|
HC CREAM WOUND CARE ATRACTAIN 2OZ
|
Facility
|
IP
|
$27.55
|
|
| Hospital Charge Code |
901606201
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$5.51 |
| Max. Negotiated Rate |
$24.80 |
| Rate for Payer: Cash Price |
$12.40
|
| Rate for Payer: Central Health Plan Commercial |
$22.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.02
|
| Rate for Payer: Galaxy Health WC |
$23.42
|
| Rate for Payer: Global Benefits Group Commercial |
$16.53
|
| Rate for Payer: Health Management Network EPO/PPO |
$24.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$18.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.51
|
| Rate for Payer: Multiplan Commercial |
$20.66
|
| Rate for Payer: Networks By Design Commercial |
$17.91
|
| Rate for Payer: Prime Health Services Commercial |
$23.42
|
|
|
HC CREATINE KINASE
|
Facility
|
IP
|
$138.00
|
|
|
Service Code
|
CPT 82550
|
| Hospital Charge Code |
900910222
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$27.60 |
| Max. Negotiated Rate |
$124.20 |
| Rate for Payer: Cash Price |
$62.10
|
| Rate for Payer: Central Health Plan Commercial |
$110.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$55.20
|
| Rate for Payer: Galaxy Health WC |
$117.30
|
| Rate for Payer: Global Benefits Group Commercial |
$82.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$124.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$92.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$52.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27.60
|
| Rate for Payer: Multiplan Commercial |
$103.50
|
| Rate for Payer: Networks By Design Commercial |
$89.70
|
| Rate for Payer: Prime Health Services Commercial |
$117.30
|
|
|
HC CREATINE KINASE
|
Facility
|
OP
|
$24.00
|
|
|
Service Code
|
CPT 82550
|
| Hospital Charge Code |
900910222
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.80 |
| Max. Negotiated Rate |
$58.19 |
| Rate for Payer: Adventist Health Medi-Cal |
$6.51
|
| Rate for Payer: Aetna of CA HMO/PPO |
$47.80
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$9.76
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6.51
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$47.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$58.19
|
| Rate for Payer: Blue Distinction Transplant |
$14.40
|
| Rate for Payer: Blue Shield of California Commercial |
$14.83
|
| Rate for Payer: Blue Shield of California EPN |
$11.66
|
| Rate for Payer: Caremore Medicare Advantage |
$6.51
|
| Rate for Payer: Cash Price |
$10.80
|
| Rate for Payer: Cash Price |
$10.80
|
| Rate for Payer: Central Health Plan Commercial |
$19.20
|
| Rate for Payer: Cigna of CA HMO |
$15.36
|
| Rate for Payer: Cigna of CA PPO |
$17.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9.76
|
| Rate for Payer: Dignity Health Media |
$6.51
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.16
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.79
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$6.51
|
| Rate for Payer: EPIC Health Plan Transplant |
$6.51
|
| Rate for Payer: Galaxy Health WC |
$20.40
|
| Rate for Payer: Global Benefits Group Commercial |
$14.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$21.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$18.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$10.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$10.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6.51
|
| Rate for Payer: InnovAge PACE Commercial |
$9.76
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8.72
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8.72
|
| Rate for Payer: Multiplan Commercial |
$18.00
|
| Rate for Payer: Networks By Design Commercial |
$15.60
|
| Rate for Payer: Prime Health Services Commercial |
$20.40
|
| Rate for Payer: Prime Health Services Medicare |
$6.90
|
| Rate for Payer: Riverside University Health System MISP |
$7.16
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$14.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$14.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.27
|
| Rate for Payer: United Healthcare All Other HMO |
$5.27
|
| Rate for Payer: United Healthcare HMO Rider |
$5.27
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.27
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$9.76
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.16
|
| Rate for Payer: Vantage Medical Group Senior |
$6.51
|
|
|
HC CREATININE
|
Facility
|
IP
|
$89.00
|
|
|
Service Code
|
CPT 82565
|
| Hospital Charge Code |
900910247
|
|
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 CREATININE
|
Facility
|
OP
|
$15.00
|
|
|
Service Code
|
CPT 82565
|
| Hospital Charge Code |
900910247
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.00 |
| Max. Negotiated Rate |
$45.40 |
| Rate for Payer: Adventist Health Medi-Cal |
$5.12
|
| Rate for Payer: Aetna of CA HMO/PPO |
$37.67
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.63
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.12
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$37.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$45.40
|
| 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 |
$5.12
|
| Rate for Payer: Cash Price |
$6.75
|
| Rate for Payer: Cash Price |
$6.75
|
| Rate for Payer: Central Health Plan Commercial |
$12.00
|
| Rate for Payer: Cigna of CA HMO |
$9.60
|
| Rate for Payer: Cigna of CA PPO |
$11.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.68
|
| Rate for Payer: Dignity Health Media |
$5.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.91
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$5.12
|
| Rate for Payer: EPIC Health Plan Transplant |
$5.12
|
| Rate for Payer: Galaxy Health WC |
$12.75
|
| Rate for Payer: Global Benefits Group Commercial |
$9.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$13.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$11.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$8.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$8.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.12
|
| Rate for Payer: InnovAge PACE Commercial |
$7.68
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.19
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.86
|
| Rate for Payer: Multiplan Commercial |
$11.25
|
| Rate for Payer: Networks By Design Commercial |
$9.75
|
| Rate for Payer: Prime Health Services Commercial |
$12.75
|
| Rate for Payer: Prime Health Services Medicare |
$5.43
|
| Rate for Payer: Riverside University Health System MISP |
$5.63
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.15
|
| Rate for Payer: United Healthcare All Other HMO |
$4.15
|
| Rate for Payer: United Healthcare HMO Rider |
$4.15
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.15
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.63
|
| Rate for Payer: Vantage Medical Group Senior |
$5.12
|
|
|
HC CREATININE BODY FLUID
|
Facility
|
OP
|
$15.00
|
|
|
Service Code
|
CPT 82570
|
| Hospital Charge Code |
900910377
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.00 |
| Max. Negotiated Rate |
$45.88 |
| Rate for Payer: Adventist Health Medi-Cal |
$5.18
|
| Rate for Payer: Aetna of CA HMO/PPO |
$37.98
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.77
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.18
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$37.61
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$45.88
|
| 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 |
$5.18
|
| Rate for Payer: Cash Price |
$6.75
|
| Rate for Payer: Cash Price |
$6.75
|
| Rate for Payer: Central Health Plan Commercial |
$12.00
|
| Rate for Payer: Cigna of CA HMO |
$9.60
|
| Rate for Payer: Cigna of CA PPO |
$11.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.77
|
| Rate for Payer: Dignity Health Media |
$5.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.99
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$5.18
|
| Rate for Payer: EPIC Health Plan Transplant |
$5.18
|
| Rate for Payer: Galaxy Health WC |
$12.75
|
| Rate for Payer: Global Benefits Group Commercial |
$9.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$13.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$11.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$8.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$8.55
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.18
|
| Rate for Payer: InnovAge PACE Commercial |
$7.77
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.94
|
| Rate for Payer: Multiplan Commercial |
$11.25
|
| Rate for Payer: Networks By Design Commercial |
$9.75
|
| Rate for Payer: Prime Health Services Commercial |
$12.75
|
| Rate for Payer: Prime Health Services Medicare |
$5.49
|
| Rate for Payer: Riverside University Health System MISP |
$5.70
|
| 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 |
$4.19
|
| Rate for Payer: United Healthcare All Other HMO |
$4.19
|
| Rate for Payer: United Healthcare HMO Rider |
$4.19
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.19
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.77
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.70
|
| Rate for Payer: Vantage Medical Group Senior |
$5.18
|
|
|
HC CREATININE BODY FLUID
|
Facility
|
IP
|
$115.00
|
|
|
Service Code
|
CPT 82570
|
| Hospital Charge Code |
900910377
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$23.00 |
| Max. Negotiated Rate |
$103.50 |
| Rate for Payer: Cash Price |
$51.75
|
| Rate for Payer: Central Health Plan Commercial |
$92.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$46.00
|
| Rate for Payer: Galaxy Health WC |
$97.75
|
| Rate for Payer: Global Benefits Group Commercial |
$69.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$103.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$76.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$43.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23.00
|
| Rate for Payer: Multiplan Commercial |
$86.25
|
| Rate for Payer: Networks By Design Commercial |
$74.75
|
| Rate for Payer: Prime Health Services Commercial |
$97.75
|
|
|
HC CREATININE CLEARAN
|
Facility
|
OP
|
$36.00
|
|
|
Service Code
|
CPT 82575
|
| Hospital Charge Code |
900910260
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.20 |
| Max. Negotiated Rate |
$83.70 |
| Rate for Payer: Adventist Health Medi-Cal |
$9.46
|
| Rate for Payer: Aetna of CA HMO/PPO |
$69.39
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$14.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10.41
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9.46
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$68.62
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$83.70
|
| Rate for Payer: Blue Distinction Transplant |
$21.60
|
| Rate for Payer: Blue Shield of California Commercial |
$22.25
|
| Rate for Payer: Blue Shield of California EPN |
$17.50
|
| Rate for Payer: Caremore Medicare Advantage |
$9.46
|
| Rate for Payer: Cash Price |
$16.20
|
| Rate for Payer: Cash Price |
$16.20
|
| Rate for Payer: Central Health Plan Commercial |
$28.80
|
| Rate for Payer: Cigna of CA HMO |
$23.04
|
| Rate for Payer: Cigna of CA PPO |
$26.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$14.19
|
| Rate for Payer: Dignity Health Media |
$9.46
|
| Rate for Payer: Dignity Health Medi-Cal |
$10.41
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.77
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$9.46
|
| Rate for Payer: EPIC Health Plan Transplant |
$9.46
|
| Rate for Payer: Galaxy Health WC |
$30.60
|
| Rate for Payer: Global Benefits Group Commercial |
$21.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$32.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$27.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$15.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$15.61
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$9.46
|
| Rate for Payer: InnovAge PACE Commercial |
$14.19
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$24.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$15.96
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$12.68
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$12.68
|
| Rate for Payer: Multiplan Commercial |
$27.00
|
| Rate for Payer: Networks By Design Commercial |
$23.40
|
| Rate for Payer: Prime Health Services Commercial |
$30.60
|
| Rate for Payer: Prime Health Services Medicare |
$10.03
|
| Rate for Payer: Riverside University Health System MISP |
$10.41
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$21.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$21.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.66
|
| Rate for Payer: United Healthcare All Other HMO |
$7.66
|
| Rate for Payer: United Healthcare HMO Rider |
$7.66
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.66
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$14.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.41
|
| Rate for Payer: Vantage Medical Group Senior |
$9.46
|
|
|
HC CREATININE CLEARAN
|
Facility
|
IP
|
$236.00
|
|
|
Service Code
|
CPT 82575
|
| Hospital Charge Code |
900910260
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$47.20 |
| Max. Negotiated Rate |
$212.40 |
| Rate for Payer: Cash Price |
$106.20
|
| Rate for Payer: Central Health Plan Commercial |
$188.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$94.40
|
| Rate for Payer: Galaxy Health WC |
$200.60
|
| Rate for Payer: Global Benefits Group Commercial |
$141.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$212.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$157.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$89.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$47.20
|
| Rate for Payer: Multiplan Commercial |
$177.00
|
| Rate for Payer: Networks By Design Commercial |
$153.40
|
| Rate for Payer: Prime Health Services Commercial |
$200.60
|
|
|
HC CREATININE INDIVIDUAL
|
Facility
|
OP
|
$15.00
|
|
|
Service Code
|
CPT 82565
|
| Hospital Charge Code |
900910493
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.00 |
| Max. Negotiated Rate |
$45.40 |
| Rate for Payer: Adventist Health Medi-Cal |
$5.12
|
| Rate for Payer: Aetna of CA HMO/PPO |
$37.67
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.63
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.12
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$37.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$45.40
|
| 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 |
$5.12
|
| Rate for Payer: Cash Price |
$6.75
|
| Rate for Payer: Cash Price |
$6.75
|
| Rate for Payer: Central Health Plan Commercial |
$12.00
|
| Rate for Payer: Cigna of CA HMO |
$9.60
|
| Rate for Payer: Cigna of CA PPO |
$11.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.68
|
| Rate for Payer: Dignity Health Media |
$5.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.91
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$5.12
|
| Rate for Payer: EPIC Health Plan Transplant |
$5.12
|
| Rate for Payer: Galaxy Health WC |
$12.75
|
| Rate for Payer: Global Benefits Group Commercial |
$9.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$13.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$11.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$8.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$8.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.12
|
| Rate for Payer: InnovAge PACE Commercial |
$7.68
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.19
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.86
|
| Rate for Payer: Multiplan Commercial |
$11.25
|
| Rate for Payer: Networks By Design Commercial |
$9.75
|
| Rate for Payer: Prime Health Services Commercial |
$12.75
|
| Rate for Payer: Prime Health Services Medicare |
$5.43
|
| Rate for Payer: Riverside University Health System MISP |
$5.63
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.15
|
| Rate for Payer: United Healthcare All Other HMO |
$4.15
|
| Rate for Payer: United Healthcare HMO Rider |
$4.15
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.15
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.63
|
| Rate for Payer: Vantage Medical Group Senior |
$5.12
|
|
|
HC CREATININE INDIVIDUAL
|
Facility
|
IP
|
$89.00
|
|
|
Service Code
|
CPT 82565
|
| Hospital Charge Code |
900910493
|
|
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 CREATININE URINE 24 HOURS
|
Facility
|
IP
|
$115.00
|
|
|
Service Code
|
CPT 82570
|
| Hospital Charge Code |
900912203
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$23.00 |
| Max. Negotiated Rate |
$103.50 |
| Rate for Payer: Cash Price |
$51.75
|
| Rate for Payer: Central Health Plan Commercial |
$92.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$46.00
|
| Rate for Payer: Galaxy Health WC |
$97.75
|
| Rate for Payer: Global Benefits Group Commercial |
$69.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$103.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$76.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$43.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23.00
|
| Rate for Payer: Multiplan Commercial |
$86.25
|
| Rate for Payer: Networks By Design Commercial |
$74.75
|
| Rate for Payer: Prime Health Services Commercial |
$97.75
|
|
|
HC CREATININE URINE 24 HOURS
|
Facility
|
OP
|
$15.00
|
|
|
Service Code
|
CPT 82570
|
| Hospital Charge Code |
900912203
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.00 |
| Max. Negotiated Rate |
$45.88 |
| Rate for Payer: Adventist Health Medi-Cal |
$5.18
|
| Rate for Payer: Aetna of CA HMO/PPO |
$37.98
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.77
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.18
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$37.61
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$45.88
|
| 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 |
$5.18
|
| Rate for Payer: Cash Price |
$6.75
|
| Rate for Payer: Cash Price |
$6.75
|
| Rate for Payer: Central Health Plan Commercial |
$12.00
|
| Rate for Payer: Cigna of CA HMO |
$9.60
|
| Rate for Payer: Cigna of CA PPO |
$11.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.77
|
| Rate for Payer: Dignity Health Media |
$5.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.99
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$5.18
|
| Rate for Payer: EPIC Health Plan Transplant |
$5.18
|
| Rate for Payer: Galaxy Health WC |
$12.75
|
| Rate for Payer: Global Benefits Group Commercial |
$9.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$13.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$11.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$8.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$8.55
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.18
|
| Rate for Payer: InnovAge PACE Commercial |
$7.77
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.94
|
| Rate for Payer: Multiplan Commercial |
$11.25
|
| Rate for Payer: Networks By Design Commercial |
$9.75
|
| Rate for Payer: Prime Health Services Commercial |
$12.75
|
| Rate for Payer: Prime Health Services Medicare |
$5.49
|
| Rate for Payer: Riverside University Health System MISP |
$5.70
|
| 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 |
$4.19
|
| Rate for Payer: United Healthcare All Other HMO |
$4.19
|
| Rate for Payer: United Healthcare HMO Rider |
$4.19
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.19
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.77
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.70
|
| Rate for Payer: Vantage Medical Group Senior |
$5.18
|
|
|
HC CREATININE URINE RANDOM
|
Facility
|
IP
|
$115.00
|
|
|
Service Code
|
CPT 82570
|
| Hospital Charge Code |
900912202
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$23.00 |
| Max. Negotiated Rate |
$103.50 |
| Rate for Payer: Cash Price |
$51.75
|
| Rate for Payer: Central Health Plan Commercial |
$92.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$46.00
|
| Rate for Payer: Galaxy Health WC |
$97.75
|
| Rate for Payer: Global Benefits Group Commercial |
$69.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$103.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$76.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$43.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23.00
|
| Rate for Payer: Multiplan Commercial |
$86.25
|
| Rate for Payer: Networks By Design Commercial |
$74.75
|
| Rate for Payer: Prime Health Services Commercial |
$97.75
|
|
|
HC CREATININE URINE RANDOM
|
Facility
|
OP
|
$15.00
|
|
|
Service Code
|
CPT 82570
|
| Hospital Charge Code |
900912202
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.00 |
| Max. Negotiated Rate |
$45.88 |
| Rate for Payer: Adventist Health Medi-Cal |
$5.18
|
| Rate for Payer: Aetna of CA HMO/PPO |
$37.98
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.77
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.18
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$37.61
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$45.88
|
| 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 |
$5.18
|
| Rate for Payer: Cash Price |
$6.75
|
| Rate for Payer: Cash Price |
$6.75
|
| Rate for Payer: Central Health Plan Commercial |
$12.00
|
| Rate for Payer: Cigna of CA HMO |
$9.60
|
| Rate for Payer: Cigna of CA PPO |
$11.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.77
|
| Rate for Payer: Dignity Health Media |
$5.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.99
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$5.18
|
| Rate for Payer: EPIC Health Plan Transplant |
$5.18
|
| Rate for Payer: Galaxy Health WC |
$12.75
|
| Rate for Payer: Global Benefits Group Commercial |
$9.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$13.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$11.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$8.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$8.55
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.18
|
| Rate for Payer: InnovAge PACE Commercial |
$7.77
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.94
|
| Rate for Payer: Multiplan Commercial |
$11.25
|
| Rate for Payer: Networks By Design Commercial |
$9.75
|
| Rate for Payer: Prime Health Services Commercial |
$12.75
|
| Rate for Payer: Prime Health Services Medicare |
$5.49
|
| Rate for Payer: Riverside University Health System MISP |
$5.70
|
| 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 |
$4.19
|
| Rate for Payer: United Healthcare All Other HMO |
$4.19
|
| Rate for Payer: United Healthcare HMO Rider |
$4.19
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.19
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.77
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.70
|
| Rate for Payer: Vantage Medical Group Senior |
$5.18
|
|
|
HC CRITICAL CARE ADDL 30 MIN
|
Facility
|
IP
|
$6,671.70
|
|
|
Service Code
|
CPT 99292
|
| Hospital Charge Code |
900501641
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$1,334.34 |
| Max. Negotiated Rate |
$6,004.53 |
| Rate for Payer: Cash Price |
$3,002.27
|
| Rate for Payer: Central Health Plan Commercial |
$5,337.36
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,668.68
|
| Rate for Payer: Galaxy Health WC |
$5,670.94
|
| Rate for Payer: Global Benefits Group Commercial |
$4,003.02
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,004.53
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,450.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,541.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,334.34
|
| Rate for Payer: Multiplan Commercial |
$5,003.78
|
| Rate for Payer: Networks By Design Commercial |
$4,336.60
|
| Rate for Payer: Prime Health Services Commercial |
$5,670.94
|
|
|
HC CRITICAL CARE ADDL 30 MIN
|
Facility
|
OP
|
$6,671.70
|
|
|
Service Code
|
CPT 99292
|
| Hospital Charge Code |
900501641
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$111.91 |
| Max. Negotiated Rate |
$6,004.53 |
| Rate for Payer: Aetna of CA HMO/PPO |
$558.04
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,670.94
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,669.44
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,669.44
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: Blue Distinction Transplant |
$4,003.02
|
| Rate for Payer: Blue Shield of California Commercial |
$4,196.50
|
| Rate for Payer: Blue Shield of California EPN |
$3,262.46
|
| Rate for Payer: Cash Price |
$3,002.27
|
| Rate for Payer: Cash Price |
$3,002.27
|
| Rate for Payer: Cash Price |
$3,002.27
|
| Rate for Payer: Central Health Plan Commercial |
$5,337.36
|
| Rate for Payer: Cigna of CA HMO |
$4,269.89
|
| Rate for Payer: Cigna of CA PPO |
$4,937.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,670.94
|
| Rate for Payer: Dignity Health Media |
$5,670.94
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,670.94
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,668.68
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,668.68
|
| Rate for Payer: Galaxy Health WC |
$5,670.94
|
| Rate for Payer: Global Benefits Group Commercial |
$4,003.02
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,004.53
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$5,003.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$2,335.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,450.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$111.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,334.34
|
| Rate for Payer: Multiplan Commercial |
$5,003.78
|
| Rate for Payer: Networks By Design Commercial |
$4,336.60
|
| Rate for Payer: Prime Health Services Commercial |
$5,670.94
|
| Rate for Payer: Riverside University Health System MISP |
$2,668.68
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,003.02
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,003.02
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,335.85
|
| Rate for Payer: United Healthcare All Other HMO |
$3,335.85
|
| Rate for Payer: United Healthcare HMO Rider |
$3,335.85
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,335.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,670.94
|
| Rate for Payer: Vantage Medical Group Senior |
$5,670.94
|
|
|
HC CRITICAL CARE ADDL 30 MIN
|
Facility
|
OP
|
$6,671.70
|
|
|
Service Code
|
CPT 99292
|
| Hospital Charge Code |
900501641
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$111.91 |
| Max. Negotiated Rate |
$6,004.53 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,670.94
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,669.44
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,669.44
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: Blue Distinction Transplant |
$4,003.02
|
| Rate for Payer: Cash Price |
$3,002.27
|
| Rate for Payer: Cash Price |
$3,002.27
|
| Rate for Payer: Cash Price |
$3,002.27
|
| Rate for Payer: Cash Price |
$3,002.27
|
| Rate for Payer: Central Health Plan Commercial |
$5,337.36
|
| Rate for Payer: Cigna of CA PPO |
$4,937.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,670.94
|
| Rate for Payer: Dignity Health Media |
$5,670.94
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,670.94
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,668.68
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,668.68
|
| Rate for Payer: Galaxy Health WC |
$5,670.94
|
| Rate for Payer: Global Benefits Group Commercial |
$4,003.02
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,004.53
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$5,003.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,450.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$111.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,334.34
|
| Rate for Payer: Multiplan Commercial |
$5,003.78
|
| Rate for Payer: Networks By Design Commercial |
$4,336.60
|
| Rate for Payer: Prime Health Services Commercial |
$5,670.94
|
| Rate for Payer: Riverside University Health System MISP |
$2,668.68
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,003.02
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,335.85
|
| Rate for Payer: United Healthcare All Other HMO |
$3,335.85
|
| Rate for Payer: United Healthcare HMO Rider |
$3,335.85
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,335.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,670.94
|
| Rate for Payer: Vantage Medical Group Senior |
$5,670.94
|
|
|
HC CRITICAL CARE ADDL 30 MIN
|
Facility
|
IP
|
$6,671.70
|
|
|
Service Code
|
CPT 99292
|
| Hospital Charge Code |
900501641
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,334.34 |
| Max. Negotiated Rate |
$6,004.53 |
| Rate for Payer: Cash Price |
$3,002.27
|
| Rate for Payer: Central Health Plan Commercial |
$5,337.36
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,668.68
|
| Rate for Payer: Galaxy Health WC |
$5,670.94
|
| Rate for Payer: Global Benefits Group Commercial |
$4,003.02
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,004.53
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,450.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,541.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,334.34
|
| Rate for Payer: Multiplan Commercial |
$5,003.78
|
| Rate for Payer: Networks By Design Commercial |
$4,336.60
|
| Rate for Payer: Prime Health Services Commercial |
$5,670.94
|
|
|
HC CRITICAL CARE E&M 30-74 MIN
|
Facility
|
OP
|
$13,350.00
|
|
|
Service Code
|
CPT 99291
|
| Hospital Charge Code |
900509291
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$231.04 |
| Max. Negotiated Rate |
$12,015.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,663.06
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,219.58
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,108.71
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: Blue Distinction Transplant |
$8,010.00
|
| Rate for Payer: Caremore Medicare Advantage |
$1,108.71
|
| Rate for Payer: Cash Price |
$6,007.50
|
| Rate for Payer: Cash Price |
$6,007.50
|
| Rate for Payer: Cash Price |
$6,007.50
|
| Rate for Payer: Cash Price |
$6,007.50
|
| Rate for Payer: Central Health Plan Commercial |
$10,680.00
|
| Rate for Payer: Cigna of CA PPO |
$9,879.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,663.06
|
| Rate for Payer: Dignity Health Media |
$1,108.71
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,219.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,496.76
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,108.71
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,108.71
|
| Rate for Payer: Galaxy Health WC |
$11,347.50
|
| Rate for Payer: Global Benefits Group Commercial |
$8,010.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$12,015.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$10,012.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,818.28
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,108.71
|
| Rate for Payer: InnovAge PACE Commercial |
$1,663.06
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,904.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$231.04
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,108.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,670.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,485.67
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,485.67
|
| Rate for Payer: Multiplan Commercial |
$10,012.50
|
| Rate for Payer: Networks By Design Commercial |
$8,677.50
|
| Rate for Payer: Prime Health Services Commercial |
$11,347.50
|
| Rate for Payer: Prime Health Services Medicare |
$1,175.23
|
| Rate for Payer: Riverside University Health System MISP |
$1,219.58
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8,010.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$7,631.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,690.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,039.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,435.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,663.06
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,219.58
|
| Rate for Payer: Vantage Medical Group Senior |
$1,108.71
|
|
|
HC CRITICAL CARE E&M 30-74 MIN
|
Facility
|
IP
|
$13,350.00
|
|
|
Service Code
|
CPT 99291
|
| Hospital Charge Code |
900509291
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,670.00 |
| Max. Negotiated Rate |
$12,015.00 |
| Rate for Payer: Cash Price |
$6,007.50
|
| Rate for Payer: Central Health Plan Commercial |
$10,680.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,340.00
|
| Rate for Payer: Galaxy Health WC |
$11,347.50
|
| Rate for Payer: Global Benefits Group Commercial |
$8,010.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$12,015.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,904.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,086.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,670.00
|
| Rate for Payer: Multiplan Commercial |
$10,012.50
|
| Rate for Payer: Networks By Design Commercial |
$8,677.50
|
| Rate for Payer: Prime Health Services Commercial |
$11,347.50
|
|
|
HC CRITICAL CARE E&M 30-74 MIN
|
Facility
|
IP
|
$13,350.00
|
|
|
Service Code
|
CPT 99291
|
| Hospital Charge Code |
900509291
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$2,670.00 |
| Max. Negotiated Rate |
$12,015.00 |
| Rate for Payer: Cash Price |
$6,007.50
|
| Rate for Payer: Central Health Plan Commercial |
$10,680.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,340.00
|
| Rate for Payer: Galaxy Health WC |
$11,347.50
|
| Rate for Payer: Global Benefits Group Commercial |
$8,010.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$12,015.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,904.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,086.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,670.00
|
| Rate for Payer: Multiplan Commercial |
$10,012.50
|
| Rate for Payer: Networks By Design Commercial |
$8,677.50
|
| Rate for Payer: Prime Health Services Commercial |
$11,347.50
|
|
|
HC CRITICAL CARE E&M 30-74 MIN
|
Facility
|
OP
|
$13,350.00
|
|
|
Service Code
|
CPT 99291
|
| Hospital Charge Code |
900509291
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$231.04 |
| Max. Negotiated Rate |
$12,015.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$1,108.71
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,112.34
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,663.06
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,219.58
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,108.71
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: Blue Distinction Transplant |
$8,010.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,397.15
|
| Rate for Payer: Blue Shield of California EPN |
$6,528.15
|
| Rate for Payer: Caremore Medicare Advantage |
$1,108.71
|
| Rate for Payer: Cash Price |
$6,007.50
|
| Rate for Payer: Cash Price |
$6,007.50
|
| Rate for Payer: Cash Price |
$6,007.50
|
| Rate for Payer: Central Health Plan Commercial |
$10,680.00
|
| Rate for Payer: Cigna of CA HMO |
$8,544.00
|
| Rate for Payer: Cigna of CA PPO |
$9,879.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,663.06
|
| Rate for Payer: Dignity Health Media |
$1,108.71
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,219.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,496.76
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,108.71
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,108.71
|
| Rate for Payer: Galaxy Health WC |
$11,347.50
|
| Rate for Payer: Global Benefits Group Commercial |
$8,010.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$12,015.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$10,012.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,818.28
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,829.37
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,108.71
|
| Rate for Payer: InnovAge PACE Commercial |
$1,663.06
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,904.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$231.04
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,108.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,670.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,485.67
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,485.67
|
| Rate for Payer: Multiplan Commercial |
$10,012.50
|
| Rate for Payer: Networks By Design Commercial |
$8,677.50
|
| Rate for Payer: Prime Health Services Commercial |
$11,347.50
|
| Rate for Payer: Prime Health Services Medicare |
$1,175.23
|
| Rate for Payer: Riverside University Health System MISP |
$1,219.58
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8,010.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$8,010.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,675.00
|
| Rate for Payer: United Healthcare All Other HMO |
$6,675.00
|
| Rate for Payer: United Healthcare HMO Rider |
$6,675.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,675.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,663.06
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,219.58
|
| Rate for Payer: Vantage Medical Group Senior |
$1,108.71
|
|
|
HC CROSSMATCH COMP
|
Facility
|
OP
|
$288.00
|
|
|
Service Code
|
CPT 86923
|
| Hospital Charge Code |
900904766
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$57.60 |
| Max. Negotiated Rate |
$352.13 |
| Rate for Payer: Adventist Health Medi-Cal |
$213.41
|
| Rate for Payer: Aetna of CA HMO/PPO |
$105.04
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$320.12
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$234.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$213.41
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$61.71
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$75.27
|
| Rate for Payer: Blue Distinction Transplant |
$172.80
|
| Rate for Payer: Blue Shield of California Commercial |
$177.98
|
| Rate for Payer: Blue Shield of California EPN |
$139.97
|
| Rate for Payer: Caremore Medicare Advantage |
$213.41
|
| Rate for Payer: Cash Price |
$129.60
|
| Rate for Payer: Cash Price |
$129.60
|
| Rate for Payer: Central Health Plan Commercial |
$230.40
|
| Rate for Payer: Cigna of CA HMO |
$184.32
|
| Rate for Payer: Cigna of CA PPO |
$213.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$320.12
|
| Rate for Payer: Dignity Health Media |
$213.41
|
| Rate for Payer: Dignity Health Medi-Cal |
$234.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$288.10
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$213.41
|
| Rate for Payer: EPIC Health Plan Transplant |
$213.41
|
| Rate for Payer: Galaxy Health WC |
$244.80
|
| Rate for Payer: Global Benefits Group Commercial |
$172.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$259.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$216.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$349.99
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$352.13
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$213.41
|
| Rate for Payer: InnovAge PACE Commercial |
$320.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$192.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$213.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$57.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$285.97
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$285.97
|
| Rate for Payer: Multiplan Commercial |
$216.00
|
| Rate for Payer: Networks By Design Commercial |
$187.20
|
| Rate for Payer: Prime Health Services Commercial |
$244.80
|
| Rate for Payer: Prime Health Services Medicare |
$226.21
|
| Rate for Payer: Riverside University Health System MISP |
$234.75
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$172.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$172.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$123.38
|
| Rate for Payer: United Healthcare All Other HMO |
$123.38
|
| Rate for Payer: United Healthcare HMO Rider |
$123.38
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$123.38
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$320.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$234.75
|
| Rate for Payer: Vantage Medical Group Senior |
$213.41
|
|
|
HC CROSSMATCH COMP
|
Facility
|
IP
|
$288.00
|
|
|
Service Code
|
CPT 86923
|
| Hospital Charge Code |
900904766
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$57.60 |
| Max. Negotiated Rate |
$259.20 |
| Rate for Payer: Cash Price |
$129.60
|
| Rate for Payer: Central Health Plan Commercial |
$230.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$115.20
|
| Rate for Payer: Galaxy Health WC |
$244.80
|
| Rate for Payer: Global Benefits Group Commercial |
$172.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$259.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$192.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$109.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$57.60
|
| Rate for Payer: Multiplan Commercial |
$216.00
|
| Rate for Payer: Networks By Design Commercial |
$187.20
|
| Rate for Payer: Prime Health Services Commercial |
$244.80
|
|
