for Payer: Adventist Health Medi-Cal |
$94.41
|
| Rate for Payer: Aetna of CA HMO/PPO |
$532.95
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$141.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$103.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$94.41
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$465.38
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$332.03
|
| Rate for Payer: Blue Distinction Transplant |
$337.20
|
| Rate for Payer: Blue Shield of California Commercial |
$347.32
|
| Rate for Payer: Blue Shield of California EPN |
$273.13
|
| Rate for Payer: Caremore Medicare Advantage |
$94.41
|
| Rate for Payer: Cash Price |
$252.90
|
| Rate for Payer: Cash Price |
$252.90
|
| Rate for Payer: Central Health Plan Commercial |
$449.60
|
| Rate for Payer: Cigna of CA HMO |
$359.68
|
| Rate for Payer: Cigna of CA PPO |
$415.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$141.62
|
| Rate for Payer: Dignity Health Media |
$94.41
|
| Rate for Payer: Dignity Health Medi-Cal |
$103.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$127.45
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$94.41
|
| Rate for Payer: EPIC Health Plan Transplant |
$94.41
|
| Rate for Payer: Galaxy Health WC |
$477.70
|
| Rate for Payer: Global Benefits Group Commercial |
$337.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$505.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$421.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$154.83
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$155.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$94.41
|
| Rate for Payer: InnovAge PACE Commercial |
$141.62
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$374.85
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$214.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$94.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$112.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$126.51
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$126.51
|
| Rate for Payer: Multiplan Commercial |
$421.50
|
| Rate for Payer: Networks By Design Commercial |
$365.30
|
| Rate for Payer: Prime Health Services Commercial |
$477.70
|
| Rate for Payer: Prime Health Services Medicare |
$100.07
|
| Rate for Payer: Riverside University Health System MISP |
$103.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$337.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$337.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$244.22
|
| Rate for Payer: United Healthcare All Other HMO |
$244.22
|
| Rate for Payer: United Healthcare HMO Rider |
$244.22
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$244.22
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$141.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$103.85
|
| Rate for Payer: Vantage Medical Group Senior |
$94.41
|
|
|
HC C-14 UREA BREATH TEST ANAL
|
Facility
|
IP
|
$562.00
|
|
|
Service Code
|
CPT 78268
|
| Hospital Charge Code |
909301258
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$112.40 |
| Max. Negotiated Rate |
$505.80 |
| Rate for Payer: Cash Price |
$252.90
|
| Rate for Payer: Central Health Plan Commercial |
$449.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$224.80
|
| Rate for Payer: Galaxy Health WC |
$477.70
|
| Rate for Payer: Global Benefits Group Commercial |
$337.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$505.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$374.85
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$214.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$112.40
|
| Rate for Payer: Multiplan Commercial |
$421.50
|
| Rate for Payer: Networks By Design Commercial |
$365.30
|
| Rate for Payer: Prime Health Services Commercial |
$477.70
|
|
|
HC CABLE MED COAXIAL UMBILICAL
|
Facility
|
OP
|
$644.00
|
|
| Hospital Charge Code |
906812449
|
|
Hospital Revenue Code
|
279
|
| Min. Negotiated Rate |
$128.80 |
| Max. Negotiated Rate |
$579.60 |
| Rate for Payer: Aetna of CA HMO/PPO |
$391.10
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$547.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$354.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$354.20
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$311.82
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$380.48
|
| Rate for Payer: Blue Distinction Transplant |
$386.40
|
| Rate for Payer: Blue Shield of California Commercial |
$405.08
|
| Rate for Payer: Blue Shield of California EPN |
$314.92
|
| Rate for Payer: Cash Price |
$289.80
|
| Rate for Payer: Central Health Plan Commercial |
$515.20
|
| Rate for Payer: Cigna of CA HMO |
$412.16
|
| Rate for Payer: Cigna of CA PPO |
$476.56
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$547.40
|
| Rate for Payer: Dignity Health Media |
$547.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$547.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$257.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$257.60
|
| Rate for Payer: Galaxy Health WC |
$547.40
|
| Rate for Payer: Global Benefits Group Commercial |
$386.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$579.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$483.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$225.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$429.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$245.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$128.80
|
| Rate for Payer: Multiplan Commercial |
$483.00
|
| Rate for Payer: Networks By Design Commercial |
$418.60
|
| Rate for Payer: Prime Health Services Commercial |
$547.40
|
| Rate for Payer: Riverside University Health System MISP |
$257.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$386.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$386.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$322.00
|
| Rate for Payer: United Healthcare All Other HMO |
$322.00
|
| Rate for Payer: United Healthcare HMO Rider |
$322.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$322.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$547.40
|
| Rate for Payer: Vantage Medical Group Senior |
$547.40
|
|
|
HC CABLE MED COAXIAL UMBILICAL
|
Facility
|
IP
|
$644.00
|
|
| Hospital Charge Code |
906812449
|
|
Hospital Revenue Code
|
279
|
| Min. Negotiated Rate |
$128.80 |
| Max. Negotiated Rate |
$579.60 |
| Rate for Payer: Cash Price |
$289.80
|
| Rate for Payer: Central Health Plan Commercial |
$515.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$257.60
|
| Rate for Payer: Galaxy Health WC |
$547.40
|
| Rate for Payer: Global Benefits Group Commercial |
$386.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$579.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$429.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$245.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$128.80
|
| Rate for Payer: Multiplan Commercial |
$483.00
|
| Rate for Payer: Networks By Design Commercial |
$418.60
|
| Rate for Payer: Prime Health Services Commercial |
$547.40
|
|
|
HC CABLE MED ELECTRICAL UMBILICAL
|
Facility
|
IP
|
$966.00
|
|
| Hospital Charge Code |
906812448
|
|
Hospital Revenue Code
|
279
|
| Min. Negotiated Rate |
$193.20 |
| Max. Negotiated Rate |
$869.40 |
| Rate for Payer: Cash Price |
$434.70
|
| Rate for Payer: Central Health Plan Commercial |
$772.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$386.40
|
| Rate for Payer: Galaxy Health WC |
$821.10
|
| Rate for Payer: Global Benefits Group Commercial |
$579.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$869.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$644.32
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$368.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$193.20
|
| Rate for Payer: Multiplan Commercial |
$724.50
|
| Rate for Payer: Networks By Design Commercial |
$627.90
|
| Rate for Payer: Prime Health Services Commercial |
$821.10
|
|
|
HC CABLE MED ELECTRICAL UMBILICAL
|
Facility
|
OP
|
$966.00
|
|
| Hospital Charge Code |
906812448
|
|
Hospital Revenue Code
|
279
|
| Min. Negotiated Rate |
$193.20 |
| Max. Negotiated Rate |
$869.40 |
| Rate for Payer: Aetna of CA HMO/PPO |
$586.65
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$821.10
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$531.30
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$531.30
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$467.74
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$570.71
|
| Rate for Payer: Blue Distinction Transplant |
$579.60
|
| Rate for Payer: Blue Shield of California Commercial |
$607.61
|
| Rate for Payer: Blue Shield of California EPN |
$472.37
|
| Rate for Payer: Cash Price |
$434.70
|
| Rate for Payer: Central Health Plan Commercial |
$772.80
|
| Rate for Payer: Cigna of CA HMO |
$618.24
|
| Rate for Payer: Cigna of CA PPO |
$714.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$821.10
|
| Rate for Payer: Dignity Health Media |
$821.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$821.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$386.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$386.40
|
| Rate for Payer: Galaxy Health WC |
$821.10
|
| Rate for Payer: Global Benefits Group Commercial |
$579.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$869.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$724.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$338.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$644.32
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$368.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$193.20
|
| Rate for Payer: Multiplan Commercial |
$724.50
|
| Rate for Payer: Networks By Design Commercial |
$627.90
|
| Rate for Payer: Prime Health Services Commercial |
$821.10
|
| Rate for Payer: Riverside University Health System MISP |
$386.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$579.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$579.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$483.00
|
| Rate for Payer: United Healthcare All Other HMO |
$483.00
|
| Rate for Payer: United Healthcare HMO Rider |
$483.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$483.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$821.10
|
| Rate for Payer: Vantage Medical Group Senior |
$821.10
|
|
|
HC CA CALCIUM IONIZED
|
Facility
|
OP
|
$45.00
|
|
|
Service Code
|
CPT 82330
|
| Hospital Charge Code |
900910502
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.00 |
| Max. Negotiated Rate |
$121.27 |
| Rate for Payer: Adventist Health Medi-Cal |
$13.68
|
| Rate for Payer: Aetna of CA HMO/PPO |
$100.32
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20.52
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13.68
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$99.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$121.27
|
| Rate for Payer: Blue Distinction Transplant |
$27.00
|
| Rate for Payer: Blue Shield of California Commercial |
$27.81
|
| Rate for Payer: Blue Shield of California EPN |
$21.87
|
| Rate for Payer: Caremore Medicare Advantage |
$13.68
|
| Rate for Payer: Cash Price |
$20.25
|
| Rate for Payer: Cash Price |
$20.25
|
| Rate for Payer: Central Health Plan Commercial |
$36.00
|
| Rate for Payer: Cigna of CA HMO |
$28.80
|
| Rate for Payer: Cigna of CA PPO |
$33.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20.52
|
| Rate for Payer: Dignity Health Media |
$13.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$15.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$18.47
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$13.68
|
| Rate for Payer: EPIC Health Plan Transplant |
$13.68
|
| Rate for Payer: Galaxy Health WC |
$38.25
|
| Rate for Payer: Global Benefits Group Commercial |
$27.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$40.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$33.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$22.44
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$22.57
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13.68
|
| Rate for Payer: InnovAge PACE Commercial |
$20.52
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$30.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$23.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18.33
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18.33
|
| Rate for Payer: Multiplan Commercial |
$33.75
|
| Rate for Payer: Networks By Design Commercial |
$29.25
|
| Rate for Payer: Prime Health Services Commercial |
$38.25
|
| Rate for Payer: Prime Health Services Medicare |
$14.50
|
| Rate for Payer: Riverside University Health System MISP |
$15.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$27.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$27.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$11.08
|
| Rate for Payer: United Healthcare All Other HMO |
$11.08
|
| Rate for Payer: United Healthcare HMO Rider |
$11.08
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15.05
|
| Rate for Payer: Vantage Medical Group Senior |
$13.68
|
|
|
HC CA CALCIUM IONIZED
|
Facility
|
IP
|
$342.00
|
|
|
Service Code
|
CPT 82330
|
| Hospital Charge Code |
900910502
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$68.40 |
| Max. Negotiated Rate |
$307.80 |
| Rate for Payer: Cash Price |
$153.90
|
| Rate for Payer: Central Health Plan Commercial |
$273.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$136.80
|
| Rate for Payer: Galaxy Health WC |
$290.70
|
| Rate for Payer: Global Benefits Group Commercial |
$205.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$307.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$228.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$130.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$68.40
|
| Rate for Payer: Multiplan Commercial |
$256.50
|
| Rate for Payer: Networks By Design Commercial |
$222.30
|
| Rate for Payer: Prime Health Services Commercial |
$290.70
|
|
|
HC CAFFEINE SERUM
|
Facility
|
OP
|
$44.00
|
|
|
Service Code
|
CPT 80299
|
| Hospital Charge Code |
900910538
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.80 |
| Max. Negotiated Rate |
$129.22 |
| Rate for Payer: Adventist Health Medi-Cal |
$18.64
|
| Rate for Payer: Aetna of CA HMO/PPO |
$97.19
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$27.96
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$20.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$18.64
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$105.94
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$129.22
|
| Rate for Payer: Blue Distinction Transplant |
$26.40
|
| Rate for Payer: Blue Shield of California Commercial |
$27.19
|
| Rate for Payer: Blue Shield of California EPN |
$21.38
|
| Rate for Payer: Caremore Medicare Advantage |
$18.64
|
| Rate for Payer: Cash Price |
$19.80
|
| Rate for Payer: Cash Price |
$19.80
|
| Rate for Payer: Central Health Plan Commercial |
$35.20
|
| Rate for Payer: Cigna of CA HMO |
$28.16
|
| Rate for Payer: Cigna of CA PPO |
$32.56
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$27.96
|
| Rate for Payer: Dignity Health Media |
$18.64
|
| Rate for Payer: Dignity Health Medi-Cal |
$20.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$25.16
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$18.64
|
| Rate for Payer: EPIC Health Plan Transplant |
$18.64
|
| Rate for Payer: Galaxy Health WC |
$37.40
|
| Rate for Payer: Global Benefits Group Commercial |
$26.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$39.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$33.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$30.57
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$30.76
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$18.64
|
| Rate for Payer: InnovAge PACE Commercial |
$27.96
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$29.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$23.92
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$24.98
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$24.98
|
| Rate for Payer: Multiplan Commercial |
$33.00
|
| Rate for Payer: Networks By Design Commercial |
$28.60
|
| Rate for Payer: Prime Health Services Commercial |
$37.40
|
| Rate for Payer: Prime Health Services Medicare |
$19.76
|
| Rate for Payer: Riverside University Health System MISP |
$20.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$26.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$26.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$15.10
|
| Rate for Payer: United Healthcare All Other HMO |
$15.10
|
| Rate for Payer: United Healthcare HMO Rider |
$15.10
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15.10
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$27.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$20.50
|
| Rate for Payer: Vantage Medical Group Senior |
$18.64
|
|
|
HC CAFFEINE SERUM
|
Facility
|
IP
|
$162.00
|
|
|
Service Code
|
CPT 80299
|
| Hospital Charge Code |
900910538
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$32.40 |
| Max. Negotiated Rate |
$145.80 |
| Rate for Payer: Cash Price |
$72.90
|
| Rate for Payer: Central Health Plan Commercial |
$129.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$64.80
|
| Rate for Payer: Galaxy Health WC |
$137.70
|
| Rate for Payer: Global Benefits Group Commercial |
$97.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$145.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$108.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$61.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$32.40
|
| Rate for Payer: Multiplan Commercial |
$121.50
|
| Rate for Payer: Networks By Design Commercial |
$105.30
|
| Rate for Payer: Prime Health Services Commercial |
$137.70
|
|
|
HC CA IONIZED (POC)
|
Facility
|
OP
|
$292.00
|
|
|
Service Code
|
CPT 82330
|
| Hospital Charge Code |
900912118
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.08 |
| Max. Negotiated Rate |
$262.80 |
| Rate for Payer: Adventist Health Medi-Cal |
$13.68
|
| Rate for Payer: Aetna of CA HMO/PPO |
$100.32
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20.52
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13.68
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$99.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$121.27
|
| Rate for Payer: Blue Distinction Transplant |
$175.20
|
| Rate for Payer: Blue Shield of California Commercial |
$180.46
|
| Rate for Payer: Blue Shield of California EPN |
$141.91
|
| Rate for Payer: Caremore Medicare Advantage |
$13.68
|
| Rate for Payer: Cash Price |
$131.40
|
| Rate for Payer: Cash Price |
$131.40
|
| Rate for Payer: Central Health Plan Commercial |
$233.60
|
| Rate for Payer: Cigna of CA HMO |
$186.88
|
| Rate for Payer: Cigna of CA PPO |
$216.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20.52
|
| Rate for Payer: Dignity Health Media |
$13.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$15.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$18.47
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$13.68
|
| Rate for Payer: EPIC Health Plan Transplant |
$13.68
|
| Rate for Payer: Galaxy Health WC |
$248.20
|
| Rate for Payer: Global Benefits Group Commercial |
$175.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$262.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$219.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$22.44
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$22.57
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13.68
|
| Rate for Payer: InnovAge PACE Commercial |
$20.52
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$194.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$23.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$58.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18.33
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18.33
|
| Rate for Payer: Multiplan Commercial |
$219.00
|
| Rate for Payer: Networks By Design Commercial |
$189.80
|
| Rate for Payer: Prime Health Services Commercial |
$248.20
|
| Rate for Payer: Prime Health Services Medicare |
$14.50
|
| Rate for Payer: Riverside University Health System MISP |
$15.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$175.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$175.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$11.08
|
| Rate for Payer: United Healthcare All Other HMO |
$11.08
|
| Rate for Payer: United Healthcare HMO Rider |
$11.08
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15.05
|
| Rate for Payer: Vantage Medical Group Senior |
$13.68
|
|
|
HC CA IONIZED (POC)
|
Facility
|
IP
|
$292.00
|
|
|
Service Code
|
CPT 82330
|
| Hospital Charge Code |
900912118
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$58.40 |
| Max. Negotiated Rate |
$262.80 |
| Rate for Payer: Cash Price |
$131.40
|
| Rate for Payer: Central Health Plan Commercial |
$233.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$116.80
|
| Rate for Payer: Galaxy Health WC |
$248.20
|
| Rate for Payer: Global Benefits Group Commercial |
$175.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$262.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$194.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$111.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$58.40
|
| Rate for Payer: Multiplan Commercial |
$219.00
|
| Rate for Payer: Networks By Design Commercial |
$189.80
|
| Rate for Payer: Prime Health Services Commercial |
$248.20
|
|
|
HC C ALBICANS OR C TROPICALIS NAT
|
Facility
|
IP
|
$109.00
|
|
|
Service Code
|
CPT 87481
|
| Hospital Charge Code |
900912492
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$21.80 |
| Max. Negotiated Rate |
$98.10 |
| Rate for Payer: Cash Price |
$49.05
|
| Rate for Payer: Central Health Plan Commercial |
$87.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$43.60
|
| Rate for Payer: Galaxy Health WC |
$92.65
|
| Rate for Payer: Global Benefits Group Commercial |
$65.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$98.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$72.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$41.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$21.80
|
| Rate for Payer: Multiplan Commercial |
$81.75
|
| Rate for Payer: Networks By Design Commercial |
$70.85
|
| Rate for Payer: Prime Health Services Commercial |
$92.65
|
|
|
HC C ALBICANS OR C TROPICALIS NAT
|
Facility
|
OP
|
$78.00
|
|
|
Service Code
|
CPT 87481
|
| Hospital Charge Code |
900912492
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$15.60 |
| Max. Negotiated Rate |
$301.33 |
| Rate for Payer: Adventist Health Medi-Cal |
$35.09
|
| Rate for Payer: Aetna of CA HMO/PPO |
$257.58
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$52.64
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$38.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$35.09
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$247.04
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$301.33
|
| Rate for Payer: Blue Distinction Transplant |
$46.80
|
| Rate for Payer: Blue Shield of California Commercial |
$48.20
|
| Rate for Payer: Blue Shield of California EPN |
$37.91
|
| Rate for Payer: Caremore Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$35.10
|
| Rate for Payer: Cash Price |
$35.10
|
| Rate for Payer: Central Health Plan Commercial |
$62.40
|
| Rate for Payer: Cigna of CA HMO |
$49.92
|
| Rate for Payer: Cigna of CA PPO |
$57.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$52.64
|
| Rate for Payer: Dignity Health Media |
$35.09
|
| Rate for Payer: Dignity Health Medi-Cal |
$38.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$47.37
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$35.09
|
| Rate for Payer: EPIC Health Plan Transplant |
$35.09
|
| Rate for Payer: Galaxy Health WC |
$66.30
|
| Rate for Payer: Global Benefits Group Commercial |
$46.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$70.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$58.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$57.55
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$57.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$35.09
|
| Rate for Payer: InnovAge PACE Commercial |
$52.64
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$52.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$59.26
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$35.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$47.02
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$47.02
|
| Rate for Payer: Multiplan Commercial |
$58.50
|
| Rate for Payer: Networks By Design Commercial |
$50.70
|
| Rate for Payer: Prime Health Services Commercial |
$66.30
|
| Rate for Payer: Prime Health Services Medicare |
$37.20
|
| Rate for Payer: Riverside University Health System MISP |
$38.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$46.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$46.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$28.42
|
| Rate for Payer: United Healthcare All Other HMO |
$28.42
|
| Rate for Payer: United Healthcare HMO Rider |
$28.42
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$28.42
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$52.64
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$38.60
|
| Rate for Payer: Vantage Medical Group Senior |
$35.09
|
|
|
HC CALCIUM TOTAL
|
Facility
|
OP
|
$15.00
|
|
|
Service Code
|
CPT 82310
|
| Hospital Charge Code |
900910239
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.00 |
| Max. Negotiated Rate |
$45.64 |
| Rate for Payer: Adventist Health Medi-Cal |
$5.16
|
| Rate for Payer: Aetna of CA HMO/PPO |
$37.86
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.74
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.68
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.16
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$37.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$45.64
|
| Rate for Payer: Blue Distinction Transplant |
$9.00
|
| Rate for Payer: Blue Shield of California Commercial |
$9.27
|
| Rate for Payer: Blue Shield of California EPN |
$7.29
|
| Rate for Payer: Caremore Medicare Advantage |
$5.16
|
| Rate for Payer: Cash Price |
$6.75
|
| Rate for Payer: Cash Price |
$6.75
|
| Rate for Payer: Central Health Plan Commercial |
$12.00
|
| Rate for Payer: Cigna of CA HMO |
$9.60
|
| Rate for Payer: Cigna of CA PPO |
$11.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.74
|
| Rate for Payer: Dignity Health Media |
$5.16
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.97
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$5.16
|
| Rate for Payer: EPIC Health Plan Transplant |
$5.16
|
| Rate for Payer: Galaxy Health WC |
$12.75
|
| Rate for Payer: Global Benefits Group Commercial |
$9.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$13.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$11.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$8.46
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$8.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.16
|
| Rate for Payer: InnovAge PACE Commercial |
$7.74
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7.79
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.91
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.91
|
| Rate for Payer: Multiplan Commercial |
$11.25
|
| Rate for Payer: Networks By Design Commercial |
$9.75
|
| Rate for Payer: Prime Health Services Commercial |
$12.75
|
| Rate for Payer: Prime Health Services Medicare |
$5.47
|
| Rate for Payer: Riverside University Health System MISP |
$5.68
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.18
|
| Rate for Payer: United Healthcare All Other HMO |
$4.18
|
| Rate for Payer: United Healthcare HMO Rider |
$4.18
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.18
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.74
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.68
|
| Rate for Payer: Vantage Medical Group Senior |
$5.16
|
|
|
HC CALCIUM TOTAL
|
Facility
|
IP
|
$89.00
|
|
|
Service Code
|
CPT 82310
|
| Hospital Charge Code |
900910239
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$17.80 |
| Max. Negotiated Rate |
$80.10 |
| Rate for Payer: Cash Price |
$40.05
|
| Rate for Payer: Central Health Plan Commercial |
$71.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$35.60
|
| Rate for Payer: Galaxy Health WC |
$75.65
|
| Rate for Payer: Global Benefits Group Commercial |
$53.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$80.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$59.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$33.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$17.80
|
| Rate for Payer: Multiplan Commercial |
$66.75
|
| Rate for Payer: Networks By Design Commercial |
$57.85
|
| Rate for Payer: Prime Health Services Commercial |
$75.65
|
|
|
HC CALCIUM URINE 24 HOURS
|
Facility
|
OP
|
$15.00
|
|
|
Service Code
|
CPT 82340
|
| Hospital Charge Code |
900912198
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.00 |
| Max. Negotiated Rate |
$53.53 |
| Rate for Payer: Adventist Health Medi-Cal |
$6.03
|
| Rate for Payer: Aetna of CA HMO/PPO |
$44.30
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$9.04
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6.63
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6.03
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$43.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$53.53
|
| Rate for Payer: Blue Distinction Transplant |
$9.00
|
| Rate for Payer: Blue Shield of California Commercial |
$9.27
|
| Rate for Payer: Blue Shield of California EPN |
$7.29
|
| Rate for Payer: Caremore Medicare Advantage |
$6.03
|
| Rate for Payer: Cash Price |
$6.75
|
| Rate for Payer: Cash Price |
$6.75
|
| Rate for Payer: Central Health Plan Commercial |
$12.00
|
| Rate for Payer: Cigna of CA HMO |
$9.60
|
| Rate for Payer: Cigna of CA PPO |
$11.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9.04
|
| Rate for Payer: Dignity Health Media |
$6.03
|
| Rate for Payer: Dignity Health Medi-Cal |
$6.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.14
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$6.03
|
| Rate for Payer: EPIC Health Plan Transplant |
$6.03
|
| Rate for Payer: Galaxy Health WC |
$12.75
|
| Rate for Payer: Global Benefits Group Commercial |
$9.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$13.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$11.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$9.89
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$9.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6.03
|
| Rate for Payer: InnovAge PACE Commercial |
$9.04
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10.18
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8.08
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8.08
|
| Rate for Payer: Multiplan Commercial |
$11.25
|
| Rate for Payer: Networks By Design Commercial |
$9.75
|
| Rate for Payer: Prime Health Services Commercial |
$12.75
|
| Rate for Payer: Prime Health Services Medicare |
$6.39
|
| Rate for Payer: Riverside University Health System MISP |
$6.63
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.89
|
| Rate for Payer: United Healthcare All Other HMO |
$4.89
|
| Rate for Payer: United Healthcare HMO Rider |
$4.89
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.89
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$9.04
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6.63
|
| Rate for Payer: Vantage Medical Group Senior |
$6.03
|
|
|
HC CALCIUM URINE 24 HOURS
|
Facility
|
IP
|
$53.00
|
|
|
Service Code
|
CPT 82340
|
| Hospital Charge Code |
900912198
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.60 |
| Max. Negotiated Rate |
$47.70 |
| Rate for Payer: Cash Price |
$23.85
|
| Rate for Payer: Central Health Plan Commercial |
$42.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$21.20
|
| Rate for Payer: Galaxy Health WC |
$45.05
|
| Rate for Payer: Global Benefits Group Commercial |
$31.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$47.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$35.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$20.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.60
|
| Rate for Payer: Multiplan Commercial |
$39.75
|
| Rate for Payer: Networks By Design Commercial |
$34.45
|
| Rate for Payer: Prime Health Services Commercial |
$45.05
|
|
