|
HC EPS FOLLOW-UP STUDY
|
Facility
|
IP
|
$14,021.00
|
|
|
Service Code
|
CPT 93624
|
| Hospital Charge Code |
906811304
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$2,804.20 |
| Max. Negotiated Rate |
$12,618.90 |
| Rate for Payer: Adventist Health Commercial |
$2,804.20
|
| Rate for Payer: Cash Price |
$6,309.45
|
| Rate for Payer: Central Health Plan Commercial |
$11,216.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9,814.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,608.40
|
| Rate for Payer: EPIC Health Plan Senior |
$5,608.40
|
| Rate for Payer: Galaxy Health WC |
$11,917.85
|
| Rate for Payer: Global Benefits Group Commercial |
$8,412.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$12,618.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8,903.33
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8,272.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,804.20
|
| Rate for Payer: Multiplan Commercial |
$10,515.75
|
| Rate for Payer: Networks By Design Commercial |
$9,113.65
|
| Rate for Payer: Prime Health Services Commercial |
$11,917.85
|
|
|
HC EPS LA/CS PACING & RECORDING
|
Facility
|
IP
|
$18,298.00
|
|
|
Service Code
|
CPT 93621
|
| Hospital Charge Code |
906811329
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$3,659.60 |
| Max. Negotiated Rate |
$16,468.20 |
| Rate for Payer: Adventist Health Commercial |
$3,659.60
|
| Rate for Payer: Cash Price |
$8,234.10
|
| Rate for Payer: Central Health Plan Commercial |
$14,638.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$12,808.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,319.20
|
| Rate for Payer: EPIC Health Plan Senior |
$7,319.20
|
| Rate for Payer: Galaxy Health WC |
$15,553.30
|
| Rate for Payer: Global Benefits Group Commercial |
$10,978.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$16,468.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$11,619.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10,795.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,659.60
|
| Rate for Payer: Multiplan Commercial |
$13,723.50
|
| Rate for Payer: Networks By Design Commercial |
$11,893.70
|
| Rate for Payer: Prime Health Services Commercial |
$15,553.30
|
|
|
HC EPS LA/CS PACING & RECORDING
|
Facility
|
OP
|
$18,298.00
|
|
|
Service Code
|
CPT 93621
|
| Hospital Charge Code |
906811329
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$260.09 |
| Max. Negotiated Rate |
$16,468.20 |
| Rate for Payer: Adventist Health Commercial |
$3,659.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$260.09
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15,553.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10,063.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13,723.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,572.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,138.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,136.21
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$8,234.10
|
| Rate for Payer: Cash Price |
$8,234.10
|
| Rate for Payer: Cash Price |
$8,234.10
|
| Rate for Payer: Cash Price |
$8,234.10
|
| Rate for Payer: Central Health Plan Commercial |
$14,638.40
|
| Rate for Payer: Cigna of CA HMO |
$11,710.72
|
| Rate for Payer: Cigna of CA PPO |
$13,540.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15,553.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$15,553.30
|
| Rate for Payer: Dignity Health Medicare Advantage |
$15,553.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$12,808.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,319.20
|
| Rate for Payer: EPIC Health Plan Senior |
$7,319.20
|
| Rate for Payer: Galaxy Health WC |
$15,553.30
|
| Rate for Payer: Global Benefits Group Commercial |
$10,978.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$16,468.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,202.86
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$11,619.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,328.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10,795.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,659.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$12,808.60
|
| Rate for Payer: Multiplan Commercial |
$13,723.50
|
| Rate for Payer: Networks By Design Commercial |
$11,893.70
|
| Rate for Payer: Prime Health Services Commercial |
$15,553.30
|
| Rate for Payer: Riverside University Health System MISP |
$7,319.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10,978.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$10,978.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,136.00
|
| Rate for Payer: United Healthcare All Other HMO |
$868.00
|
| Rate for Payer: United Healthcare HMO Rider |
$737.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$676.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15,553.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15,553.30
|
| Rate for Payer: Vantage Medical Group Senior |
$15,553.30
|
|
|
HC EPS LV PACING & RECORDING
|
Facility
|
OP
|
$11,869.00
|
|
|
Service Code
|
CPT 93622
|
| Hospital Charge Code |
906811330
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$381.33 |
| Max. Negotiated Rate |
$10,682.10 |
| Rate for Payer: Adventist Health Commercial |
$2,373.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$381.33
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10,088.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6,527.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8,901.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,572.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,138.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,136.21
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$5,341.05
|
| Rate for Payer: Cash Price |
$5,341.05
|
| Rate for Payer: Cash Price |
$5,341.05
|
| Rate for Payer: Cash Price |
$5,341.05
|
| Rate for Payer: Central Health Plan Commercial |
$9,495.20
|
| Rate for Payer: Cigna of CA HMO |
$7,596.16
|
| Rate for Payer: Cigna of CA PPO |
$8,783.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,088.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$10,088.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10,088.65
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8,308.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,747.60
|
| Rate for Payer: EPIC Health Plan Senior |
$4,747.60
|
| Rate for Payer: Galaxy Health WC |
$10,088.65
|
| Rate for Payer: Global Benefits Group Commercial |
$7,121.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,682.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,202.86
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7,536.81
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,328.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7,002.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,373.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$8,308.30
|
| Rate for Payer: Multiplan Commercial |
$8,901.75
|
| Rate for Payer: Networks By Design Commercial |
$7,714.85
|
| Rate for Payer: Prime Health Services Commercial |
$10,088.65
|
| Rate for Payer: Riverside University Health System MISP |
$4,747.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,121.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7,121.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,136.00
|
| Rate for Payer: United Healthcare All Other HMO |
$868.00
|
| Rate for Payer: United Healthcare HMO Rider |
$737.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$676.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,088.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10,088.65
|
| Rate for Payer: Vantage Medical Group Senior |
$10,088.65
|
|
|
HC EPS LV PACING & RECORDING
|
Facility
|
IP
|
$11,869.00
|
|
|
Service Code
|
CPT 93622
|
| Hospital Charge Code |
906811330
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$2,373.80 |
| Max. Negotiated Rate |
$10,682.10 |
| Rate for Payer: Adventist Health Commercial |
$2,373.80
|
| Rate for Payer: Cash Price |
$5,341.05
|
| Rate for Payer: Central Health Plan Commercial |
$9,495.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8,308.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,747.60
|
| Rate for Payer: EPIC Health Plan Senior |
$4,747.60
|
| Rate for Payer: Galaxy Health WC |
$10,088.65
|
| Rate for Payer: Global Benefits Group Commercial |
$7,121.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,682.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7,536.81
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7,002.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,373.80
|
| Rate for Payer: Multiplan Commercial |
$8,901.75
|
| Rate for Payer: Networks By Design Commercial |
$7,714.85
|
| Rate for Payer: Prime Health Services Commercial |
$10,088.65
|
|
|
HC EPS POST DRUG INFUSION
|
Facility
|
IP
|
$9,352.00
|
|
|
Service Code
|
CPT 93623
|
| Hospital Charge Code |
906811331
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1,870.40 |
| Max. Negotiated Rate |
$8,416.80 |
| Rate for Payer: Adventist Health Commercial |
$1,870.40
|
| Rate for Payer: Cash Price |
$4,208.40
|
| Rate for Payer: Central Health Plan Commercial |
$7,481.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,546.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,740.80
|
| Rate for Payer: EPIC Health Plan Senior |
$3,740.80
|
| Rate for Payer: Galaxy Health WC |
$7,949.20
|
| Rate for Payer: Global Benefits Group Commercial |
$5,611.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,416.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,938.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,517.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,870.40
|
| Rate for Payer: Multiplan Commercial |
$7,014.00
|
| Rate for Payer: Networks By Design Commercial |
$6,078.80
|
| Rate for Payer: Prime Health Services Commercial |
$7,949.20
|
|
|
HC EPS POST DRUG INFUSION
|
Facility
|
OP
|
$9,352.00
|
|
|
Service Code
|
CPT 93623
|
| Hospital Charge Code |
906811331
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$353.42 |
| Max. Negotiated Rate |
$8,416.80 |
| Rate for Payer: Adventist Health Commercial |
$1,870.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$353.42
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,949.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,143.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,014.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,074.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,136.21
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$4,208.40
|
| Rate for Payer: Cash Price |
$4,208.40
|
| Rate for Payer: Cash Price |
$4,208.40
|
| Rate for Payer: Cash Price |
$4,208.40
|
| Rate for Payer: Central Health Plan Commercial |
$7,481.60
|
| Rate for Payer: Cigna of CA HMO |
$5,985.28
|
| Rate for Payer: Cigna of CA PPO |
$6,920.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,949.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,949.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7,949.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,546.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,740.80
|
| Rate for Payer: EPIC Health Plan Senior |
$3,740.80
|
| Rate for Payer: Galaxy Health WC |
$7,949.20
|
| Rate for Payer: Global Benefits Group Commercial |
$5,611.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,416.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,938.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,517.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,870.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$6,546.40
|
| Rate for Payer: Multiplan Commercial |
$7,014.00
|
| Rate for Payer: Networks By Design Commercial |
$6,078.80
|
| Rate for Payer: Prime Health Services Commercial |
$7,949.20
|
| Rate for Payer: Riverside University Health System MISP |
$3,740.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,611.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,611.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,136.00
|
| Rate for Payer: United Healthcare All Other HMO |
$868.00
|
| Rate for Payer: United Healthcare HMO Rider |
$737.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$676.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,949.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,949.20
|
| Rate for Payer: Vantage Medical Group Senior |
$7,949.20
|
|
|
HC EPS RV RECORDING
|
Facility
|
IP
|
$5,983.00
|
|
|
Service Code
|
CPT 93603
|
| Hospital Charge Code |
906811321
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1,196.60 |
| Max. Negotiated Rate |
$5,384.70 |
| Rate for Payer: Adventist Health Commercial |
$1,196.60
|
| Rate for Payer: Cash Price |
$2,692.35
|
| Rate for Payer: Central Health Plan Commercial |
$4,786.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,188.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,393.20
|
| Rate for Payer: EPIC Health Plan Senior |
$2,393.20
|
| Rate for Payer: Galaxy Health WC |
$5,085.55
|
| Rate for Payer: Global Benefits Group Commercial |
$3,589.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,384.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,799.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,529.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,196.60
|
| Rate for Payer: Multiplan Commercial |
$4,487.25
|
| Rate for Payer: Networks By Design Commercial |
$3,888.95
|
| Rate for Payer: Prime Health Services Commercial |
$5,085.55
|
|
|
HC EPS RV RECORDING
|
Facility
|
OP
|
$5,983.00
|
|
|
Service Code
|
CPT 93603
|
| Hospital Charge Code |
906811321
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$274.01 |
| Max. Negotiated Rate |
$8,136.21 |
| Rate for Payer: Adventist Health Commercial |
$1,196.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,565.96
|
| Rate for Payer: Aetna of CA HMO/PPO |
$456.93
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,348.94
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,722.56
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,565.96
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,136.21
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$2,692.35
|
| Rate for Payer: Cash Price |
$2,692.35
|
| Rate for Payer: Cash Price |
$2,692.35
|
| Rate for Payer: Cash Price |
$2,692.35
|
| Rate for Payer: Central Health Plan Commercial |
$4,786.40
|
| Rate for Payer: Cigna of CA HMO |
$3,829.12
|
| Rate for Payer: Cigna of CA PPO |
$4,427.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,348.94
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,722.56
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,565.96
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,188.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,583.83
|
| Rate for Payer: EPIC Health Plan Senior |
$1,722.56
|
| Rate for Payer: Galaxy Health WC |
$5,085.55
|
| Rate for Payer: Global Benefits Group Commercial |
$3,589.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,384.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,568.17
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$274.01
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,565.96
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,799.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$302.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,192.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,196.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,098.39
|
| Rate for Payer: Multiplan Commercial |
$4,487.25
|
| Rate for Payer: Networks By Design Commercial |
$3,888.95
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,565.96
|
| Rate for Payer: Prime Health Services Commercial |
$5,085.55
|
| Rate for Payer: Prime Health Services Medicare |
$1,659.92
|
| Rate for Payer: Riverside University Health System MISP |
$1,722.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,589.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,589.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,136.00
|
| Rate for Payer: United Healthcare All Other HMO |
$868.00
|
| Rate for Payer: United Healthcare HMO Rider |
$737.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$676.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,565.96
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,348.94
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,722.56
|
| Rate for Payer: Vantage Medical Group Senior |
$1,565.96
|
|
|
HC EPSTEIN ANTIBODY SCREEN IGM
|
Facility
|
IP
|
$77.00
|
|
|
Service Code
|
CPT 86308
|
| Hospital Charge Code |
900913657
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.40 |
| Max. Negotiated Rate |
$69.30 |
| Rate for Payer: Adventist Health Commercial |
$15.40
|
| Rate for Payer: Cash Price |
$34.65
|
| Rate for Payer: Central Health Plan Commercial |
$61.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$53.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$30.80
|
| Rate for Payer: EPIC Health Plan Senior |
$30.80
|
| Rate for Payer: Galaxy Health WC |
$65.45
|
| Rate for Payer: Global Benefits Group Commercial |
$46.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$69.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$48.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$45.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.40
|
| Rate for Payer: Multiplan Commercial |
$57.75
|
| Rate for Payer: Networks By Design Commercial |
$50.05
|
| Rate for Payer: Prime Health Services Commercial |
$65.45
|
|
|
HC EPSTEIN ANTIBODY SCREEN IGM
|
Facility
|
OP
|
$55.00
|
|
|
Service Code
|
CPT 86308
|
| Hospital Charge Code |
900913657
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.19 |
| Max. Negotiated Rate |
$52.29 |
| Rate for Payer: Adventist Health Commercial |
$11.00
|
| Rate for Payer: Adventist Health Commercial |
$15.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$5.18
|
| Rate for Payer: Adventist Health Medi-Cal |
$5.18
|
| Rate for Payer: Aetna of CA HMO/PPO |
$37.98
|
| Rate for Payer: Aetna of CA HMO/PPO |
$37.98
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.77
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.77
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.18
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$37.61
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$37.61
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$52.29
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$52.29
|
| Rate for Payer: Blue Shield of California Commercial |
$48.51
|
| Rate for Payer: Blue Shield of California Commercial |
$34.65
|
| Rate for Payer: Blue Shield of California EPN |
$30.57
|
| Rate for Payer: Blue Shield of California EPN |
$21.84
|
| Rate for Payer: Cash Price |
$34.65
|
| Rate for Payer: Cash Price |
$34.65
|
| Rate for Payer: Cash Price |
$24.75
|
| Rate for Payer: Cash Price |
$24.75
|
| Rate for Payer: Central Health Plan Commercial |
$44.00
|
| Rate for Payer: Central Health Plan Commercial |
$61.60
|
| Rate for Payer: Cigna of CA HMO |
$49.28
|
| Rate for Payer: Cigna of CA HMO |
$35.20
|
| Rate for Payer: Cigna of CA PPO |
$56.98
|
| Rate for Payer: Cigna of CA PPO |
$40.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.77
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.77
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.18
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.18
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$38.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$53.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.55
|
| Rate for Payer: EPIC Health Plan Senior |
$5.70
|
| Rate for Payer: EPIC Health Plan Senior |
$5.70
|
| Rate for Payer: Galaxy Health WC |
$65.45
|
| Rate for Payer: Galaxy Health WC |
$46.75
|
| Rate for Payer: Global Benefits Group Commercial |
$46.20
|
| Rate for Payer: Global Benefits Group Commercial |
$33.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$69.30
|
| Rate for Payer: Health Management Network EPO/PPO |
$49.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$8.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$8.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$7.72
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$7.72
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.18
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$34.92
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$48.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$6.94
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$6.94
|
| Rate for Payer: Multiplan Commercial |
$57.75
|
| Rate for Payer: Multiplan Commercial |
$41.25
|
| Rate for Payer: Networks By Design Commercial |
$35.75
|
| Rate for Payer: Networks By Design Commercial |
$50.05
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$5.18
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$5.18
|
| Rate for Payer: Prime Health Services Commercial |
$65.45
|
| Rate for Payer: Prime Health Services Commercial |
$46.75
|
| Rate for Payer: Prime Health Services Medicare |
$5.49
|
| Rate for Payer: Prime Health Services Medicare |
$5.49
|
| Rate for Payer: Riverside University Health System MISP |
$5.70
|
| Rate for Payer: Riverside University Health System MISP |
$5.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$33.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$46.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$46.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$33.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.19
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.19
|
| Rate for Payer: United Healthcare All Other HMO |
$4.19
|
| Rate for Payer: United Healthcare All Other HMO |
$4.19
|
| Rate for Payer: United Healthcare HMO Rider |
$4.19
|
| Rate for Payer: United Healthcare HMO Rider |
$4.19
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.19
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.19
|
| Rate for Payer: Upland Medical Group Pediatric |
$5.18
|
| Rate for Payer: Upland Medical Group Pediatric |
$5.18
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.77
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.77
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.70
|
| Rate for Payer: Vantage Medical Group Senior |
$5.18
|
| Rate for Payer: Vantage Medical Group Senior |
$5.18
|
|
|
HC EPSTEIN BARR EARLY ANTIGEN IGG
|
Facility
|
IP
|
$77.00
|
|
|
Service Code
|
CPT 86663
|
| Hospital Charge Code |
900913653
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.40 |
| Max. Negotiated Rate |
$69.30 |
| Rate for Payer: Adventist Health Commercial |
$15.40
|
| Rate for Payer: Cash Price |
$34.65
|
| Rate for Payer: Central Health Plan Commercial |
$61.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$53.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$30.80
|
| Rate for Payer: EPIC Health Plan Senior |
$30.80
|
| Rate for Payer: Galaxy Health WC |
$65.45
|
| Rate for Payer: Global Benefits Group Commercial |
$46.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$69.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$48.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$45.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.40
|
| Rate for Payer: Multiplan Commercial |
$57.75
|
| Rate for Payer: Networks By Design Commercial |
$50.05
|
| Rate for Payer: Prime Health Services Commercial |
$65.45
|
|
|
HC EPSTEIN BARR EARLY ANTIGEN IGG
|
Facility
|
OP
|
$56.00
|
|
|
Service Code
|
CPT 86663
|
| Hospital Charge Code |
900913653
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.63 |
| Max. Negotiated Rate |
$133.39 |
| Rate for Payer: Adventist Health Commercial |
$11.20
|
| Rate for Payer: Adventist Health Commercial |
$15.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$13.12
|
| Rate for Payer: Adventist Health Medi-Cal |
$13.12
|
| Rate for Payer: Aetna of CA HMO/PPO |
$96.27
|
| Rate for Payer: Aetna of CA HMO/PPO |
$96.27
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19.68
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.43
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.43
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13.12
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$95.95
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$95.95
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$133.39
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$133.39
|
| Rate for Payer: Blue Shield of California Commercial |
$48.51
|
| Rate for Payer: Blue Shield of California Commercial |
$35.28
|
| Rate for Payer: Blue Shield of California EPN |
$30.57
|
| Rate for Payer: Blue Shield of California EPN |
$22.23
|
| Rate for Payer: Cash Price |
$34.65
|
| Rate for Payer: Cash Price |
$34.65
|
| Rate for Payer: Cash Price |
$25.20
|
| Rate for Payer: Cash Price |
$25.20
|
| Rate for Payer: Central Health Plan Commercial |
$44.80
|
| Rate for Payer: Central Health Plan Commercial |
$61.60
|
| Rate for Payer: Cigna of CA HMO |
$49.28
|
| Rate for Payer: Cigna of CA HMO |
$35.84
|
| Rate for Payer: Cigna of CA PPO |
$56.98
|
| Rate for Payer: Cigna of CA PPO |
$41.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.43
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.43
|
| Rate for Payer: Dignity Health Medicare Advantage |
$13.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$13.12
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$39.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$53.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$21.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$21.65
|
| Rate for Payer: EPIC Health Plan Senior |
$14.43
|
| Rate for Payer: EPIC Health Plan Senior |
$14.43
|
| Rate for Payer: Galaxy Health WC |
$65.45
|
| Rate for Payer: Galaxy Health WC |
$47.60
|
| Rate for Payer: Global Benefits Group Commercial |
$46.20
|
| Rate for Payer: Global Benefits Group Commercial |
$33.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$69.30
|
| Rate for Payer: Health Management Network EPO/PPO |
$50.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$21.52
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$21.52
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$20.06
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$20.06
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13.12
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$35.56
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$48.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$22.15
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$22.15
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$18.37
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$18.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$17.58
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$17.58
|
| Rate for Payer: Multiplan Commercial |
$57.75
|
| Rate for Payer: Multiplan Commercial |
$42.00
|
| Rate for Payer: Networks By Design Commercial |
$36.40
|
| Rate for Payer: Networks By Design Commercial |
$50.05
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$13.12
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$13.12
|
| Rate for Payer: Prime Health Services Commercial |
$65.45
|
| Rate for Payer: Prime Health Services Commercial |
$47.60
|
| Rate for Payer: Prime Health Services Medicare |
$13.91
|
| Rate for Payer: Prime Health Services Medicare |
$13.91
|
| Rate for Payer: Riverside University Health System MISP |
$14.43
|
| Rate for Payer: Riverside University Health System MISP |
$14.43
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$33.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$46.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$46.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$33.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.63
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.63
|
| Rate for Payer: United Healthcare All Other HMO |
$10.63
|
| Rate for Payer: United Healthcare All Other HMO |
$10.63
|
| Rate for Payer: United Healthcare HMO Rider |
$10.63
|
| Rate for Payer: United Healthcare HMO Rider |
$10.63
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.63
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.63
|
| Rate for Payer: Upland Medical Group Pediatric |
$13.12
|
| Rate for Payer: Upland Medical Group Pediatric |
$13.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.68
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.43
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.43
|
| Rate for Payer: Vantage Medical Group Senior |
$13.12
|
| Rate for Payer: Vantage Medical Group Senior |
$13.12
|
|
|
HC EPSTEIN BARR NUCLEAR ANTIGEN IGG
|
Facility
|
OP
|
$134.00
|
|
|
Service Code
|
CPT 86664
|
| Hospital Charge Code |
900913654
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.38 |
| Max. Negotiated Rate |
$157.02 |
| Rate for Payer: Adventist Health Commercial |
$26.80
|
| Rate for Payer: Adventist Health Commercial |
$19.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$15.29
|
| Rate for Payer: Adventist Health Medi-Cal |
$15.29
|
| Rate for Payer: Aetna of CA HMO/PPO |
$112.28
|
| Rate for Payer: Aetna of CA HMO/PPO |
$112.28
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$22.93
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$22.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$16.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$16.82
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$15.29
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$15.29
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$112.94
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$112.94
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$157.02
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$157.02
|
| Rate for Payer: Blue Shield of California Commercial |
$61.74
|
| Rate for Payer: Blue Shield of California Commercial |
$84.42
|
| Rate for Payer: Blue Shield of California EPN |
$38.91
|
| Rate for Payer: Blue Shield of California EPN |
$53.20
|
| Rate for Payer: Cash Price |
$44.10
|
| Rate for Payer: Cash Price |
$44.10
|
| Rate for Payer: Cash Price |
$60.30
|
| Rate for Payer: Cash Price |
$60.30
|
| Rate for Payer: Central Health Plan Commercial |
$107.20
|
| Rate for Payer: Central Health Plan Commercial |
$78.40
|
| Rate for Payer: Cigna of CA HMO |
$62.72
|
| Rate for Payer: Cigna of CA HMO |
$85.76
|
| Rate for Payer: Cigna of CA PPO |
$72.52
|
| Rate for Payer: Cigna of CA PPO |
$99.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$22.93
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$22.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$16.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$16.82
|
| Rate for Payer: Dignity Health Medicare Advantage |
$15.29
|
| Rate for Payer: Dignity Health Medicare Advantage |
$15.29
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$93.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$68.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$25.23
|
| Rate for Payer: EPIC Health Plan Commercial |
$25.23
|
| Rate for Payer: EPIC Health Plan Senior |
$16.82
|
| Rate for Payer: EPIC Health Plan Senior |
$16.82
|
| Rate for Payer: Galaxy Health WC |
$83.30
|
| Rate for Payer: Galaxy Health WC |
$113.90
|
| Rate for Payer: Global Benefits Group Commercial |
$58.80
|
| Rate for Payer: Global Benefits Group Commercial |
$80.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$88.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$120.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$25.08
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$25.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$23.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$23.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$15.29
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$15.29
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$85.09
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$62.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$25.84
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$25.84
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$21.41
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$21.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$26.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$20.49
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$20.49
|
| Rate for Payer: Multiplan Commercial |
$73.50
|
| Rate for Payer: Multiplan Commercial |
$100.50
|
| Rate for Payer: Networks By Design Commercial |
$87.10
|
| Rate for Payer: Networks By Design Commercial |
$63.70
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$15.29
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$15.29
|
| Rate for Payer: Prime Health Services Commercial |
$83.30
|
| Rate for Payer: Prime Health Services Commercial |
$113.90
|
| Rate for Payer: Prime Health Services Medicare |
$16.21
|
| Rate for Payer: Prime Health Services Medicare |
$16.21
|
| Rate for Payer: Riverside University Health System MISP |
$16.82
|
| Rate for Payer: Riverside University Health System MISP |
$16.82
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$80.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$58.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$58.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$80.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$12.38
|
| Rate for Payer: United Healthcare All Other Commercial |
$12.38
|
| Rate for Payer: United Healthcare All Other HMO |
$12.38
|
| Rate for Payer: United Healthcare All Other HMO |
$12.38
|
| Rate for Payer: United Healthcare HMO Rider |
$12.38
|
| Rate for Payer: United Healthcare HMO Rider |
$12.38
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$12.38
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$12.38
|
| Rate for Payer: Upland Medical Group Pediatric |
$15.29
|
| Rate for Payer: Upland Medical Group Pediatric |
$15.29
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$22.93
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$22.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$16.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$16.82
|
| Rate for Payer: Vantage Medical Group Senior |
$15.29
|
| Rate for Payer: Vantage Medical Group Senior |
$15.29
|
|
|
HC EPSTEIN BARR NUCLEAR ANTIGEN IGG
|
Facility
|
IP
|
$134.00
|
|
|
Service Code
|
CPT 86664
|
| Hospital Charge Code |
900913654
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$26.80 |
| Max. Negotiated Rate |
$120.60 |
| Rate for Payer: Adventist Health Commercial |
$26.80
|
| Rate for Payer: Cash Price |
$60.30
|
| Rate for Payer: Central Health Plan Commercial |
$107.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$93.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$53.60
|
| Rate for Payer: EPIC Health Plan Senior |
$53.60
|
| Rate for Payer: Galaxy Health WC |
$113.90
|
| Rate for Payer: Global Benefits Group Commercial |
$80.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$120.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$85.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$79.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$26.80
|
| Rate for Payer: Multiplan Commercial |
$100.50
|
| Rate for Payer: Networks By Design Commercial |
$87.10
|
| Rate for Payer: Prime Health Services Commercial |
$113.90
|
|
|
HC EPSTEIN BARR VIRAL CAPSID IGG
|
Facility
|
IP
|
$134.00
|
|
|
Service Code
|
CPT 86665
|
| Hospital Charge Code |
900913655
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$26.80 |
| Max. Negotiated Rate |
$120.60 |
| Rate for Payer: Adventist Health Commercial |
$26.80
|
| Rate for Payer: Cash Price |
$60.30
|
| Rate for Payer: Central Health Plan Commercial |
$107.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$93.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$53.60
|
| Rate for Payer: EPIC Health Plan Senior |
$53.60
|
| Rate for Payer: Galaxy Health WC |
$113.90
|
| Rate for Payer: Global Benefits Group Commercial |
$80.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$120.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$85.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$79.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$26.80
|
| Rate for Payer: Multiplan Commercial |
$100.50
|
| Rate for Payer: Networks By Design Commercial |
$87.10
|
| Rate for Payer: Prime Health Services Commercial |
$113.90
|
|
|
HC EPSTEIN BARR VIRAL CAPSID IGG
|
Facility
|
OP
|
$134.00
|
|
|
Service Code
|
CPT 86665
|
| Hospital Charge Code |
900913655
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$14.70 |
| Max. Negotiated Rate |
$163.08 |
| Rate for Payer: Adventist Health Commercial |
$26.80
|
| Rate for Payer: Adventist Health Commercial |
$19.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$18.14
|
| Rate for Payer: Adventist Health Medi-Cal |
$18.14
|
| Rate for Payer: Aetna of CA HMO/PPO |
$133.14
|
| Rate for Payer: Aetna of CA HMO/PPO |
$133.14
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$27.21
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$27.21
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$18.14
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$18.14
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$117.30
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$117.30
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$163.08
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$163.08
|
| Rate for Payer: Blue Shield of California Commercial |
$61.74
|
| Rate for Payer: Blue Shield of California Commercial |
$84.42
|
| Rate for Payer: Blue Shield of California EPN |
$38.91
|
| Rate for Payer: Blue Shield of California EPN |
$53.20
|
| Rate for Payer: Cash Price |
$44.10
|
| Rate for Payer: Cash Price |
$44.10
|
| Rate for Payer: Cash Price |
$60.30
|
| Rate for Payer: Cash Price |
$60.30
|
| Rate for Payer: Central Health Plan Commercial |
$107.20
|
| Rate for Payer: Central Health Plan Commercial |
$78.40
|
| Rate for Payer: Cigna of CA HMO |
$62.72
|
| Rate for Payer: Cigna of CA HMO |
$85.76
|
| Rate for Payer: Cigna of CA PPO |
$72.52
|
| Rate for Payer: Cigna of CA PPO |
$99.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$27.21
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$27.21
|
| Rate for Payer: Dignity Health Medi-Cal |
$19.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$19.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$18.14
|
| Rate for Payer: Dignity Health Medicare Advantage |
$18.14
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$93.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$68.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$29.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$29.93
|
| Rate for Payer: EPIC Health Plan Senior |
$19.95
|
| Rate for Payer: EPIC Health Plan Senior |
$19.95
|
| Rate for Payer: Galaxy Health WC |
$83.30
|
| Rate for Payer: Galaxy Health WC |
$113.90
|
| Rate for Payer: Global Benefits Group Commercial |
$58.80
|
| Rate for Payer: Global Benefits Group Commercial |
$80.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$88.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$120.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$29.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$29.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$27.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$27.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$18.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$18.14
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$85.09
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$62.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$30.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$30.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$25.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$25.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$26.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$24.31
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$24.31
|
| Rate for Payer: Multiplan Commercial |
$73.50
|
| Rate for Payer: Multiplan Commercial |
$100.50
|
| Rate for Payer: Networks By Design Commercial |
$87.10
|
| Rate for Payer: Networks By Design Commercial |
$63.70
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$18.14
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$18.14
|
| Rate for Payer: Prime Health Services Commercial |
$83.30
|
| Rate for Payer: Prime Health Services Commercial |
$113.90
|
| Rate for Payer: Prime Health Services Medicare |
$19.23
|
| Rate for Payer: Prime Health Services Medicare |
$19.23
|
| Rate for Payer: Riverside University Health System MISP |
$19.95
|
| Rate for Payer: Riverside University Health System MISP |
$19.95
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$80.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$58.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$58.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$80.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.70
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.70
|
| Rate for Payer: United Healthcare All Other HMO |
$14.70
|
| Rate for Payer: United Healthcare All Other HMO |
$14.70
|
| Rate for Payer: United Healthcare HMO Rider |
$14.70
|
| Rate for Payer: United Healthcare HMO Rider |
$14.70
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.70
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.70
|
| Rate for Payer: Upland Medical Group Pediatric |
$18.14
|
| Rate for Payer: Upland Medical Group Pediatric |
$18.14
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$27.21
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$27.21
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.95
|
| Rate for Payer: Vantage Medical Group Senior |
$18.14
|
| Rate for Payer: Vantage Medical Group Senior |
$18.14
|
|
|
HC EPSTEIN BARR VIRAL CAPSID IGM
|
Facility
|
IP
|
$134.00
|
|
|
Service Code
|
CPT 86665
|
| Hospital Charge Code |
900913656
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$26.80 |
| Max. Negotiated Rate |
$120.60 |
| Rate for Payer: Adventist Health Commercial |
$26.80
|
| Rate for Payer: Cash Price |
$60.30
|
| Rate for Payer: Central Health Plan Commercial |
$107.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$93.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$53.60
|
| Rate for Payer: EPIC Health Plan Senior |
$53.60
|
| Rate for Payer: Galaxy Health WC |
$113.90
|
| Rate for Payer: Global Benefits Group Commercial |
$80.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$120.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$85.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$79.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$26.80
|
| Rate for Payer: Multiplan Commercial |
$100.50
|
| Rate for Payer: Networks By Design Commercial |
$87.10
|
| Rate for Payer: Prime Health Services Commercial |
$113.90
|
|
|
HC EPSTEIN BARR VIRAL CAPSID IGM
|
Facility
|
OP
|
$134.00
|
|
|
Service Code
|
CPT 86665
|
| Hospital Charge Code |
900913656
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$14.70 |
| Max. Negotiated Rate |
$163.08 |
| Rate for Payer: Adventist Health Commercial |
$26.80
|
| Rate for Payer: Adventist Health Commercial |
$19.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$18.14
|
| Rate for Payer: Adventist Health Medi-Cal |
$18.14
|
| Rate for Payer: Aetna of CA HMO/PPO |
$133.14
|
| Rate for Payer: Aetna of CA HMO/PPO |
$133.14
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$27.21
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$27.21
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$18.14
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$18.14
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$117.30
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$117.30
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$163.08
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$163.08
|
| Rate for Payer: Blue Shield of California Commercial |
$61.74
|
| Rate for Payer: Blue Shield of California Commercial |
$84.42
|
| Rate for Payer: Blue Shield of California EPN |
$38.91
|
| Rate for Payer: Blue Shield of California EPN |
$53.20
|
| Rate for Payer: Cash Price |
$44.10
|
| Rate for Payer: Cash Price |
$44.10
|
| Rate for Payer: Cash Price |
$60.30
|
| Rate for Payer: Cash Price |
$60.30
|
| Rate for Payer: Central Health Plan Commercial |
$107.20
|
| Rate for Payer: Central Health Plan Commercial |
$78.40
|
| Rate for Payer: Cigna of CA HMO |
$62.72
|
| Rate for Payer: Cigna of CA HMO |
$85.76
|
| Rate for Payer: Cigna of CA PPO |
$72.52
|
| Rate for Payer: Cigna of CA PPO |
$99.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$27.21
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$27.21
|
| Rate for Payer: Dignity Health Medi-Cal |
$19.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$19.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$18.14
|
| Rate for Payer: Dignity Health Medicare Advantage |
$18.14
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$93.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$68.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$29.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$29.93
|
| Rate for Payer: EPIC Health Plan Senior |
$19.95
|
| Rate for Payer: EPIC Health Plan Senior |
$19.95
|
| Rate for Payer: Galaxy Health WC |
$83.30
|
| Rate for Payer: Galaxy Health WC |
$113.90
|
| Rate for Payer: Global Benefits Group Commercial |
$58.80
|
| Rate for Payer: Global Benefits Group Commercial |
$80.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$88.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$120.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$29.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$29.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$27.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$27.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$18.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$18.14
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$85.09
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$62.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$30.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$30.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$25.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$25.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$26.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$24.31
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$24.31
|
| Rate for Payer: Multiplan Commercial |
$73.50
|
| Rate for Payer: Multiplan Commercial |
$100.50
|
| Rate for Payer: Networks By Design Commercial |
$87.10
|
| Rate for Payer: Networks By Design Commercial |
$63.70
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$18.14
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$18.14
|
| Rate for Payer: Prime Health Services Commercial |
$83.30
|
| Rate for Payer: Prime Health Services Commercial |
$113.90
|
| Rate for Payer: Prime Health Services Medicare |
$19.23
|
| Rate for Payer: Prime Health Services Medicare |
$19.23
|
| Rate for Payer: Riverside University Health System MISP |
$19.95
|
| Rate for Payer: Riverside University Health System MISP |
$19.95
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$80.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$58.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$58.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$80.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.70
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.70
|
| Rate for Payer: United Healthcare All Other HMO |
$14.70
|
| Rate for Payer: United Healthcare All Other HMO |
$14.70
|
| Rate for Payer: United Healthcare HMO Rider |
$14.70
|
| Rate for Payer: United Healthcare HMO Rider |
$14.70
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.70
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.70
|
| Rate for Payer: Upland Medical Group Pediatric |
$18.14
|
| Rate for Payer: Upland Medical Group Pediatric |
$18.14
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$27.21
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$27.21
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.95
|
| Rate for Payer: Vantage Medical Group Senior |
$18.14
|
| Rate for Payer: Vantage Medical Group Senior |
$18.14
|
|
|
HC EP STIMULATION BY MEDICATION
|
Facility
|
IP
|
$840.00
|
|
|
Service Code
|
CPT 93799
|
| Hospital Charge Code |
906811482
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$168.00 |
| Max. Negotiated Rate |
$756.00 |
| Rate for Payer: Adventist Health Commercial |
$168.00
|
| Rate for Payer: Cash Price |
$378.00
|
| Rate for Payer: Central Health Plan Commercial |
$672.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$588.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$336.00
|
| Rate for Payer: EPIC Health Plan Senior |
$336.00
|
| Rate for Payer: Galaxy Health WC |
$714.00
|
| Rate for Payer: Global Benefits Group Commercial |
$504.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$756.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$533.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$495.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$168.00
|
| Rate for Payer: Multiplan Commercial |
$630.00
|
| Rate for Payer: Networks By Design Commercial |
$546.00
|
| Rate for Payer: Prime Health Services Commercial |
$714.00
|
|
|
HC EP STIMULATION BY MEDICATION
|
Facility
|
OP
|
$840.00
|
|
|
Service Code
|
CPT 93799
|
| Hospital Charge Code |
906811482
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$165.49 |
| Max. Negotiated Rate |
$8,136.21 |
| Rate for Payer: Adventist Health Commercial |
$168.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$165.49
|
| Rate for Payer: Aetna of CA HMO/PPO |
$510.13
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$248.24
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$182.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$165.49
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$406.73
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$488.63
|
| Rate for Payer: Blue Shield of California Commercial |
$8,136.21
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$378.00
|
| Rate for Payer: Cash Price |
$378.00
|
| Rate for Payer: Cash Price |
$378.00
|
| Rate for Payer: Cash Price |
$378.00
|
| Rate for Payer: Central Health Plan Commercial |
$672.00
|
| Rate for Payer: Cigna of CA HMO |
$537.60
|
| Rate for Payer: Cigna of CA PPO |
$621.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$248.24
|
| Rate for Payer: Dignity Health Medi-Cal |
$182.04
|
| Rate for Payer: Dignity Health Medicare Advantage |
$165.49
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$588.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$273.06
|
| Rate for Payer: EPIC Health Plan Senior |
$182.04
|
| Rate for Payer: Galaxy Health WC |
$714.00
|
| Rate for Payer: Global Benefits Group Commercial |
$504.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$756.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$271.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$165.49
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$533.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$231.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$168.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$221.76
|
| Rate for Payer: Multiplan Commercial |
$630.00
|
| Rate for Payer: Networks By Design Commercial |
$546.00
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$165.49
|
| Rate for Payer: Prime Health Services Commercial |
$714.00
|
| Rate for Payer: Prime Health Services Medicare |
$175.42
|
| Rate for Payer: Riverside University Health System MISP |
$182.04
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$504.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$504.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,136.00
|
| Rate for Payer: United Healthcare All Other HMO |
$868.00
|
| Rate for Payer: United Healthcare HMO Rider |
$737.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$676.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$165.49
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$248.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$182.04
|
| Rate for Payer: Vantage Medical Group Senior |
$165.49
|
|
|
HC EP ST J ABLATION CABLE
|
Facility
|
IP
|
$580.00
|
|
| Hospital Charge Code |
906812640
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$522.00 |
| Rate for Payer: Adventist Health Commercial |
$116.00
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Central Health Plan Commercial |
$464.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$406.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Senior |
$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 Foundation Hospitals Commercial/Self Funded |
$368.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$342.20
|
| 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 EP ST J ABLATION CABLE
|
Facility
|
OP
|
$580.00
|
|
| Hospital Charge Code |
906812640
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$522.00 |
| Rate for Payer: Adventist Health Commercial |
$116.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$352.23
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$493.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$319.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$435.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$280.84
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$337.39
|
| Rate for Payer: Blue Shield of California Commercial |
$367.72
|
| Rate for Payer: Blue Shield of California EPN |
$231.42
|
| 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 |
$493.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$493.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$493.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$406.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Senior |
$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 Foundation Hospitals Commercial/Self Funded |
$368.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$210.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$342.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$116.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$406.00
|
| 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
|
| Rate for Payer: Riverside University Health System MISP |
$232.00
|
| 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 |
$290.00
|
| Rate for Payer: United Healthcare All Other HMO |
$290.00
|
| Rate for Payer: United Healthcare HMO Rider |
$290.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$290.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$493.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$493.00
|
| Rate for Payer: Vantage Medical Group Senior |
$493.00
|
|
|
HC EP ST J COOL POINT TUBING
|
Facility
|
OP
|
$580.00
|
|
| Hospital Charge Code |
906812643
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$522.00 |
| Rate for Payer: Adventist Health Commercial |
$116.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$352.23
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$493.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$319.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$435.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$280.84
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$337.39
|
| Rate for Payer: Blue Shield of California Commercial |
$367.72
|
| Rate for Payer: Blue Shield of California EPN |
$231.42
|
| 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 |
$493.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$493.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$493.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$406.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Senior |
$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 Foundation Hospitals Commercial/Self Funded |
$368.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$210.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$342.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$116.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$406.00
|
| 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
|
| Rate for Payer: Riverside University Health System MISP |
$232.00
|
| 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 |
$290.00
|
| Rate for Payer: United Healthcare All Other HMO |
$290.00
|
| Rate for Payer: United Healthcare HMO Rider |
$290.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$290.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$493.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$493.00
|
| Rate for Payer: Vantage Medical Group Senior |
$493.00
|
|
|
HC EP ST J COOL POINT TUBING
|
Facility
|
IP
|
$580.00
|
|
| Hospital Charge Code |
906812643
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$522.00 |
| Rate for Payer: Adventist Health Commercial |
$116.00
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Central Health Plan Commercial |
$464.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$406.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Senior |
$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 Foundation Hospitals Commercial/Self Funded |
$368.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$342.20
|
| 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
|
|
