|
HC CBC W WO DIFFERENTIAL INDIVIDUAL
|
Facility
|
IP
|
$99.00
|
|
|
Service Code
|
CPT 85027
|
| Hospital Charge Code |
900912019
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$19.80 |
| Max. Negotiated Rate |
$89.10 |
| Rate for Payer: Cash Price |
$44.55
|
| Rate for Payer: Central Health Plan Commercial |
$79.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$39.60
|
| Rate for Payer: Galaxy Health WC |
$84.15
|
| Rate for Payer: Global Benefits Group Commercial |
$59.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$89.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$66.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$37.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.80
|
| Rate for Payer: Multiplan Commercial |
$74.25
|
| Rate for Payer: Networks By Design Commercial |
$64.35
|
| Rate for Payer: Prime Health Services Commercial |
$84.15
|
|
|
HC CBC W WO DIFFERENTIAL INDIVIDUAL
|
Facility
|
OP
|
$16.00
|
|
|
Service Code
|
CPT 85027
|
| Hospital Charge Code |
900912019
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$3.20 |
| Max. Negotiated Rate |
$57.41 |
| Rate for Payer: Adventist Health Medi-Cal |
$6.47
|
| Rate for Payer: Aetna of CA HMO/PPO |
$47.49
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$9.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6.47
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$47.07
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$57.41
|
| Rate for Payer: Blue Distinction Transplant |
$9.60
|
| Rate for Payer: Blue Shield of California Commercial |
$9.89
|
| Rate for Payer: Blue Shield of California EPN |
$7.78
|
| Rate for Payer: Caremore Medicare Advantage |
$6.47
|
| Rate for Payer: Cash Price |
$7.20
|
| Rate for Payer: Cash Price |
$7.20
|
| Rate for Payer: Central Health Plan Commercial |
$12.80
|
| Rate for Payer: Cigna of CA HMO |
$10.24
|
| Rate for Payer: Cigna of CA PPO |
$11.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9.70
|
| Rate for Payer: Dignity Health Media |
$6.47
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.73
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$6.47
|
| Rate for Payer: EPIC Health Plan Transplant |
$6.47
|
| Rate for Payer: Galaxy Health WC |
$13.60
|
| Rate for Payer: Global Benefits Group Commercial |
$9.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$14.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$12.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$10.61
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$10.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6.47
|
| Rate for Payer: InnovAge PACE Commercial |
$9.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10.85
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8.67
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8.67
|
| Rate for Payer: Multiplan Commercial |
$12.00
|
| Rate for Payer: Networks By Design Commercial |
$10.40
|
| Rate for Payer: Prime Health Services Commercial |
$13.60
|
| Rate for Payer: Prime Health Services Medicare |
$6.86
|
| Rate for Payer: Riverside University Health System MISP |
$7.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.24
|
| Rate for Payer: United Healthcare All Other HMO |
$5.24
|
| Rate for Payer: United Healthcare HMO Rider |
$5.24
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.24
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$9.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.12
|
| Rate for Payer: Vantage Medical Group Senior |
$6.47
|
|
|
HC CCPD DAILY TREATMENT
|
Facility
|
OP
|
$1,288.00
|
|
|
Service Code
|
CPT 90945
|
| Hospital Charge Code |
905400102
|
|
Hospital Revenue Code
|
851
|
| Min. Negotiated Rate |
$137.10 |
| Max. Negotiated Rate |
$1,159.20 |
| Rate for Payer: Adventist Health Medi-Cal |
$553.39
|
| Rate for Payer: Aetna of CA HMO/PPO |
$475.70
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$830.08
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$608.73
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$553.39
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$623.65
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$760.95
|
| Rate for Payer: Blue Distinction Transplant |
$772.80
|
| Rate for Payer: Caremore Medicare Advantage |
$553.39
|
| Rate for Payer: Cash Price |
$579.60
|
| Rate for Payer: Cash Price |
$579.60
|
| Rate for Payer: Cash Price |
$579.60
|
| Rate for Payer: Central Health Plan Commercial |
$1,030.40
|
| Rate for Payer: Cigna of CA HMO |
$824.32
|
| Rate for Payer: Cigna of CA PPO |
$953.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$830.08
|
| Rate for Payer: Dignity Health Media |
$553.39
|
| Rate for Payer: Dignity Health Medi-Cal |
$608.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$747.08
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$553.39
|
| Rate for Payer: EPIC Health Plan Transplant |
$553.39
|
| Rate for Payer: Galaxy Health WC |
$1,094.80
|
| Rate for Payer: Global Benefits Group Commercial |
$772.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,159.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$966.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$907.56
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$913.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$553.39
|
| Rate for Payer: InnovAge PACE Commercial |
$830.08
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$859.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$137.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$553.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$257.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$741.54
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$741.54
|
| Rate for Payer: Multiplan Commercial |
$966.00
|
| Rate for Payer: Networks By Design Commercial |
$837.20
|
| Rate for Payer: Prime Health Services Commercial |
$1,094.80
|
| Rate for Payer: Prime Health Services Medicare |
$586.59
|
| Rate for Payer: Riverside University Health System MISP |
$608.73
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$772.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$772.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$698.00
|
| Rate for Payer: United Healthcare All Other HMO |
$691.00
|
| Rate for Payer: United Healthcare HMO Rider |
$524.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$479.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$830.08
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$608.73
|
| Rate for Payer: Vantage Medical Group Senior |
$553.39
|
|
|
HC CCPD DAILY TREATMENT
|
Facility
|
OP
|
$1,288.00
|
|
|
Service Code
|
CPT 90945
|
| Hospital Charge Code |
943000102
|
|
Hospital Revenue Code
|
851
|
| Min. Negotiated Rate |
$137.10 |
| Max. Negotiated Rate |
$1,159.20 |
| Rate for Payer: Adventist Health Medi-Cal |
$553.39
|
| Rate for Payer: Aetna of CA HMO/PPO |
$475.70
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$830.08
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$608.73
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$553.39
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$623.65
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$760.95
|
| Rate for Payer: Blue Distinction Transplant |
$772.80
|
| Rate for Payer: Caremore Medicare Advantage |
$553.39
|
| Rate for Payer: Cash Price |
$579.60
|
| Rate for Payer: Cash Price |
$579.60
|
| Rate for Payer: Cash Price |
$579.60
|
| Rate for Payer: Central Health Plan Commercial |
$1,030.40
|
| Rate for Payer: Cigna of CA HMO |
$824.32
|
| Rate for Payer: Cigna of CA PPO |
$953.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$830.08
|
| Rate for Payer: Dignity Health Media |
$553.39
|
| Rate for Payer: Dignity Health Medi-Cal |
$608.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$747.08
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$553.39
|
| Rate for Payer: EPIC Health Plan Transplant |
$553.39
|
| Rate for Payer: Galaxy Health WC |
$1,094.80
|
| Rate for Payer: Global Benefits Group Commercial |
$772.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,159.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$966.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$907.56
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$913.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$553.39
|
| Rate for Payer: InnovAge PACE Commercial |
$830.08
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$859.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$137.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$553.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$257.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$741.54
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$741.54
|
| Rate for Payer: Multiplan Commercial |
$966.00
|
| Rate for Payer: Networks By Design Commercial |
$837.20
|
| Rate for Payer: Prime Health Services Commercial |
$1,094.80
|
| Rate for Payer: Prime Health Services Medicare |
$586.59
|
| Rate for Payer: Riverside University Health System MISP |
$608.73
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$772.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$772.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$698.00
|
| Rate for Payer: United Healthcare All Other HMO |
$691.00
|
| Rate for Payer: United Healthcare HMO Rider |
$524.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$479.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$830.08
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$608.73
|
| Rate for Payer: Vantage Medical Group Senior |
$553.39
|
|
|
HC CCPD DAILY TREATMENT
|
Facility
|
IP
|
$1,288.00
|
|
|
Service Code
|
CPT 90945
|
| Hospital Charge Code |
943000102
|
|
Hospital Revenue Code
|
851
|
| Min. Negotiated Rate |
$257.60 |
| Max. Negotiated Rate |
$1,159.20 |
| Rate for Payer: Cash Price |
$579.60
|
| Rate for Payer: Central Health Plan Commercial |
$1,030.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$515.20
|
| Rate for Payer: Galaxy Health WC |
$1,094.80
|
| Rate for Payer: Global Benefits Group Commercial |
$772.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,159.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$859.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$490.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$257.60
|
| Rate for Payer: Multiplan Commercial |
$966.00
|
| Rate for Payer: Networks By Design Commercial |
$837.20
|
| Rate for Payer: Prime Health Services Commercial |
$1,094.80
|
|
|
HC CCPD DAILY TREATMENT
|
Facility
|
IP
|
$1,288.00
|
|
|
Service Code
|
CPT 90945
|
| Hospital Charge Code |
905400102
|
|
Hospital Revenue Code
|
851
|
| Min. Negotiated Rate |
$257.60 |
| Max. Negotiated Rate |
$1,159.20 |
| Rate for Payer: Cash Price |
$579.60
|
| Rate for Payer: Central Health Plan Commercial |
$1,030.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$515.20
|
| Rate for Payer: Galaxy Health WC |
$1,094.80
|
| Rate for Payer: Global Benefits Group Commercial |
$772.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,159.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$859.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$490.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$257.60
|
| Rate for Payer: Multiplan Commercial |
$966.00
|
| Rate for Payer: Networks By Design Commercial |
$837.20
|
| Rate for Payer: Prime Health Services Commercial |
$1,094.80
|
|
|
HC CCPD RE-TRAINING
|
Facility
|
OP
|
$2,198.00
|
|
|
Service Code
|
CPT 90993
|
| Hospital Charge Code |
943000207
|
|
Hospital Revenue Code
|
841
|
| Min. Negotiated Rate |
$52.93 |
| Max. Negotiated Rate |
$1,978.20 |
| Rate for Payer: Aetna of CA HMO/PPO |
$459.01
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,868.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,208.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,208.90
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,064.27
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,298.58
|
| Rate for Payer: Blue Distinction Transplant |
$1,318.80
|
| Rate for Payer: Cash Price |
$989.10
|
| Rate for Payer: Cash Price |
$989.10
|
| Rate for Payer: Cash Price |
$989.10
|
| Rate for Payer: Central Health Plan Commercial |
$1,758.40
|
| Rate for Payer: Cigna of CA HMO |
$1,406.72
|
| Rate for Payer: Cigna of CA PPO |
$1,626.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,868.30
|
| Rate for Payer: Dignity Health Media |
$1,868.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,868.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$879.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$879.20
|
| Rate for Payer: Galaxy Health WC |
$1,868.30
|
| Rate for Payer: Global Benefits Group Commercial |
$1,318.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,978.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,648.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$769.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,466.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$52.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$439.60
|
| Rate for Payer: Multiplan Commercial |
$1,648.50
|
| Rate for Payer: Networks By Design Commercial |
$1,428.70
|
| Rate for Payer: Prime Health Services Commercial |
$1,868.30
|
| Rate for Payer: Riverside University Health System MISP |
$879.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,318.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,318.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$698.00
|
| Rate for Payer: United Healthcare All Other HMO |
$691.00
|
| Rate for Payer: United Healthcare HMO Rider |
$524.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$479.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,868.30
|
| Rate for Payer: Vantage Medical Group Senior |
$1,868.30
|
|
|
HC CCPD RE-TRAINING
|
Facility
|
IP
|
$2,198.00
|
|
|
Service Code
|
CPT 90993
|
| Hospital Charge Code |
943000207
|
|
Hospital Revenue Code
|
841
|
| Min. Negotiated Rate |
$439.60 |
| Max. Negotiated Rate |
$1,978.20 |
| Rate for Payer: Cash Price |
$989.10
|
| Rate for Payer: Central Health Plan Commercial |
$1,758.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$879.20
|
| Rate for Payer: Galaxy Health WC |
$1,868.30
|
| Rate for Payer: Global Benefits Group Commercial |
$1,318.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,978.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,466.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$837.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$439.60
|
| Rate for Payer: Multiplan Commercial |
$1,648.50
|
| Rate for Payer: Networks By Design Commercial |
$1,428.70
|
| Rate for Payer: Prime Health Services Commercial |
$1,868.30
|
|
|
HC CCPD TRAINING
|
Facility
|
OP
|
$2,198.00
|
|
|
Service Code
|
CPT 90989
|
| Hospital Charge Code |
943000202
|
|
Hospital Revenue Code
|
851
|
| Min. Negotiated Rate |
$439.60 |
| Max. Negotiated Rate |
$2,129.64 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,129.64
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,868.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,208.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,208.90
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,064.27
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,298.58
|
| Rate for Payer: Blue Distinction Transplant |
$1,318.80
|
| Rate for Payer: Cash Price |
$989.10
|
| Rate for Payer: Cash Price |
$989.10
|
| Rate for Payer: Cash Price |
$989.10
|
| Rate for Payer: Central Health Plan Commercial |
$1,758.40
|
| Rate for Payer: Cigna of CA HMO |
$1,406.72
|
| Rate for Payer: Cigna of CA PPO |
$1,626.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,868.30
|
| Rate for Payer: Dignity Health Media |
$1,868.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,868.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$879.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$879.20
|
| Rate for Payer: Galaxy Health WC |
$1,868.30
|
| Rate for Payer: Global Benefits Group Commercial |
$1,318.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,978.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,648.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$769.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,466.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,268.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$439.60
|
| Rate for Payer: Multiplan Commercial |
$1,648.50
|
| Rate for Payer: Networks By Design Commercial |
$1,428.70
|
| Rate for Payer: Prime Health Services Commercial |
$1,868.30
|
| Rate for Payer: Riverside University Health System MISP |
$879.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,318.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,318.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$698.00
|
| Rate for Payer: United Healthcare All Other HMO |
$691.00
|
| Rate for Payer: United Healthcare HMO Rider |
$524.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$479.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,868.30
|
| Rate for Payer: Vantage Medical Group Senior |
$1,868.30
|
|
|
HC CCPD TRAINING
|
Facility
|
IP
|
$2,198.00
|
|
|
Service Code
|
CPT 90989
|
| Hospital Charge Code |
943000202
|
|
Hospital Revenue Code
|
851
|
| Min. Negotiated Rate |
$439.60 |
| Max. Negotiated Rate |
$1,978.20 |
| Rate for Payer: Cash Price |
$989.10
|
| Rate for Payer: Central Health Plan Commercial |
$1,758.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$879.20
|
| Rate for Payer: Galaxy Health WC |
$1,868.30
|
| Rate for Payer: Global Benefits Group Commercial |
$1,318.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,978.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,466.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$837.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$439.60
|
| Rate for Payer: Multiplan Commercial |
$1,648.50
|
| Rate for Payer: Networks By Design Commercial |
$1,428.70
|
| Rate for Payer: Prime Health Services Commercial |
$1,868.30
|
|
|
HC CD3
|
Facility
|
OP
|
$144.00
|
|
|
Service Code
|
CPT 86359
|
| Hospital Charge Code |
903900102
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$28.80 |
| Max. Negotiated Rate |
$335.32 |
| Rate for Payer: Adventist Health Medi-Cal |
$37.73
|
| Rate for Payer: Aetna of CA HMO/PPO |
$276.84
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$56.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$41.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$37.73
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$274.91
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$335.32
|
| Rate for Payer: Blue Distinction Transplant |
$86.40
|
| Rate for Payer: Blue Shield of California Commercial |
$88.99
|
| Rate for Payer: Blue Shield of California EPN |
$69.98
|
| Rate for Payer: Caremore Medicare Advantage |
$37.73
|
| Rate for Payer: Cash Price |
$64.80
|
| Rate for Payer: Cash Price |
$64.80
|
| Rate for Payer: Central Health Plan Commercial |
$115.20
|
| Rate for Payer: Cigna of CA HMO |
$92.16
|
| Rate for Payer: Cigna of CA PPO |
$106.56
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$56.60
|
| Rate for Payer: Dignity Health Media |
$37.73
|
| Rate for Payer: Dignity Health Medi-Cal |
$41.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$50.94
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$37.73
|
| Rate for Payer: EPIC Health Plan Transplant |
$37.73
|
| Rate for Payer: Galaxy Health WC |
$122.40
|
| Rate for Payer: Global Benefits Group Commercial |
$86.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$129.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$108.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$61.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$62.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$37.73
|
| Rate for Payer: InnovAge PACE Commercial |
$56.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$96.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$63.71
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$37.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$28.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$50.56
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$50.56
|
| Rate for Payer: Multiplan Commercial |
$108.00
|
| Rate for Payer: Networks By Design Commercial |
$93.60
|
| Rate for Payer: Prime Health Services Commercial |
$122.40
|
| Rate for Payer: Prime Health Services Medicare |
$39.99
|
| Rate for Payer: Riverside University Health System MISP |
$41.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$86.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$86.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$30.56
|
| Rate for Payer: United Healthcare All Other HMO |
$30.56
|
| Rate for Payer: United Healthcare HMO Rider |
$30.56
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$30.56
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$56.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$41.50
|
| Rate for Payer: Vantage Medical Group Senior |
$37.73
|
|
|
HC CD3
|
Facility
|
IP
|
$398.00
|
|
|
Service Code
|
CPT 86359
|
| Hospital Charge Code |
903900102
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$79.60 |
| Max. Negotiated Rate |
$358.20 |
| Rate for Payer: Cash Price |
$179.10
|
| Rate for Payer: Central Health Plan Commercial |
$318.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$159.20
|
| Rate for Payer: Galaxy Health WC |
$338.30
|
| Rate for Payer: Global Benefits Group Commercial |
$238.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$358.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$265.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$151.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$79.60
|
| Rate for Payer: Multiplan Commercial |
$298.50
|
| Rate for Payer: Networks By Design Commercial |
$258.70
|
| Rate for Payer: Prime Health Services Commercial |
$338.30
|
|
|
HC CD45 LEUKEMIA/LYMPHOMA
|
Facility
|
IP
|
$773.00
|
|
|
Service Code
|
CPT 88184
|
| Hospital Charge Code |
903900100
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$154.60 |
| Max. Negotiated Rate |
$695.70 |
| Rate for Payer: Cash Price |
$347.85
|
| Rate for Payer: Central Health Plan Commercial |
$618.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$309.20
|
| Rate for Payer: Galaxy Health WC |
$657.05
|
| Rate for Payer: Global Benefits Group Commercial |
$463.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$695.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$515.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$294.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$154.60
|
| Rate for Payer: Multiplan Commercial |
$579.75
|
| Rate for Payer: Networks By Design Commercial |
$502.45
|
| Rate for Payer: Prime Health Services Commercial |
$657.05
|
|
|
HC CD45 LEUKEMIA/LYMPHOMA
|
Facility
|
OP
|
$245.00
|
|
|
Service Code
|
CPT 88184
|
| Hospital Charge Code |
903900100
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$49.00 |
| Max. Negotiated Rate |
$741.03 |
| Rate for Payer: Adventist Health Medi-Cal |
$449.11
|
| Rate for Payer: Aetna of CA HMO/PPO |
$470.85
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$673.66
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$494.02
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$449.11
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$283.77
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$346.13
|
| Rate for Payer: Blue Distinction Transplant |
$147.00
|
| Rate for Payer: Blue Shield of California Commercial |
$151.41
|
| Rate for Payer: Blue Shield of California EPN |
$119.07
|
| Rate for Payer: Caremore Medicare Advantage |
$449.11
|
| Rate for Payer: Cash Price |
$110.25
|
| Rate for Payer: Cash Price |
$110.25
|
| Rate for Payer: Central Health Plan Commercial |
$196.00
|
| Rate for Payer: Cigna of CA HMO |
$156.80
|
| Rate for Payer: Cigna of CA PPO |
$181.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$673.66
|
| Rate for Payer: Dignity Health Media |
$449.11
|
| Rate for Payer: Dignity Health Medi-Cal |
$494.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$606.30
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$449.11
|
| Rate for Payer: EPIC Health Plan Transplant |
$449.11
|
| Rate for Payer: Galaxy Health WC |
$208.25
|
| Rate for Payer: Global Benefits Group Commercial |
$147.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$220.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$183.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$736.54
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$741.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$449.11
|
| Rate for Payer: InnovAge PACE Commercial |
$673.66
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$163.42
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$80.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$449.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$49.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$601.81
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$601.81
|
| Rate for Payer: Multiplan Commercial |
$183.75
|
| Rate for Payer: Networks By Design Commercial |
$159.25
|
| Rate for Payer: Prime Health Services Commercial |
$208.25
|
| Rate for Payer: Prime Health Services Medicare |
$476.06
|
| Rate for Payer: Riverside University Health System MISP |
$494.02
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$147.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$147.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$240.94
|
| Rate for Payer: United Healthcare All Other HMO |
$240.94
|
| Rate for Payer: United Healthcare HMO Rider |
$240.94
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$240.94
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$673.66
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$494.02
|
| Rate for Payer: Vantage Medical Group Senior |
$449.11
|
|
|
HC C DIFFICILE TOXIN A/B ASSAY
|
Facility
|
OP
|
$39.00
|
|
|
Service Code
|
CPT 87324
|
| Hospital Charge Code |
900911750
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$7.80 |
| Max. Negotiated Rate |
$79.75 |
| Rate for Payer: Adventist Health Medi-Cal |
$11.98
|
| Rate for Payer: Aetna of CA HMO/PPO |
$68.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$17.97
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11.98
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$65.38
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$79.75
|
| Rate for Payer: Blue Distinction Transplant |
$23.40
|
| Rate for Payer: Blue Shield of California Commercial |
$24.10
|
| Rate for Payer: Blue Shield of California EPN |
$18.95
|
| Rate for Payer: Caremore Medicare Advantage |
$11.98
|
| Rate for Payer: Cash Price |
$17.55
|
| Rate for Payer: Cash Price |
$17.55
|
| Rate for Payer: Central Health Plan Commercial |
$31.20
|
| Rate for Payer: Cigna of CA HMO |
$24.96
|
| Rate for Payer: Cigna of CA PPO |
$28.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$17.97
|
| Rate for Payer: Dignity Health Media |
$11.98
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.17
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$11.98
|
| Rate for Payer: EPIC Health Plan Transplant |
$11.98
|
| Rate for Payer: Galaxy Health WC |
$33.15
|
| Rate for Payer: Global Benefits Group Commercial |
$23.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$35.10
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$29.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$19.65
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$19.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$11.98
|
| Rate for Payer: InnovAge PACE Commercial |
$17.97
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$26.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$15.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$11.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16.05
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16.05
|
| Rate for Payer: Multiplan Commercial |
$29.25
|
| Rate for Payer: Networks By Design Commercial |
$25.35
|
| Rate for Payer: Prime Health Services Commercial |
$33.15
|
| Rate for Payer: Prime Health Services Medicare |
$12.70
|
| Rate for Payer: Riverside University Health System MISP |
$13.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$23.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$23.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.70
|
| Rate for Payer: United Healthcare All Other HMO |
$9.70
|
| Rate for Payer: United Healthcare HMO Rider |
$9.70
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.70
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$17.97
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.18
|
| Rate for Payer: Vantage Medical Group Senior |
$11.98
|
|
|
HC C DIFFICILE TOXIN A/B ASSAY
|
Facility
|
IP
|
$250.00
|
|
|
Service Code
|
CPT 87324
|
| Hospital Charge Code |
900911750
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$50.00 |
| Max. Negotiated Rate |
$225.00 |
| Rate for Payer: Cash Price |
$112.50
|
| Rate for Payer: Central Health Plan Commercial |
$200.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$100.00
|
| Rate for Payer: Galaxy Health WC |
$212.50
|
| Rate for Payer: Global Benefits Group Commercial |
$150.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$225.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$166.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$95.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$50.00
|
| Rate for Payer: Multiplan Commercial |
$187.50
|
| Rate for Payer: Networks By Design Commercial |
$162.50
|
| Rate for Payer: Prime Health Services Commercial |
$212.50
|
|
|
HC CDIFF NUCLEIC ACID TEST
|
Facility
|
OP
|
$62.00
|
|
|
Service Code
|
CPT 87493
|
| Hospital Charge Code |
900912489
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$12.40 |
| Max. Negotiated Rate |
$381.98 |
| Rate for Payer: Adventist Health Medi-Cal |
$37.27
|
| Rate for Payer: Aetna of CA HMO/PPO |
$257.58
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$55.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$41.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$37.27
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$313.16
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$381.98
|
| Rate for Payer: Blue Distinction Transplant |
$37.20
|
| Rate for Payer: Blue Shield of California Commercial |
$38.32
|
| Rate for Payer: Blue Shield of California EPN |
$30.13
|
| Rate for Payer: Caremore Medicare Advantage |
$37.27
|
| Rate for Payer: Cash Price |
$27.90
|
| Rate for Payer: Cash Price |
$27.90
|
| Rate for Payer: Central Health Plan Commercial |
$49.60
|
| Rate for Payer: Cigna of CA HMO |
$39.68
|
| Rate for Payer: Cigna of CA PPO |
$45.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$55.90
|
| Rate for Payer: Dignity Health Media |
$37.27
|
| Rate for Payer: Dignity Health Medi-Cal |
$41.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$50.31
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$37.27
|
| Rate for Payer: EPIC Health Plan Transplant |
$37.27
|
| Rate for Payer: Galaxy Health WC |
$52.70
|
| Rate for Payer: Global Benefits Group Commercial |
$37.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$55.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$46.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$61.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$61.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$37.27
|
| Rate for Payer: InnovAge PACE Commercial |
$55.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$41.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$54.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$37.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$49.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$49.94
|
| Rate for Payer: Multiplan Commercial |
$46.50
|
| Rate for Payer: Networks By Design Commercial |
$40.30
|
| Rate for Payer: Prime Health Services Commercial |
$52.70
|
| Rate for Payer: Prime Health Services Medicare |
$39.51
|
| Rate for Payer: Riverside University Health System MISP |
$41.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$37.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$37.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$30.19
|
| Rate for Payer: United Healthcare All Other HMO |
$30.19
|
| Rate for Payer: United Healthcare HMO Rider |
$30.19
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$30.19
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$55.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$41.00
|
| Rate for Payer: Vantage Medical Group Senior |
$37.27
|
|
|
HC CDIFF NUCLEIC ACID TEST
|
Facility
|
IP
|
$84.00
|
|
|
Service Code
|
CPT 87493
|
| Hospital Charge Code |
900912489
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$16.80 |
| Max. Negotiated Rate |
$75.60 |
| Rate for Payer: Cash Price |
$37.80
|
| Rate for Payer: Central Health Plan Commercial |
$67.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$33.60
|
| Rate for Payer: Galaxy Health WC |
$71.40
|
| Rate for Payer: Global Benefits Group Commercial |
$50.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$75.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$56.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$32.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.80
|
| Rate for Payer: Multiplan Commercial |
$63.00
|
| Rate for Payer: Networks By Design Commercial |
$54.60
|
| Rate for Payer: Prime Health Services Commercial |
$71.40
|
|
|
HC CEFINASE
|
Facility
|
OP
|
$18.00
|
|
|
Service Code
|
CPT 87185
|
| Hospital Charge Code |
900912424
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$2.30 |
| Max. Negotiated Rate |
$25.57 |
| Rate for Payer: Adventist Health Medi-Cal |
$4.75
|
| Rate for Payer: Aetna of CA HMO/PPO |
$11.96
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.12
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.22
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$20.96
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$25.57
|
| Rate for Payer: Blue Distinction Transplant |
$10.80
|
| Rate for Payer: Blue Shield of California Commercial |
$11.12
|
| Rate for Payer: Blue Shield of California EPN |
$8.75
|
| Rate for Payer: Caremore Medicare Advantage |
$4.75
|
| Rate for Payer: Cash Price |
$8.10
|
| Rate for Payer: Cash Price |
$8.10
|
| Rate for Payer: Central Health Plan Commercial |
$14.40
|
| Rate for Payer: Cigna of CA HMO |
$11.52
|
| Rate for Payer: Cigna of CA PPO |
$13.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.12
|
| Rate for Payer: Dignity Health Media |
$4.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.41
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4.75
|
| Rate for Payer: EPIC Health Plan Transplant |
$4.75
|
| Rate for Payer: Galaxy Health WC |
$15.30
|
| Rate for Payer: Global Benefits Group Commercial |
$10.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$16.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$13.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7.79
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$7.84
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4.75
|
| Rate for Payer: InnovAge PACE Commercial |
$7.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.36
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.36
|
| Rate for Payer: Multiplan Commercial |
$13.50
|
| Rate for Payer: Networks By Design Commercial |
$11.70
|
| Rate for Payer: Prime Health Services Commercial |
$15.30
|
| Rate for Payer: Prime Health Services Medicare |
$5.04
|
| Rate for Payer: Riverside University Health System MISP |
$5.22
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$10.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.85
|
| Rate for Payer: United Healthcare All Other HMO |
$3.85
|
| Rate for Payer: United Healthcare HMO Rider |
$3.85
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.85
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.22
|
| Rate for Payer: Vantage Medical Group Senior |
$4.75
|
|
|
HC CEFINASE
|
Facility
|
IP
|
$105.00
|
|
|
Service Code
|
CPT 87185
|
| Hospital Charge Code |
900912424
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$21.00 |
| Max. Negotiated Rate |
$94.50 |
| Rate for Payer: Cash Price |
$47.25
|
| Rate for Payer: Central Health Plan Commercial |
$84.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$42.00
|
| Rate for Payer: Galaxy Health WC |
$89.25
|
| Rate for Payer: Global Benefits Group Commercial |
$63.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$94.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$70.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$40.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$21.00
|
| Rate for Payer: Multiplan Commercial |
$78.75
|
| Rate for Payer: Networks By Design Commercial |
$68.25
|
| Rate for Payer: Prime Health Services Commercial |
$89.25
|
|
|
HC CELIAC BLOCK INJECTION
|
Facility
|
OP
|
$5,230.00
|
|
|
Service Code
|
CPT 64620
|
| Hospital Charge Code |
906764620
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$188.86 |
| Max. Negotiated Rate |
$4,846.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$1,138.83
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,708.24
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,252.71
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,138.83
|
| 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 |
$3,138.00
|
| 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 |
$1,138.83
|
| Rate for Payer: Cash Price |
$2,353.50
|
| Rate for Payer: Cash Price |
$2,353.50
|
| Rate for Payer: Central Health Plan Commercial |
$4,184.00
|
| Rate for Payer: Cigna of CA PPO |
$3,870.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,708.24
|
| Rate for Payer: Dignity Health Media |
$1,138.83
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,252.71
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,537.42
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,138.83
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,138.83
|
| Rate for Payer: Galaxy Health WC |
$4,445.50
|
| Rate for Payer: Global Benefits Group Commercial |
$3,138.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,707.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$3,922.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,867.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,879.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,138.83
|
| Rate for Payer: InnovAge PACE Commercial |
$1,708.24
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,488.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$188.86
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,138.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,046.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,526.03
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,526.03
|
| Rate for Payer: Multiplan Commercial |
$3,922.50
|
| Rate for Payer: Networks By Design Commercial |
$3,399.50
|
| Rate for Payer: Prime Health Services Commercial |
$4,445.50
|
| Rate for Payer: Prime Health Services Medicare |
$1,207.16
|
| Rate for Payer: Riverside University Health System MISP |
$1,252.71
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,138.00
|
| 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 |
$1,708.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,252.71
|
| Rate for Payer: Vantage Medical Group Senior |
$1,138.83
|
|
|
HC CELIAC BLOCK INJECTION
|
Facility
|
IP
|
$5,230.00
|
|
|
Service Code
|
CPT 64620
|
| Hospital Charge Code |
906764620
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,046.00 |
| Max. Negotiated Rate |
$4,707.00 |
| Rate for Payer: Cash Price |
$2,353.50
|
| Rate for Payer: Central Health Plan Commercial |
$4,184.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,092.00
|
| Rate for Payer: Galaxy Health WC |
$4,445.50
|
| Rate for Payer: Global Benefits Group Commercial |
$3,138.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,707.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,488.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,992.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,046.00
|
| Rate for Payer: Multiplan Commercial |
$3,922.50
|
| Rate for Payer: Networks By Design Commercial |
$3,399.50
|
| Rate for Payer: Prime Health Services Commercial |
$4,445.50
|
|
|
HC CELL COUNT & DIFF
|
Facility
|
OP
|
$21.00
|
|
|
Service Code
|
CPT 89051
|
| Hospital Charge Code |
900910124
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$4.20 |
| Max. Negotiated Rate |
$48.93 |
| Rate for Payer: Adventist Health Medi-Cal |
$5.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$40.43
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$8.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.60
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$40.11
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$48.93
|
| Rate for Payer: Blue Distinction Transplant |
$12.60
|
| Rate for Payer: Blue Shield of California Commercial |
$12.98
|
| Rate for Payer: Blue Shield of California EPN |
$10.21
|
| Rate for Payer: Caremore Medicare Advantage |
$5.60
|
| Rate for Payer: Cash Price |
$9.45
|
| Rate for Payer: Cash Price |
$9.45
|
| Rate for Payer: Central Health Plan Commercial |
$16.80
|
| Rate for Payer: Cigna of CA HMO |
$13.44
|
| Rate for Payer: Cigna of CA PPO |
$15.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8.40
|
| Rate for Payer: Dignity Health Media |
$5.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$6.16
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.56
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$5.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$5.60
|
| Rate for Payer: Galaxy Health WC |
$17.85
|
| Rate for Payer: Global Benefits Group Commercial |
$12.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$18.90
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$15.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$9.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$9.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.60
|
| Rate for Payer: InnovAge PACE Commercial |
$8.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$14.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.23
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$7.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$7.50
|
| Rate for Payer: Multiplan Commercial |
$15.75
|
| Rate for Payer: Networks By Design Commercial |
$13.65
|
| Rate for Payer: Prime Health Services Commercial |
$17.85
|
| Rate for Payer: Prime Health Services Medicare |
$5.94
|
| Rate for Payer: Riverside University Health System MISP |
$6.16
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$12.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$12.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.54
|
| Rate for Payer: United Healthcare All Other HMO |
$4.54
|
| Rate for Payer: United Healthcare HMO Rider |
$4.54
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.54
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$8.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6.16
|
| Rate for Payer: Vantage Medical Group Senior |
$5.60
|
|
|
HC CELL COUNT & DIFF
|
Facility
|
IP
|
$292.00
|
|
|
Service Code
|
CPT 89051
|
| Hospital Charge Code |
900910124
|
|
Hospital Revenue Code
|
300
|
| 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 CELL EXPANSION
|
Facility
|
OP
|
$426.00
|
|
|
Service Code
|
CPT 88233
|
| Hospital Charge Code |
900918001
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$85.20 |
| Max. Negotiated Rate |
$1,060.09 |
| Rate for Payer: Adventist Health Medi-Cal |
$140.73
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,032.82
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$211.10
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$154.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$140.73
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$869.10
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,060.09
|
| Rate for Payer: Blue Distinction Transplant |
$255.60
|
| Rate for Payer: Blue Shield of California Commercial |
$263.27
|
| Rate for Payer: Blue Shield of California EPN |
$207.04
|
| Rate for Payer: Caremore Medicare Advantage |
$140.73
|
| Rate for Payer: Cash Price |
$191.70
|
| Rate for Payer: Cash Price |
$191.70
|
| Rate for Payer: Central Health Plan Commercial |
$340.80
|
| Rate for Payer: Cigna of CA HMO |
$272.64
|
| Rate for Payer: Cigna of CA PPO |
$315.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$211.10
|
| Rate for Payer: Dignity Health Media |
$140.73
|
| Rate for Payer: Dignity Health Medi-Cal |
$154.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$189.99
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$140.73
|
| Rate for Payer: EPIC Health Plan Transplant |
$140.73
|
| Rate for Payer: Galaxy Health WC |
$362.10
|
| Rate for Payer: Global Benefits Group Commercial |
$255.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$383.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$319.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$230.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$232.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$140.73
|
| Rate for Payer: InnovAge PACE Commercial |
$211.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$284.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$237.65
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$140.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$85.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$188.58
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$188.58
|
| Rate for Payer: Multiplan Commercial |
$319.50
|
| Rate for Payer: Networks By Design Commercial |
$276.90
|
| Rate for Payer: Prime Health Services Commercial |
$362.10
|
| Rate for Payer: Prime Health Services Medicare |
$149.17
|
| Rate for Payer: Riverside University Health System MISP |
$154.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$255.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$255.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$113.99
|
| Rate for Payer: United Healthcare All Other HMO |
$113.99
|
| Rate for Payer: United Healthcare HMO Rider |
$113.99
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$113.99
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$211.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$154.80
|
| Rate for Payer: Vantage Medical Group Senior |
$140.73
|
|
