|
HC CULTURE URINE ID
|
Facility
|
IP
|
$204.00
|
|
|
Service Code
|
CPT 87088
|
| Hospital Charge Code |
900911556
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$40.80 |
| Max. Negotiated Rate |
$183.60 |
| Rate for Payer: Cash Price |
$91.80
|
| Rate for Payer: Central Health Plan Commercial |
$163.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$81.60
|
| Rate for Payer: Galaxy Health WC |
$173.40
|
| Rate for Payer: Global Benefits Group Commercial |
$122.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$183.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$136.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$77.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$40.80
|
| Rate for Payer: Multiplan Commercial |
$153.00
|
| Rate for Payer: Networks By Design Commercial |
$132.60
|
| Rate for Payer: Prime Health Services Commercial |
$173.40
|
|
|
HC CULTURE URINE ID
|
Facility
|
OP
|
$27.00
|
|
|
Service Code
|
CPT 87088
|
| Hospital Charge Code |
900911556
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$5.40 |
| Max. Negotiated Rate |
$63.86 |
| Rate for Payer: Adventist Health Medi-Cal |
$8.09
|
| Rate for Payer: Aetna of CA HMO/PPO |
$48.10
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.14
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.09
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$52.36
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$63.86
|
| Rate for Payer: Blue Distinction Transplant |
$16.20
|
| Rate for Payer: Blue Shield of California Commercial |
$16.69
|
| Rate for Payer: Blue Shield of California EPN |
$13.12
|
| Rate for Payer: Caremore Medicare Advantage |
$8.09
|
| Rate for Payer: Cash Price |
$12.15
|
| Rate for Payer: Cash Price |
$12.15
|
| Rate for Payer: Central Health Plan Commercial |
$21.60
|
| Rate for Payer: Cigna of CA HMO |
$17.28
|
| Rate for Payer: Cigna of CA PPO |
$19.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.14
|
| Rate for Payer: Dignity Health Media |
$8.09
|
| Rate for Payer: Dignity Health Medi-Cal |
$8.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.92
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$8.09
|
| Rate for Payer: EPIC Health Plan Transplant |
$8.09
|
| Rate for Payer: Galaxy Health WC |
$22.95
|
| Rate for Payer: Global Benefits Group Commercial |
$16.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$24.30
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$20.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$13.27
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$13.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.09
|
| Rate for Payer: InnovAge PACE Commercial |
$12.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$18.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.55
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.84
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10.84
|
| Rate for Payer: Multiplan Commercial |
$20.25
|
| Rate for Payer: Networks By Design Commercial |
$17.55
|
| Rate for Payer: Prime Health Services Commercial |
$22.95
|
| Rate for Payer: Prime Health Services Medicare |
$8.58
|
| Rate for Payer: Riverside University Health System MISP |
$8.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$16.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$16.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.55
|
| Rate for Payer: United Healthcare All Other HMO |
$6.55
|
| Rate for Payer: United Healthcare HMO Rider |
$6.55
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.55
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.14
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.90
|
| Rate for Payer: Vantage Medical Group Senior |
$8.09
|
|
|
HC CULTURE UROGENITAL
|
Facility
|
IP
|
$399.00
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
900911519
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$79.80 |
| Max. Negotiated Rate |
$359.10 |
| Rate for Payer: Cash Price |
$179.55
|
| Rate for Payer: Central Health Plan Commercial |
$319.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$159.60
|
| Rate for Payer: Galaxy Health WC |
$339.15
|
| Rate for Payer: Global Benefits Group Commercial |
$239.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$359.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$266.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$152.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$79.80
|
| Rate for Payer: Multiplan Commercial |
$299.25
|
| Rate for Payer: Networks By Design Commercial |
$259.35
|
| Rate for Payer: Prime Health Services Commercial |
$339.15
|
|
|
HC CULTURE UROGENITAL
|
Facility
|
OP
|
$32.00
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
900911519
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.40 |
| Max. Negotiated Rate |
$225.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$8.62
|
| Rate for Payer: Aetna of CA HMO/PPO |
$63.20
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9.48
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.62
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$62.59
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$76.35
|
| Rate for Payer: Blue Distinction Transplant |
$19.20
|
| Rate for Payer: Blue Shield of California Commercial |
$19.78
|
| Rate for Payer: Blue Shield of California EPN |
$15.55
|
| Rate for Payer: Caremore Medicare Advantage |
$8.62
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Central Health Plan Commercial |
$25.60
|
| Rate for Payer: Cigna of CA HMO |
$20.48
|
| Rate for Payer: Cigna of CA PPO |
$23.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.93
|
| Rate for Payer: Dignity Health Media |
$8.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.64
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$8.62
|
| Rate for Payer: EPIC Health Plan Transplant |
$8.62
|
| Rate for Payer: Galaxy Health WC |
$27.20
|
| Rate for Payer: Global Benefits Group Commercial |
$19.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$28.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$24.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$14.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$14.22
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.62
|
| Rate for Payer: InnovAge PACE Commercial |
$12.93
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$21.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14.27
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11.55
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11.55
|
| Rate for Payer: Multiplan Commercial |
$24.00
|
| Rate for Payer: Networks By Design Commercial |
$20.80
|
| Rate for Payer: Prime Health Services Commercial |
$27.20
|
| Rate for Payer: Prime Health Services Medicare |
$9.14
|
| Rate for Payer: Riverside University Health System MISP |
$9.48
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$19.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$225.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.98
|
| Rate for Payer: United Healthcare All Other HMO |
$6.98
|
| Rate for Payer: United Healthcare HMO Rider |
$6.98
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.98
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.48
|
| Rate for Payer: Vantage Medical Group Senior |
$8.62
|
|
|
HC CULTURE WOUND
|
Facility
|
IP
|
$399.00
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
900911520
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$79.80 |
| Max. Negotiated Rate |
$359.10 |
| Rate for Payer: Cash Price |
$179.55
|
| Rate for Payer: Central Health Plan Commercial |
$319.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$159.60
|
| Rate for Payer: Galaxy Health WC |
$339.15
|
| Rate for Payer: Global Benefits Group Commercial |
$239.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$359.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$266.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$152.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$79.80
|
| Rate for Payer: Multiplan Commercial |
$299.25
|
| Rate for Payer: Networks By Design Commercial |
$259.35
|
| Rate for Payer: Prime Health Services Commercial |
$339.15
|
|
|
HC CULTURE WOUND
|
Facility
|
OP
|
$32.00
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
900911520
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.40 |
| Max. Negotiated Rate |
$225.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$8.62
|
| Rate for Payer: Aetna of CA HMO/PPO |
$63.20
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9.48
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.62
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$62.59
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$76.35
|
| Rate for Payer: Blue Distinction Transplant |
$19.20
|
| Rate for Payer: Blue Shield of California Commercial |
$19.78
|
| Rate for Payer: Blue Shield of California EPN |
$15.55
|
| Rate for Payer: Caremore Medicare Advantage |
$8.62
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Central Health Plan Commercial |
$25.60
|
| Rate for Payer: Cigna of CA HMO |
$20.48
|
| Rate for Payer: Cigna of CA PPO |
$23.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.93
|
| Rate for Payer: Dignity Health Media |
$8.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.64
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$8.62
|
| Rate for Payer: EPIC Health Plan Transplant |
$8.62
|
| Rate for Payer: Galaxy Health WC |
$27.20
|
| Rate for Payer: Global Benefits Group Commercial |
$19.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$28.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$24.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$14.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$14.22
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.62
|
| Rate for Payer: InnovAge PACE Commercial |
$12.93
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$21.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14.27
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11.55
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11.55
|
| Rate for Payer: Multiplan Commercial |
$24.00
|
| Rate for Payer: Networks By Design Commercial |
$20.80
|
| Rate for Payer: Prime Health Services Commercial |
$27.20
|
| Rate for Payer: Prime Health Services Medicare |
$9.14
|
| Rate for Payer: Riverside University Health System MISP |
$9.48
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$19.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$225.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.98
|
| Rate for Payer: United Healthcare All Other HMO |
$6.98
|
| Rate for Payer: United Healthcare HMO Rider |
$6.98
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.98
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.48
|
| Rate for Payer: Vantage Medical Group Senior |
$8.62
|
|
|
HC CULTURE YEAST ID
|
Facility
|
OP
|
$34.00
|
|
|
Service Code
|
CPT 87106
|
| Hospital Charge Code |
900911555
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.80 |
| Max. Negotiated Rate |
$91.58 |
| Rate for Payer: Adventist Health Medi-Cal |
$10.32
|
| Rate for Payer: Aetna of CA HMO/PPO |
$75.78
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15.48
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10.32
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$75.08
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$91.58
|
| Rate for Payer: Blue Distinction Transplant |
$20.40
|
| Rate for Payer: Blue Shield of California Commercial |
$21.01
|
| Rate for Payer: Blue Shield of California EPN |
$16.52
|
| Rate for Payer: Caremore Medicare Advantage |
$10.32
|
| Rate for Payer: Cash Price |
$15.30
|
| Rate for Payer: Cash Price |
$15.30
|
| Rate for Payer: Central Health Plan Commercial |
$27.20
|
| Rate for Payer: Cigna of CA HMO |
$21.76
|
| Rate for Payer: Cigna of CA PPO |
$25.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15.48
|
| Rate for Payer: Dignity Health Media |
$10.32
|
| Rate for Payer: Dignity Health Medi-Cal |
$11.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.93
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$10.32
|
| Rate for Payer: EPIC Health Plan Transplant |
$10.32
|
| Rate for Payer: Galaxy Health WC |
$28.90
|
| Rate for Payer: Global Benefits Group Commercial |
$20.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$30.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$25.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$16.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$17.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10.32
|
| Rate for Payer: InnovAge PACE Commercial |
$15.48
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$22.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$15.43
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$13.83
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$13.83
|
| Rate for Payer: Multiplan Commercial |
$25.50
|
| Rate for Payer: Networks By Design Commercial |
$22.10
|
| Rate for Payer: Prime Health Services Commercial |
$28.90
|
| Rate for Payer: Prime Health Services Medicare |
$10.94
|
| Rate for Payer: Riverside University Health System MISP |
$11.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$20.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$20.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$8.36
|
| Rate for Payer: United Healthcare All Other HMO |
$8.36
|
| Rate for Payer: United Healthcare HMO Rider |
$8.36
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8.36
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11.35
|
| Rate for Payer: Vantage Medical Group Senior |
$10.32
|
|
|
HC CULTURE YEAST ID
|
Facility
|
IP
|
$288.00
|
|
|
Service Code
|
CPT 87106
|
| Hospital Charge Code |
900911555
|
|
Hospital Revenue Code
|
306
|
| 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
|
|
|
HC CULTURE YEAST RAPID ID
|
Facility
|
IP
|
$204.00
|
|
|
Service Code
|
CPT 87077
|
| Hospital Charge Code |
900912425
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$40.80 |
| Max. Negotiated Rate |
$183.60 |
| Rate for Payer: Cash Price |
$91.80
|
| Rate for Payer: Central Health Plan Commercial |
$163.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$81.60
|
| Rate for Payer: Galaxy Health WC |
$173.40
|
| Rate for Payer: Global Benefits Group Commercial |
$122.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$183.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$136.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$77.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$40.80
|
| Rate for Payer: Multiplan Commercial |
$153.00
|
| Rate for Payer: Networks By Design Commercial |
$132.60
|
| Rate for Payer: Prime Health Services Commercial |
$173.40
|
|
|
HC CULTURE YEAST RAPID ID
|
Facility
|
OP
|
$31.00
|
|
|
Service Code
|
CPT 87077
|
| Hospital Charge Code |
900912425
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.20 |
| Max. Negotiated Rate |
$225.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$8.08
|
| Rate for Payer: Aetna of CA HMO/PPO |
$59.27
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.12
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.89
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.08
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$58.72
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$71.63
|
| Rate for Payer: Blue Distinction Transplant |
$18.60
|
| Rate for Payer: Blue Shield of California Commercial |
$19.16
|
| Rate for Payer: Blue Shield of California EPN |
$15.07
|
| Rate for Payer: Caremore Medicare Advantage |
$8.08
|
| Rate for Payer: Cash Price |
$13.95
|
| Rate for Payer: Cash Price |
$13.95
|
| Rate for Payer: Cash Price |
$13.95
|
| Rate for Payer: Central Health Plan Commercial |
$24.80
|
| Rate for Payer: Cigna of CA HMO |
$19.84
|
| Rate for Payer: Cigna of CA PPO |
$22.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.12
|
| Rate for Payer: Dignity Health Media |
$8.08
|
| Rate for Payer: Dignity Health Medi-Cal |
$8.89
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.91
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$8.08
|
| Rate for Payer: EPIC Health Plan Transplant |
$8.08
|
| Rate for Payer: Galaxy Health WC |
$26.35
|
| Rate for Payer: Global Benefits Group Commercial |
$18.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$27.90
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$23.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$13.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$13.33
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.08
|
| Rate for Payer: InnovAge PACE Commercial |
$12.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12.64
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.83
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10.83
|
| Rate for Payer: Multiplan Commercial |
$23.25
|
| Rate for Payer: Networks By Design Commercial |
$20.15
|
| Rate for Payer: Prime Health Services Commercial |
$26.35
|
| Rate for Payer: Prime Health Services Medicare |
$8.56
|
| Rate for Payer: Riverside University Health System MISP |
$8.89
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$18.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$225.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.54
|
| Rate for Payer: United Healthcare All Other HMO |
$6.54
|
| Rate for Payer: United Healthcare HMO Rider |
$6.54
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.54
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.89
|
| Rate for Payer: Vantage Medical Group Senior |
$8.08
|
|
|
HC CULTURE YERSINIA
|
Facility
|
IP
|
$399.00
|
|
|
Service Code
|
CPT 87046
|
| Hospital Charge Code |
900911529
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$79.80 |
| Max. Negotiated Rate |
$359.10 |
| Rate for Payer: Cash Price |
$179.55
|
| Rate for Payer: Central Health Plan Commercial |
$319.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$159.60
|
| Rate for Payer: Galaxy Health WC |
$339.15
|
| Rate for Payer: Global Benefits Group Commercial |
$239.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$359.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$266.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$152.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$79.80
|
| Rate for Payer: Multiplan Commercial |
$299.25
|
| Rate for Payer: Networks By Design Commercial |
$259.35
|
| Rate for Payer: Prime Health Services Commercial |
$339.15
|
|
|
HC CULTURE YERSINIA
|
Facility
|
OP
|
$36.00
|
|
|
Service Code
|
CPT 87046
|
| Hospital Charge Code |
900911529
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$4.96 |
| Max. Negotiated Rate |
$69.27 |
| Rate for Payer: Adventist Health Medi-Cal |
$9.44
|
| Rate for Payer: Aetna of CA HMO/PPO |
$69.27
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$14.16
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10.38
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9.44
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$17.14
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$20.91
|
| 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 |
$9.44
|
| 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 |
$14.16
|
| Rate for Payer: Dignity Health Media |
$9.44
|
| Rate for Payer: Dignity Health Medi-Cal |
$10.38
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.74
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$9.44
|
| Rate for Payer: EPIC Health Plan Transplant |
$9.44
|
| 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 |
$15.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$15.58
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$9.44
|
| Rate for Payer: InnovAge PACE Commercial |
$14.16
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$24.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.96
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$12.65
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$12.65
|
| 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 |
$10.01
|
| Rate for Payer: Riverside University Health System MISP |
$10.38
|
| 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 |
$7.65
|
| Rate for Payer: United Healthcare All Other HMO |
$7.65
|
| Rate for Payer: United Healthcare HMO Rider |
$7.65
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.65
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$14.16
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.38
|
| Rate for Payer: Vantage Medical Group Senior |
$9.44
|
|
|
HC CUS ELBO SKT IN FOR CON/ATYP
|
Facility
|
IP
|
$2,219.00
|
|
|
Service Code
|
CPT L6696
|
| Hospital Charge Code |
905356696
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$443.80 |
| Max. Negotiated Rate |
$1,997.10 |
| Rate for Payer: Blue Shield of California EPN |
$1,184.95
|
| Rate for Payer: Cash Price |
$998.55
|
| Rate for Payer: Central Health Plan Commercial |
$1,775.20
|
| Rate for Payer: Cigna of CA HMO |
$1,553.30
|
| Rate for Payer: Cigna of CA PPO |
$1,553.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$887.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$887.60
|
| Rate for Payer: Galaxy Health WC |
$1,886.15
|
| Rate for Payer: Global Benefits Group Commercial |
$1,331.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,997.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,480.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$845.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$443.80
|
| Rate for Payer: Multiplan Commercial |
$1,664.25
|
| Rate for Payer: Networks By Design Commercial |
$1,109.50
|
| Rate for Payer: Prime Health Services Commercial |
$1,886.15
|
| Rate for Payer: United Healthcare All Other Commercial |
$837.89
|
| Rate for Payer: United Healthcare All Other HMO |
$818.37
|
| Rate for Payer: United Healthcare HMO Rider |
$800.62
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$732.27
|
|
|
HC CUS ELBO SKT IN FOR CON/ATYP
|
Facility
|
OP
|
$2,219.00
|
|
|
Service Code
|
CPT L6696
|
| Hospital Charge Code |
905356696
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$776.65 |
| Max. Negotiated Rate |
$1,997.10 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,886.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,220.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,220.45
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,074.44
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,310.99
|
| Rate for Payer: Blue Distinction Transplant |
$1,331.40
|
| Rate for Payer: Blue Shield of California Commercial |
$1,664.25
|
| Rate for Payer: Blue Shield of California EPN |
$1,207.14
|
| Rate for Payer: Cash Price |
$998.55
|
| Rate for Payer: Cash Price |
$998.55
|
| Rate for Payer: Central Health Plan Commercial |
$1,775.20
|
| Rate for Payer: Cigna of CA HMO |
$1,553.30
|
| Rate for Payer: Cigna of CA PPO |
$1,553.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,886.15
|
| Rate for Payer: Dignity Health Media |
$1,886.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,886.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$887.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$887.60
|
| Rate for Payer: Galaxy Health WC |
$1,886.15
|
| Rate for Payer: Global Benefits Group Commercial |
$1,331.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,997.10
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,664.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$776.65
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,480.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,574.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$909.79
|
| Rate for Payer: Multiplan Commercial |
$1,664.25
|
| Rate for Payer: Networks By Design Commercial |
$1,109.50
|
| Rate for Payer: Prime Health Services Commercial |
$1,886.15
|
| Rate for Payer: Riverside University Health System MISP |
$887.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,331.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,331.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,109.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,109.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,109.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,109.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,886.15
|
| Rate for Payer: Vantage Medical Group Senior |
$1,886.15
|
|
|
HC CUS ELBO SKT IN NOT CON/ATYP
|
Facility
|
IP
|
$2,219.00
|
|
|
Service Code
|
CPT L6697
|
| Hospital Charge Code |
905356697
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$443.80 |
| Max. Negotiated Rate |
$1,997.10 |
| Rate for Payer: Blue Shield of California EPN |
$1,184.95
|
| Rate for Payer: Cash Price |
$998.55
|
| Rate for Payer: Central Health Plan Commercial |
$1,775.20
|
| Rate for Payer: Cigna of CA HMO |
$1,553.30
|
| Rate for Payer: Cigna of CA PPO |
$1,553.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$887.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$887.60
|
| Rate for Payer: Galaxy Health WC |
$1,886.15
|
| Rate for Payer: Global Benefits Group Commercial |
$1,331.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,997.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,480.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$845.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$443.80
|
| Rate for Payer: Multiplan Commercial |
$1,664.25
|
| Rate for Payer: Networks By Design Commercial |
$1,109.50
|
| Rate for Payer: Prime Health Services Commercial |
$1,886.15
|
| Rate for Payer: United Healthcare All Other Commercial |
$837.89
|
| Rate for Payer: United Healthcare All Other HMO |
$818.37
|
| Rate for Payer: United Healthcare HMO Rider |
$800.62
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$732.27
|
|
|
HC CUS ELBO SKT IN NOT CON/ATYP
|
Facility
|
OP
|
$2,219.00
|
|
|
Service Code
|
CPT L6697
|
| Hospital Charge Code |
905356697
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$776.65 |
| Max. Negotiated Rate |
$1,997.10 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,886.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,220.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,220.45
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,074.44
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,310.99
|
| Rate for Payer: Blue Distinction Transplant |
$1,331.40
|
| Rate for Payer: Blue Shield of California Commercial |
$1,664.25
|
| Rate for Payer: Blue Shield of California EPN |
$1,207.14
|
| Rate for Payer: Cash Price |
$998.55
|
| Rate for Payer: Cash Price |
$998.55
|
| Rate for Payer: Central Health Plan Commercial |
$1,775.20
|
| Rate for Payer: Cigna of CA HMO |
$1,553.30
|
| Rate for Payer: Cigna of CA PPO |
$1,553.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,886.15
|
| Rate for Payer: Dignity Health Media |
$1,886.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,886.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$887.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$887.60
|
| Rate for Payer: Galaxy Health WC |
$1,886.15
|
| Rate for Payer: Global Benefits Group Commercial |
$1,331.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,997.10
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,664.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$776.65
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,480.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,574.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$909.79
|
| Rate for Payer: Multiplan Commercial |
$1,664.25
|
| Rate for Payer: Networks By Design Commercial |
$1,109.50
|
| Rate for Payer: Prime Health Services Commercial |
$1,886.15
|
| Rate for Payer: Riverside University Health System MISP |
$887.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,331.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,331.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,109.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,109.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,109.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,109.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,886.15
|
| Rate for Payer: Vantage Medical Group Senior |
$1,886.15
|
|
|
HC CUTTING BALLOON
|
Facility
|
OP
|
$1,920.00
|
|
|
Service Code
|
CPT C1714
|
| Hospital Charge Code |
909080044
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$384.00 |
| Max. Negotiated Rate |
$23,685.15 |
| Rate for Payer: Aetna of CA HMO/PPO |
$23,685.15
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,632.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,056.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,056.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$929.66
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,134.34
|
| Rate for Payer: Blue Distinction Transplant |
$1,152.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,207.68
|
| Rate for Payer: Blue Shield of California EPN |
$938.88
|
| Rate for Payer: Cash Price |
$864.00
|
| Rate for Payer: Cash Price |
$864.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,536.00
|
| Rate for Payer: Cigna of CA HMO |
$1,228.80
|
| Rate for Payer: Cigna of CA PPO |
$1,420.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,632.00
|
| Rate for Payer: Dignity Health Media |
$1,632.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,632.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$768.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$768.00
|
| Rate for Payer: Galaxy Health WC |
$1,632.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,152.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,728.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,440.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$672.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,280.64
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$731.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$384.00
|
| Rate for Payer: Multiplan Commercial |
$1,440.00
|
| Rate for Payer: Networks By Design Commercial |
$1,248.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,632.00
|
| Rate for Payer: Riverside University Health System MISP |
$768.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,152.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,152.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$960.00
|
| Rate for Payer: United Healthcare All Other HMO |
$960.00
|
| Rate for Payer: United Healthcare HMO Rider |
$960.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$960.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,632.00
|
| Rate for Payer: Vantage Medical Group Senior |
$1,632.00
|
|
|
HC CUTTING BALLOON
|
Facility
|
IP
|
$1,920.00
|
|
|
Service Code
|
CPT C1714
|
| Hospital Charge Code |
909080044
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$384.00 |
| Max. Negotiated Rate |
$1,728.00 |
| Rate for Payer: Cash Price |
$864.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,536.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$768.00
|
| Rate for Payer: Galaxy Health WC |
$1,632.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,152.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,728.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,280.64
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$731.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$384.00
|
| Rate for Payer: Multiplan Commercial |
$1,440.00
|
| Rate for Payer: Networks By Design Commercial |
$1,248.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,632.00
|
|
|
HC CVP-R & L TESSO CATH
|
Facility
|
OP
|
$1,019.00
|
|
|
Service Code
|
CPT C1750
|
| Hospital Charge Code |
909081702
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$203.80 |
| Max. Negotiated Rate |
$2,565.15 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,565.15
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$866.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$560.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$560.45
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$493.40
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$602.03
|
| Rate for Payer: Blue Distinction Transplant |
$611.40
|
| Rate for Payer: Blue Shield of California Commercial |
$640.95
|
| Rate for Payer: Blue Shield of California EPN |
$498.29
|
| Rate for Payer: Cash Price |
$458.55
|
| Rate for Payer: Cash Price |
$458.55
|
| Rate for Payer: Central Health Plan Commercial |
$815.20
|
| Rate for Payer: Cigna of CA HMO |
$652.16
|
| Rate for Payer: Cigna of CA PPO |
$754.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$866.15
|
| Rate for Payer: Dignity Health Media |
$866.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$866.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$407.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$407.60
|
| Rate for Payer: Galaxy Health WC |
$866.15
|
| Rate for Payer: Global Benefits Group Commercial |
$611.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$917.10
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$764.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$356.65
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$679.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$388.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$203.80
|
| Rate for Payer: Multiplan Commercial |
$764.25
|
| Rate for Payer: Networks By Design Commercial |
$662.35
|
| Rate for Payer: Prime Health Services Commercial |
$866.15
|
| Rate for Payer: Riverside University Health System MISP |
$407.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$611.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$611.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$509.50
|
| Rate for Payer: United Healthcare All Other HMO |
$509.50
|
| Rate for Payer: United Healthcare HMO Rider |
$509.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$509.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$866.15
|
| Rate for Payer: Vantage Medical Group Senior |
$866.15
|
|
|
HC CVP-R & L TESSO CATH
|
Facility
|
IP
|
$1,019.00
|
|
|
Service Code
|
CPT C1750
|
| Hospital Charge Code |
909081702
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$203.80 |
| Max. Negotiated Rate |
$917.10 |
| Rate for Payer: Cash Price |
$458.55
|
| Rate for Payer: Central Health Plan Commercial |
$815.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$407.60
|
| Rate for Payer: Galaxy Health WC |
$866.15
|
| Rate for Payer: Global Benefits Group Commercial |
$611.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$917.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$679.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$388.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$203.80
|
| Rate for Payer: Multiplan Commercial |
$764.25
|
| Rate for Payer: Networks By Design Commercial |
$662.35
|
| Rate for Payer: Prime Health Services Commercial |
$866.15
|
|
|
HC CYCLIC CITRUL PEPT AB
|
Facility
|
IP
|
$58.00
|
|
|
Service Code
|
CPT 86200
|
| Hospital Charge Code |
900913652
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.60 |
| Max. Negotiated Rate |
$52.20 |
| Rate for Payer: Cash Price |
$26.10
|
| Rate for Payer: Central Health Plan Commercial |
$46.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$23.20
|
| Rate for Payer: Galaxy Health WC |
$49.30
|
| Rate for Payer: Global Benefits Group Commercial |
$34.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$52.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$38.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$22.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.60
|
| Rate for Payer: Multiplan Commercial |
$43.50
|
| Rate for Payer: Networks By Design Commercial |
$37.70
|
| Rate for Payer: Prime Health Services Commercial |
$49.30
|
|
|
HC CYCLIC CITRUL PEPT AB
|
Facility
|
OP
|
$39.00
|
|
|
Service Code
|
CPT 86200
|
| Hospital Charge Code |
900913652
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.80 |
| Max. Negotiated Rate |
$112.37 |
| Rate for Payer: Adventist Health Medi-Cal |
$12.95
|
| Rate for Payer: Aetna of CA HMO/PPO |
$95.04
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19.42
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.24
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12.95
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$92.13
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$112.37
|
| Rate for Payer: Blue Distinction Transplant |
$23.40
|
| Rate for Payer: Blue Shield of California Commercial |
$24.10
|
| Rate for Payer: Blue Shield of California EPN |
$18.95
|
| Rate for Payer: Caremore Medicare Advantage |
$12.95
|
| Rate for Payer: Cash Price |
$17.55
|
| Rate for Payer: Cash Price |
$17.55
|
| Rate for Payer: Central Health Plan Commercial |
$31.20
|
| Rate for Payer: Cigna of CA HMO |
$24.96
|
| Rate for Payer: Cigna of CA PPO |
$28.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.42
|
| Rate for Payer: Dignity Health Media |
$12.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$17.48
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$12.95
|
| Rate for Payer: EPIC Health Plan Transplant |
$12.95
|
| Rate for Payer: Galaxy Health WC |
$33.15
|
| Rate for Payer: Global Benefits Group Commercial |
$23.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$35.10
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$29.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$21.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$21.37
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$12.95
|
| Rate for Payer: InnovAge PACE Commercial |
$19.42
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$26.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13.49
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17.35
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17.35
|
| Rate for Payer: Multiplan Commercial |
$29.25
|
| Rate for Payer: Networks By Design Commercial |
$25.35
|
| Rate for Payer: Prime Health Services Commercial |
$33.15
|
| Rate for Payer: Prime Health Services Medicare |
$13.73
|
| Rate for Payer: Riverside University Health System MISP |
$14.24
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$23.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$23.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.49
|
| Rate for Payer: United Healthcare All Other HMO |
$10.49
|
| Rate for Payer: United Healthcare HMO Rider |
$10.49
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.49
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.42
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.24
|
| Rate for Payer: Vantage Medical Group Senior |
$12.95
|
|
|
HC CYCLOSPORINE A (EMIT)
|
Facility
|
OP
|
$69.00
|
|
|
Service Code
|
CPT 80158
|
| Hospital Charge Code |
900910933
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.80 |
| Max. Negotiated Rate |
$160.22 |
| Rate for Payer: Adventist Health Medi-Cal |
$18.05
|
| Rate for Payer: Aetna of CA HMO/PPO |
$132.47
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$27.08
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$18.05
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$131.36
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$160.22
|
| Rate for Payer: Blue Distinction Transplant |
$41.40
|
| Rate for Payer: Blue Shield of California Commercial |
$42.64
|
| Rate for Payer: Blue Shield of California EPN |
$33.53
|
| Rate for Payer: Caremore Medicare Advantage |
$18.05
|
| Rate for Payer: Cash Price |
$31.05
|
| Rate for Payer: Cash Price |
$31.05
|
| Rate for Payer: Central Health Plan Commercial |
$55.20
|
| Rate for Payer: Cigna of CA HMO |
$44.16
|
| Rate for Payer: Cigna of CA PPO |
$51.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$27.08
|
| Rate for Payer: Dignity Health Media |
$18.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$19.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$24.37
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$18.05
|
| Rate for Payer: EPIC Health Plan Transplant |
$18.05
|
| Rate for Payer: Galaxy Health WC |
$58.65
|
| Rate for Payer: Global Benefits Group Commercial |
$41.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$62.10
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$51.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$29.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$29.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$18.05
|
| Rate for Payer: InnovAge PACE Commercial |
$27.08
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$46.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$30.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$24.19
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$24.19
|
| Rate for Payer: Multiplan Commercial |
$51.75
|
| Rate for Payer: Networks By Design Commercial |
$44.85
|
| Rate for Payer: Prime Health Services Commercial |
$58.65
|
| Rate for Payer: Prime Health Services Medicare |
$19.13
|
| Rate for Payer: Riverside University Health System MISP |
$19.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$41.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$41.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.62
|
| Rate for Payer: United Healthcare All Other HMO |
$14.62
|
| Rate for Payer: United Healthcare HMO Rider |
$14.62
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.62
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$27.08
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.86
|
| Rate for Payer: Vantage Medical Group Senior |
$18.05
|
|
|
HC CYCLOSPORINE A (EMIT)
|
Facility
|
IP
|
$248.00
|
|
|
Service Code
|
CPT 80158
|
| Hospital Charge Code |
900910933
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$49.60 |
| Max. Negotiated Rate |
$223.20 |
| Rate for Payer: Cash Price |
$111.60
|
| Rate for Payer: Central Health Plan Commercial |
$198.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$99.20
|
| Rate for Payer: Galaxy Health WC |
$210.80
|
| Rate for Payer: Global Benefits Group Commercial |
$148.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$223.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$165.42
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$94.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$49.60
|
| Rate for Payer: Multiplan Commercial |
$186.00
|
| Rate for Payer: Networks By Design Commercial |
$161.20
|
| Rate for Payer: Prime Health Services Commercial |
$210.80
|
|
|
HC CYLINDER CAST-THIGH TO ANKLE
|
Facility
|
OP
|
$699.00
|
|
|
Service Code
|
CPT 29365
|
| Hospital Charge Code |
950510041
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$139.80 |
| Max. Negotiated Rate |
$2,696.00 |
| 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 |
$503.32
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$369.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$335.55
|
| 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 |
$419.40
|
| Rate for Payer: Caremore Medicare Advantage |
$335.55
|
| Rate for Payer: Cash Price |
$314.55
|
| Rate for Payer: Cash Price |
$314.55
|
| Rate for Payer: Cash Price |
$314.55
|
| Rate for Payer: Cash Price |
$314.55
|
| Rate for Payer: Central Health Plan Commercial |
$559.20
|
| Rate for Payer: Cigna of CA PPO |
$517.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$503.32
|
| Rate for Payer: Dignity Health Media |
$335.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$369.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$452.99
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$335.55
|
| Rate for Payer: EPIC Health Plan Transplant |
$335.55
|
| Rate for Payer: Galaxy Health WC |
$594.15
|
| Rate for Payer: Global Benefits Group Commercial |
$419.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$629.10
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$524.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$550.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$335.55
|
| Rate for Payer: InnovAge PACE Commercial |
$503.32
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$466.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$195.95
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$335.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$139.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$449.64
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$449.64
|
| Rate for Payer: Multiplan Commercial |
$524.25
|
| Rate for Payer: Networks By Design Commercial |
$454.35
|
| Rate for Payer: Prime Health Services Commercial |
$594.15
|
| Rate for Payer: Prime Health Services Medicare |
$355.68
|
| Rate for Payer: Riverside University Health System MISP |
$369.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$419.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$349.50
|
| Rate for Payer: United Healthcare All Other HMO |
$349.50
|
| Rate for Payer: United Healthcare HMO Rider |
$349.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$349.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$503.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$369.10
|
| Rate for Payer: Vantage Medical Group Senior |
$335.55
|
|
