|
HC CHEST WALL MANIPULATION INIT
|
Facility
|
IP
|
$529.00
|
|
|
Service Code
|
CPT 94667
|
| Hospital Charge Code |
900800390
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$105.80 |
| Max. Negotiated Rate |
$476.10 |
| Rate for Payer: Cash Price |
$238.05
|
| Rate for Payer: Central Health Plan Commercial |
$423.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$211.60
|
| Rate for Payer: Galaxy Health WC |
$449.65
|
| Rate for Payer: Global Benefits Group Commercial |
$317.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$476.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$352.84
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$201.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$105.80
|
| Rate for Payer: Multiplan Commercial |
$396.75
|
| Rate for Payer: Networks By Design Commercial |
$343.85
|
| Rate for Payer: Prime Health Services Commercial |
$449.65
|
|
|
HC CHEST WALL MANIPULATION SUB
|
Facility
|
OP
|
$329.00
|
|
|
Service Code
|
CPT 94668
|
| Hospital Charge Code |
900800391
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$22.23 |
| Max. Negotiated Rate |
$509.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$159.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$131.30
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$239.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$175.56
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$159.60
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$92.32
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$408.00
|
| Rate for Payer: Blue Distinction Transplant |
$197.40
|
| Rate for Payer: Blue Shield of California Commercial |
$400.00
|
| Rate for Payer: Blue Shield of California EPN |
$287.00
|
| Rate for Payer: Caremore Medicare Advantage |
$159.60
|
| Rate for Payer: Cash Price |
$148.05
|
| Rate for Payer: Cash Price |
$148.05
|
| Rate for Payer: Cash Price |
$148.05
|
| Rate for Payer: Cash Price |
$148.05
|
| Rate for Payer: Central Health Plan Commercial |
$263.20
|
| Rate for Payer: Cigna of CA HMO |
$210.56
|
| Rate for Payer: Cigna of CA PPO |
$243.46
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$239.40
|
| Rate for Payer: Dignity Health Media |
$159.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$175.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$215.46
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$159.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$159.60
|
| Rate for Payer: Galaxy Health WC |
$279.65
|
| Rate for Payer: Global Benefits Group Commercial |
$197.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$296.10
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$246.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$261.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$263.34
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$159.60
|
| Rate for Payer: InnovAge PACE Commercial |
$239.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$219.44
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$22.23
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$159.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$65.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$213.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$213.86
|
| Rate for Payer: Multiplan Commercial |
$246.75
|
| Rate for Payer: Networks By Design Commercial |
$213.85
|
| Rate for Payer: Prime Health Services Commercial |
$279.65
|
| Rate for Payer: Prime Health Services Medicare |
$169.18
|
| Rate for Payer: Riverside University Health System MISP |
$175.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$197.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$197.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$509.00
|
| Rate for Payer: United Healthcare All Other HMO |
$478.00
|
| Rate for Payer: United Healthcare HMO Rider |
$428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$391.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$239.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$175.56
|
| Rate for Payer: Vantage Medical Group Senior |
$159.60
|
|
|
HC CHEST WALL MANIPULATION SUB
|
Facility
|
IP
|
$329.00
|
|
|
Service Code
|
CPT 94668
|
| Hospital Charge Code |
900800391
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$65.80 |
| Max. Negotiated Rate |
$296.10 |
| Rate for Payer: Cash Price |
$148.05
|
| Rate for Payer: Central Health Plan Commercial |
$263.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$131.60
|
| Rate for Payer: Galaxy Health WC |
$279.65
|
| Rate for Payer: Global Benefits Group Commercial |
$197.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$296.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$219.44
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$125.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$65.80
|
| Rate for Payer: Multiplan Commercial |
$246.75
|
| Rate for Payer: Networks By Design Commercial |
$213.85
|
| Rate for Payer: Prime Health Services Commercial |
$279.65
|
|
|
HC CHICKEN FEATHERS IGE
|
Facility
|
IP
|
$64.00
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
900913634
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.80 |
| Max. Negotiated Rate |
$57.60 |
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Central Health Plan Commercial |
$51.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$25.60
|
| Rate for Payer: Galaxy Health WC |
$54.40
|
| Rate for Payer: Global Benefits Group Commercial |
$38.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$57.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$42.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$24.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.80
|
| Rate for Payer: Multiplan Commercial |
$48.00
|
| Rate for Payer: Networks By Design Commercial |
$41.60
|
| Rate for Payer: Prime Health Services Commercial |
$54.40
|
|
|
HC CHICKEN FEATHERS IGE
|
Facility
|
OP
|
$64.00
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
900913634
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.23 |
| Max. Negotiated Rate |
$140.27 |
| Rate for Payer: Adventist Health Medi-Cal |
$5.22
|
| Rate for Payer: Aetna of CA HMO/PPO |
$38.29
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.83
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.74
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.22
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$115.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$140.27
|
| Rate for Payer: Blue Distinction Transplant |
$38.40
|
| Rate for Payer: Blue Shield of California Commercial |
$39.55
|
| Rate for Payer: Blue Shield of California EPN |
$31.10
|
| Rate for Payer: Caremore Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Central Health Plan Commercial |
$51.20
|
| Rate for Payer: Cigna of CA HMO |
$40.96
|
| Rate for Payer: Cigna of CA PPO |
$47.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.83
|
| Rate for Payer: Dignity Health Media |
$5.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.05
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$5.22
|
| Rate for Payer: EPIC Health Plan Transplant |
$5.22
|
| Rate for Payer: Galaxy Health WC |
$54.40
|
| Rate for Payer: Global Benefits Group Commercial |
$38.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$57.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$48.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$8.56
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$8.61
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.22
|
| Rate for Payer: InnovAge PACE Commercial |
$7.83
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$42.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.99
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.99
|
| Rate for Payer: Multiplan Commercial |
$48.00
|
| Rate for Payer: Networks By Design Commercial |
$41.60
|
| Rate for Payer: Prime Health Services Commercial |
$54.40
|
| Rate for Payer: Prime Health Services Medicare |
$5.53
|
| Rate for Payer: Riverside University Health System MISP |
$5.74
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$38.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$38.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.23
|
| Rate for Payer: United Healthcare All Other HMO |
$4.23
|
| Rate for Payer: United Healthcare HMO Rider |
$4.23
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.23
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.74
|
| Rate for Payer: Vantage Medical Group Senior |
$5.22
|
|
|
HC CHILI PEPPER IGE
|
Facility
|
IP
|
$64.00
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
900913635
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.80 |
| Max. Negotiated Rate |
$57.60 |
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Central Health Plan Commercial |
$51.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$25.60
|
| Rate for Payer: Galaxy Health WC |
$54.40
|
| Rate for Payer: Global Benefits Group Commercial |
$38.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$57.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$42.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$24.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.80
|
| Rate for Payer: Multiplan Commercial |
$48.00
|
| Rate for Payer: Networks By Design Commercial |
$41.60
|
| Rate for Payer: Prime Health Services Commercial |
$54.40
|
|
|
HC CHILI PEPPER IGE
|
Facility
|
OP
|
$64.00
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
900913635
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.23 |
| Max. Negotiated Rate |
$140.27 |
| Rate for Payer: Adventist Health Medi-Cal |
$5.22
|
| Rate for Payer: Aetna of CA HMO/PPO |
$38.29
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.83
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.74
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.22
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$115.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$140.27
|
| Rate for Payer: Blue Distinction Transplant |
$38.40
|
| Rate for Payer: Blue Shield of California Commercial |
$39.55
|
| Rate for Payer: Blue Shield of California EPN |
$31.10
|
| Rate for Payer: Caremore Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Central Health Plan Commercial |
$51.20
|
| Rate for Payer: Cigna of CA HMO |
$40.96
|
| Rate for Payer: Cigna of CA PPO |
$47.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.83
|
| Rate for Payer: Dignity Health Media |
$5.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.05
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$5.22
|
| Rate for Payer: EPIC Health Plan Transplant |
$5.22
|
| Rate for Payer: Galaxy Health WC |
$54.40
|
| Rate for Payer: Global Benefits Group Commercial |
$38.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$57.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$48.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$8.56
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$8.61
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.22
|
| Rate for Payer: InnovAge PACE Commercial |
$7.83
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$42.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.99
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.99
|
| Rate for Payer: Multiplan Commercial |
$48.00
|
| Rate for Payer: Networks By Design Commercial |
$41.60
|
| Rate for Payer: Prime Health Services Commercial |
$54.40
|
| Rate for Payer: Prime Health Services Medicare |
$5.53
|
| Rate for Payer: Riverside University Health System MISP |
$5.74
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$38.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$38.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.23
|
| Rate for Payer: United Healthcare All Other HMO |
$4.23
|
| Rate for Payer: United Healthcare HMO Rider |
$4.23
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.23
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.74
|
| Rate for Payer: Vantage Medical Group Senior |
$5.22
|
|
|
HC CHLAMYDIA AMPLIFICATION
|
Facility
|
IP
|
$356.00
|
|
|
Service Code
|
CPT 87491
|
| Hospital Charge Code |
900912304
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$71.20 |
| Max. Negotiated Rate |
$320.40 |
| Rate for Payer: Cash Price |
$160.20
|
| Rate for Payer: Central Health Plan Commercial |
$284.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$142.40
|
| Rate for Payer: Galaxy Health WC |
$302.60
|
| Rate for Payer: Global Benefits Group Commercial |
$213.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$320.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$237.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$135.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$71.20
|
| Rate for Payer: Multiplan Commercial |
$267.00
|
| Rate for Payer: Networks By Design Commercial |
$231.40
|
| Rate for Payer: Prime Health Services Commercial |
$302.60
|
|
|
HC CHLAMYDIA AMPLIFICATION
|
Facility
|
OP
|
$103.00
|
|
|
Service Code
|
CPT 87491
|
| Hospital Charge Code |
900912304
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$20.60 |
| Max. Negotiated Rate |
$301.33 |
| Rate for Payer: Adventist Health Medi-Cal |
$35.09
|
| Rate for Payer: Aetna of CA HMO/PPO |
$257.58
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$52.64
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$38.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$35.09
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$247.04
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$301.33
|
| Rate for Payer: Blue Distinction Transplant |
$61.80
|
| Rate for Payer: Blue Shield of California Commercial |
$63.65
|
| Rate for Payer: Blue Shield of California EPN |
$50.06
|
| Rate for Payer: Caremore Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$46.35
|
| Rate for Payer: Cash Price |
$46.35
|
| Rate for Payer: Central Health Plan Commercial |
$82.40
|
| Rate for Payer: Cigna of CA HMO |
$65.92
|
| Rate for Payer: Cigna of CA PPO |
$76.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$52.64
|
| Rate for Payer: Dignity Health Media |
$35.09
|
| Rate for Payer: Dignity Health Medi-Cal |
$38.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$47.37
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$35.09
|
| Rate for Payer: EPIC Health Plan Transplant |
$35.09
|
| Rate for Payer: Galaxy Health WC |
$87.55
|
| Rate for Payer: Global Benefits Group Commercial |
$61.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$92.70
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$77.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$57.55
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$57.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$35.09
|
| Rate for Payer: InnovAge PACE Commercial |
$52.64
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$68.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$48.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$35.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$47.02
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$47.02
|
| Rate for Payer: Multiplan Commercial |
$77.25
|
| Rate for Payer: Networks By Design Commercial |
$66.95
|
| Rate for Payer: Prime Health Services Commercial |
$87.55
|
| Rate for Payer: Prime Health Services Medicare |
$37.20
|
| Rate for Payer: Riverside University Health System MISP |
$38.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$61.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$61.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$28.42
|
| Rate for Payer: United Healthcare All Other HMO |
$28.42
|
| Rate for Payer: United Healthcare HMO Rider |
$28.42
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$28.42
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$52.64
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$38.60
|
| Rate for Payer: Vantage Medical Group Senior |
$35.09
|
|
|
HC CHLAMYDIA PNEU CULTR SOURCE SO
|
Facility
|
OP
|
$21.09
|
|
|
Service Code
|
CPT 87140
|
| Hospital Charge Code |
900914083
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$4.22 |
| Max. Negotiated Rate |
$49.52 |
| Rate for Payer: Adventist Health Medi-Cal |
$5.57
|
| Rate for Payer: Aetna of CA HMO/PPO |
$40.86
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$8.36
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.57
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$40.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$49.52
|
| Rate for Payer: Blue Distinction Transplant |
$12.65
|
| Rate for Payer: Blue Shield of California Commercial |
$13.03
|
| Rate for Payer: Blue Shield of California EPN |
$10.25
|
| Rate for Payer: Caremore Medicare Advantage |
$5.57
|
| Rate for Payer: Cash Price |
$9.49
|
| Rate for Payer: Cash Price |
$9.49
|
| Rate for Payer: Central Health Plan Commercial |
$16.87
|
| Rate for Payer: Cigna of CA HMO |
$13.50
|
| Rate for Payer: Cigna of CA PPO |
$15.61
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8.36
|
| Rate for Payer: Dignity Health Media |
$5.57
|
| Rate for Payer: Dignity Health Medi-Cal |
$6.13
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.52
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$5.57
|
| Rate for Payer: EPIC Health Plan Transplant |
$5.57
|
| Rate for Payer: Galaxy Health WC |
$17.93
|
| Rate for Payer: Global Benefits Group Commercial |
$12.65
|
| Rate for Payer: Health Management Network EPO/PPO |
$18.98
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$15.82
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$9.13
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$9.19
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.57
|
| Rate for Payer: InnovAge PACE Commercial |
$8.36
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$14.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.40
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.22
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$7.46
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$7.46
|
| Rate for Payer: Multiplan Commercial |
$15.82
|
| Rate for Payer: Networks By Design Commercial |
$13.71
|
| Rate for Payer: Prime Health Services Commercial |
$17.93
|
| Rate for Payer: Prime Health Services Medicare |
$5.90
|
| Rate for Payer: Riverside University Health System MISP |
$6.13
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$12.65
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$12.65
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.51
|
| Rate for Payer: United Healthcare All Other HMO |
$4.51
|
| Rate for Payer: United Healthcare HMO Rider |
$4.51
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.51
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$8.36
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6.13
|
| Rate for Payer: Vantage Medical Group Senior |
$5.57
|
|
|
HC CHLAMYDIA PNEU CULTR SOURCE SO
|
Facility
|
IP
|
$21.09
|
|
|
Service Code
|
CPT 87140
|
| Hospital Charge Code |
900914083
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$4.22 |
| Max. Negotiated Rate |
$18.98 |
| Rate for Payer: Cash Price |
$9.49
|
| Rate for Payer: Central Health Plan Commercial |
$16.87
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.44
|
| Rate for Payer: Galaxy Health WC |
$17.93
|
| Rate for Payer: Global Benefits Group Commercial |
$12.65
|
| Rate for Payer: Health Management Network EPO/PPO |
$18.98
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$14.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.22
|
| Rate for Payer: Multiplan Commercial |
$15.82
|
| Rate for Payer: Networks By Design Commercial |
$13.71
|
| Rate for Payer: Prime Health Services Commercial |
$17.93
|
|
|
HC CHLORAMPHENICOL E TEST
|
Facility
|
OP
|
$19.00
|
|
|
Service Code
|
CPT 87181
|
| Hospital Charge Code |
900912442
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$2.20 |
| Max. Negotiated Rate |
$20.01 |
| 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 |
$16.41
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$20.01
|
| Rate for Payer: Blue Distinction Transplant |
$11.40
|
| Rate for Payer: Blue Shield of California Commercial |
$11.74
|
| Rate for Payer: Blue Shield of California EPN |
$9.23
|
| Rate for Payer: Caremore Medicare Advantage |
$4.75
|
| Rate for Payer: Cash Price |
$8.55
|
| Rate for Payer: Cash Price |
$8.55
|
| Rate for Payer: Central Health Plan Commercial |
$15.20
|
| Rate for Payer: Cigna of CA HMO |
$12.16
|
| Rate for Payer: Cigna of CA PPO |
$14.06
|
| 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 |
$16.15
|
| Rate for Payer: Global Benefits Group Commercial |
$11.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$17.10
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$14.25
|
| 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 |
$12.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.20
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.80
|
| 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 |
$14.25
|
| Rate for Payer: Networks By Design Commercial |
$12.35
|
| Rate for Payer: Prime Health Services Commercial |
$16.15
|
| 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 |
$11.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$11.40
|
| 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 CHLORAMPHENICOL E TEST
|
Facility
|
IP
|
$87.00
|
|
|
Service Code
|
CPT 87181
|
| Hospital Charge Code |
900912442
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$17.40 |
| Max. Negotiated Rate |
$78.30 |
| Rate for Payer: Cash Price |
$39.15
|
| Rate for Payer: Central Health Plan Commercial |
$69.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$34.80
|
| Rate for Payer: Galaxy Health WC |
$73.95
|
| Rate for Payer: Global Benefits Group Commercial |
$52.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$78.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$58.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$33.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$17.40
|
| Rate for Payer: Multiplan Commercial |
$65.25
|
| Rate for Payer: Networks By Design Commercial |
$56.55
|
| Rate for Payer: Prime Health Services Commercial |
$73.95
|
|
|
HC CHLORIDE
|
Facility
|
OP
|
$15.00
|
|
|
Service Code
|
CPT 82435
|
| Hospital Charge Code |
900910256
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.00 |
| Max. Negotiated Rate |
$41.16 |
| Rate for Payer: Adventist Health Medi-Cal |
$4.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$33.75
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.06
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4.60
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$33.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$41.16
|
| Rate for Payer: Blue Distinction Transplant |
$9.00
|
| Rate for Payer: Blue Shield of California Commercial |
$9.27
|
| Rate for Payer: Blue Shield of California EPN |
$7.29
|
| Rate for Payer: Caremore Medicare Advantage |
$4.60
|
| Rate for Payer: Cash Price |
$6.75
|
| Rate for Payer: Cash Price |
$6.75
|
| Rate for Payer: Central Health Plan Commercial |
$12.00
|
| Rate for Payer: Cigna of CA HMO |
$9.60
|
| Rate for Payer: Cigna of CA PPO |
$11.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6.90
|
| Rate for Payer: Dignity Health Media |
$4.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.21
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$4.60
|
| Rate for Payer: Galaxy Health WC |
$12.75
|
| Rate for Payer: Global Benefits Group Commercial |
$9.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$13.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$11.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7.54
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$7.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4.60
|
| Rate for Payer: InnovAge PACE Commercial |
$6.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.72
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.16
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.16
|
| Rate for Payer: Multiplan Commercial |
$11.25
|
| Rate for Payer: Networks By Design Commercial |
$9.75
|
| Rate for Payer: Prime Health Services Commercial |
$12.75
|
| Rate for Payer: Prime Health Services Medicare |
$4.88
|
| Rate for Payer: Riverside University Health System MISP |
$5.06
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.73
|
| Rate for Payer: United Healthcare All Other HMO |
$3.73
|
| Rate for Payer: United Healthcare HMO Rider |
$3.73
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.73
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.06
|
| Rate for Payer: Vantage Medical Group Senior |
$4.60
|
|
|
HC CHLORIDE
|
Facility
|
IP
|
$89.00
|
|
|
Service Code
|
CPT 82435
|
| Hospital Charge Code |
900910256
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$17.80 |
| Max. Negotiated Rate |
$80.10 |
| Rate for Payer: Cash Price |
$40.05
|
| Rate for Payer: Central Health Plan Commercial |
$71.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$35.60
|
| Rate for Payer: Galaxy Health WC |
$75.65
|
| Rate for Payer: Global Benefits Group Commercial |
$53.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$80.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$59.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$33.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$17.80
|
| Rate for Payer: Multiplan Commercial |
$66.75
|
| Rate for Payer: Networks By Design Commercial |
$57.85
|
| Rate for Payer: Prime Health Services Commercial |
$75.65
|
|
|
HC CHLORIDE STOOL
|
Facility
|
OP
|
$16.00
|
|
|
Service Code
|
CPT 82438
|
| Hospital Charge Code |
900910420
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.20 |
| Max. Negotiated Rate |
$43.37 |
| Rate for Payer: Adventist Health Medi-Cal |
$5.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$35.89
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$35.56
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$43.37
|
| 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 |
$5.00
|
| 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 |
$7.50
|
| Rate for Payer: Dignity Health Media |
$5.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.75
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$5.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$5.00
|
| 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 |
$8.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$8.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.00
|
| Rate for Payer: InnovAge PACE Commercial |
$7.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.70
|
| 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 |
$5.30
|
| Rate for Payer: Riverside University Health System MISP |
$5.50
|
| 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 |
$4.05
|
| Rate for Payer: United Healthcare All Other HMO |
$4.05
|
| Rate for Payer: United Healthcare HMO Rider |
$4.05
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.50
|
| Rate for Payer: Vantage Medical Group Senior |
$5.00
|
|
|
HC CHLORIDE STOOL
|
Facility
|
IP
|
$179.00
|
|
|
Service Code
|
CPT 82438
|
| Hospital Charge Code |
900910420
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$35.80 |
| Max. Negotiated Rate |
$161.10 |
| Rate for Payer: Cash Price |
$80.55
|
| Rate for Payer: Central Health Plan Commercial |
$143.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$71.60
|
| Rate for Payer: Galaxy Health WC |
$152.15
|
| Rate for Payer: Global Benefits Group Commercial |
$107.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$161.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$119.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$68.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$35.80
|
| Rate for Payer: Multiplan Commercial |
$134.25
|
| Rate for Payer: Networks By Design Commercial |
$116.35
|
| Rate for Payer: Prime Health Services Commercial |
$152.15
|
|
|
HC CHLORIDE URINE
|
Facility
|
OP
|
$15.00
|
|
|
Service Code
|
CPT 82436
|
| Hospital Charge Code |
900910268
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.00 |
| Max. Negotiated Rate |
$44.57 |
| Rate for Payer: Adventist Health Medi-Cal |
$5.75
|
| Rate for Payer: Aetna of CA HMO/PPO |
$36.88
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$8.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6.32
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$36.54
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$44.57
|
| Rate for Payer: Blue Distinction Transplant |
$9.00
|
| Rate for Payer: Blue Shield of California Commercial |
$9.27
|
| Rate for Payer: Blue Shield of California EPN |
$7.29
|
| Rate for Payer: Caremore Medicare Advantage |
$5.75
|
| Rate for Payer: Cash Price |
$6.75
|
| Rate for Payer: Cash Price |
$6.75
|
| Rate for Payer: Central Health Plan Commercial |
$12.00
|
| Rate for Payer: Cigna of CA HMO |
$9.60
|
| Rate for Payer: Cigna of CA PPO |
$11.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8.62
|
| Rate for Payer: Dignity Health Media |
$5.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$6.32
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.76
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$5.75
|
| Rate for Payer: EPIC Health Plan Transplant |
$5.75
|
| Rate for Payer: Galaxy Health WC |
$12.75
|
| Rate for Payer: Global Benefits Group Commercial |
$9.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$13.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$11.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$9.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$9.49
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.75
|
| Rate for Payer: InnovAge PACE Commercial |
$8.62
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$7.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$7.70
|
| Rate for Payer: Multiplan Commercial |
$11.25
|
| Rate for Payer: Networks By Design Commercial |
$9.75
|
| Rate for Payer: Prime Health Services Commercial |
$12.75
|
| Rate for Payer: Prime Health Services Medicare |
$6.10
|
| Rate for Payer: Riverside University Health System MISP |
$6.32
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.66
|
| Rate for Payer: United Healthcare All Other HMO |
$4.66
|
| Rate for Payer: United Healthcare HMO Rider |
$4.66
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.66
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$8.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6.32
|
| Rate for Payer: Vantage Medical Group Senior |
$5.75
|
|
|
HC CHLORIDE URINE
|
Facility
|
IP
|
$106.00
|
|
|
Service Code
|
CPT 82436
|
| Hospital Charge Code |
900910268
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$21.20 |
| Max. Negotiated Rate |
$95.40 |
| Rate for Payer: Cash Price |
$47.70
|
| Rate for Payer: Central Health Plan Commercial |
$84.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$42.40
|
| Rate for Payer: Galaxy Health WC |
$90.10
|
| Rate for Payer: Global Benefits Group Commercial |
$63.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$95.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$70.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$40.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$21.20
|
| Rate for Payer: Multiplan Commercial |
$79.50
|
| Rate for Payer: Networks By Design Commercial |
$68.90
|
| Rate for Payer: Prime Health Services Commercial |
$90.10
|
|
|
HC CHLORIDE URINE 24 HOURS
|
Facility
|
OP
|
$15.00
|
|
|
Service Code
|
CPT 82436
|
| Hospital Charge Code |
900912201
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.00 |
| Max. Negotiated Rate |
$44.57 |
| Rate for Payer: Adventist Health Medi-Cal |
$5.75
|
| Rate for Payer: Aetna of CA HMO/PPO |
$36.88
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$8.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6.32
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$36.54
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$44.57
|
| Rate for Payer: Blue Distinction Transplant |
$9.00
|
| Rate for Payer: Blue Shield of California Commercial |
$9.27
|
| Rate for Payer: Blue Shield of California EPN |
$7.29
|
| Rate for Payer: Caremore Medicare Advantage |
$5.75
|
| Rate for Payer: Cash Price |
$6.75
|
| Rate for Payer: Cash Price |
$6.75
|
| Rate for Payer: Central Health Plan Commercial |
$12.00
|
| Rate for Payer: Cigna of CA HMO |
$9.60
|
| Rate for Payer: Cigna of CA PPO |
$11.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8.62
|
| Rate for Payer: Dignity Health Media |
$5.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$6.32
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.76
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$5.75
|
| Rate for Payer: EPIC Health Plan Transplant |
$5.75
|
| Rate for Payer: Galaxy Health WC |
$12.75
|
| Rate for Payer: Global Benefits Group Commercial |
$9.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$13.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$11.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$9.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$9.49
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.75
|
| Rate for Payer: InnovAge PACE Commercial |
$8.62
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$7.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$7.70
|
| Rate for Payer: Multiplan Commercial |
$11.25
|
| Rate for Payer: Networks By Design Commercial |
$9.75
|
| Rate for Payer: Prime Health Services Commercial |
$12.75
|
| Rate for Payer: Prime Health Services Medicare |
$6.10
|
| Rate for Payer: Riverside University Health System MISP |
$6.32
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.66
|
| Rate for Payer: United Healthcare All Other HMO |
$4.66
|
| Rate for Payer: United Healthcare HMO Rider |
$4.66
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.66
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$8.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6.32
|
| Rate for Payer: Vantage Medical Group Senior |
$5.75
|
|
|
HC CHLORIDE URINE 24 HOURS
|
Facility
|
IP
|
$106.00
|
|
|
Service Code
|
CPT 82436
|
| Hospital Charge Code |
900912201
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$21.20 |
| Max. Negotiated Rate |
$95.40 |
| Rate for Payer: Cash Price |
$47.70
|
| Rate for Payer: Central Health Plan Commercial |
$84.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$42.40
|
| Rate for Payer: Galaxy Health WC |
$90.10
|
| Rate for Payer: Global Benefits Group Commercial |
$63.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$95.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$70.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$40.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$21.20
|
| Rate for Payer: Multiplan Commercial |
$79.50
|
| Rate for Payer: Networks By Design Commercial |
$68.90
|
| Rate for Payer: Prime Health Services Commercial |
$90.10
|
|
|
HC CHLORIDE URINE RANDOM
|
Facility
|
IP
|
$106.00
|
|
|
Service Code
|
CPT 82436
|
| Hospital Charge Code |
900912200
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$21.20 |
| Max. Negotiated Rate |
$95.40 |
| Rate for Payer: Cash Price |
$47.70
|
| Rate for Payer: Central Health Plan Commercial |
$84.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$42.40
|
| Rate for Payer: Galaxy Health WC |
$90.10
|
| Rate for Payer: Global Benefits Group Commercial |
$63.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$95.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$70.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$40.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$21.20
|
| Rate for Payer: Multiplan Commercial |
$79.50
|
| Rate for Payer: Networks By Design Commercial |
$68.90
|
| Rate for Payer: Prime Health Services Commercial |
$90.10
|
|
|
HC CHLORIDE URINE RANDOM
|
Facility
|
OP
|
$15.00
|
|
|
Service Code
|
CPT 82436
|
| Hospital Charge Code |
900912200
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.00 |
| Max. Negotiated Rate |
$44.57 |
| Rate for Payer: Adventist Health Medi-Cal |
$5.75
|
| Rate for Payer: Aetna of CA HMO/PPO |
$36.88
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$8.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6.32
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$36.54
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$44.57
|
| Rate for Payer: Blue Distinction Transplant |
$9.00
|
| Rate for Payer: Blue Shield of California Commercial |
$9.27
|
| Rate for Payer: Blue Shield of California EPN |
$7.29
|
| Rate for Payer: Caremore Medicare Advantage |
$5.75
|
| Rate for Payer: Cash Price |
$6.75
|
| Rate for Payer: Cash Price |
$6.75
|
| Rate for Payer: Central Health Plan Commercial |
$12.00
|
| Rate for Payer: Cigna of CA HMO |
$9.60
|
| Rate for Payer: Cigna of CA PPO |
$11.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8.62
|
| Rate for Payer: Dignity Health Media |
$5.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$6.32
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.76
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$5.75
|
| Rate for Payer: EPIC Health Plan Transplant |
$5.75
|
| Rate for Payer: Galaxy Health WC |
$12.75
|
| Rate for Payer: Global Benefits Group Commercial |
$9.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$13.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$11.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$9.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$9.49
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.75
|
| Rate for Payer: InnovAge PACE Commercial |
$8.62
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$7.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$7.70
|
| Rate for Payer: Multiplan Commercial |
$11.25
|
| Rate for Payer: Networks By Design Commercial |
$9.75
|
| Rate for Payer: Prime Health Services Commercial |
$12.75
|
| Rate for Payer: Prime Health Services Medicare |
$6.10
|
| Rate for Payer: Riverside University Health System MISP |
$6.32
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.66
|
| Rate for Payer: United Healthcare All Other HMO |
$4.66
|
| Rate for Payer: United Healthcare HMO Rider |
$4.66
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.66
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$8.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6.32
|
| Rate for Payer: Vantage Medical Group Senior |
$5.75
|
|
|
HC CHNG PERC TUBE
|
Facility
|
IP
|
$8,298.00
|
|
|
Service Code
|
CPT 49423
|
| Hospital Charge Code |
909000203
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,659.60 |
| Max. Negotiated Rate |
$7,468.20 |
| Rate for Payer: Cash Price |
$3,734.10
|
| Rate for Payer: Central Health Plan Commercial |
$6,638.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,319.20
|
| Rate for Payer: Galaxy Health WC |
$7,053.30
|
| Rate for Payer: Global Benefits Group Commercial |
$4,978.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,468.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,534.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,161.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,659.60
|
| Rate for Payer: Multiplan Commercial |
$6,223.50
|
| Rate for Payer: Networks By Design Commercial |
$5,393.70
|
| Rate for Payer: Prime Health Services Commercial |
$7,053.30
|
|
|
HC CHNG PERC TUBE
|
Facility
|
OP
|
$8,298.00
|
|
|
Service Code
|
CPT 49423
|
| Hospital Charge Code |
909000203
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$130.15 |
| Max. Negotiated Rate |
$7,468.20 |
| Rate for Payer: Adventist Health Medi-Cal |
$2,377.45
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,566.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,615.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,377.45
|
| 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 |
$4,978.80
|
| Rate for Payer: Blue Shield of California Commercial |
$3,079.84
|
| Rate for Payer: Blue Shield of California EPN |
$2,212.08
|
| Rate for Payer: Caremore Medicare Advantage |
$2,377.45
|
| Rate for Payer: Cash Price |
$3,734.10
|
| Rate for Payer: Cash Price |
$3,734.10
|
| Rate for Payer: Central Health Plan Commercial |
$6,638.40
|
| Rate for Payer: Cigna of CA PPO |
$6,140.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,566.18
|
| Rate for Payer: Dignity Health Media |
$2,377.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,615.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,209.56
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,377.45
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,377.45
|
| Rate for Payer: Galaxy Health WC |
$7,053.30
|
| Rate for Payer: Global Benefits Group Commercial |
$4,978.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,468.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$6,223.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,899.02
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3,922.79
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,377.45
|
| Rate for Payer: InnovAge PACE Commercial |
$3,566.18
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,534.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$130.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,377.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,659.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,185.78
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,185.78
|
| Rate for Payer: Multiplan Commercial |
$6,223.50
|
| Rate for Payer: Networks By Design Commercial |
$5,393.70
|
| Rate for Payer: Prime Health Services Commercial |
$7,053.30
|
| Rate for Payer: Prime Health Services Medicare |
$2,520.10
|
| Rate for Payer: Riverside University Health System MISP |
$2,615.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,978.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,893.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,027.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,217.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,566.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,615.20
|
| Rate for Payer: Vantage Medical Group Senior |
$2,377.45
|
|
