|
HC HKAFO UNILAT TRSN BALL BEARING
|
Facility
|
IP
|
$858.00
|
|
|
Service Code
|
CPT L2090
|
| Hospital Charge Code |
905352090
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$171.60 |
| Max. Negotiated Rate |
$772.20 |
| Rate for Payer: Adventist Health Commercial |
$171.60
|
| Rate for Payer: Blue Shield of California Commercial |
$688.12
|
| Rate for Payer: Blue Shield of California EPN |
$432.43
|
| Rate for Payer: Cash Price |
$386.10
|
| Rate for Payer: Central Health Plan Commercial |
$686.40
|
| Rate for Payer: Cigna of CA HMO |
$600.60
|
| Rate for Payer: Cigna of CA PPO |
$600.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$600.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$343.20
|
| Rate for Payer: EPIC Health Plan Senior |
$343.20
|
| Rate for Payer: Galaxy Health WC |
$729.30
|
| Rate for Payer: Global Benefits Group Commercial |
$514.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$772.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$544.83
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$506.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$171.60
|
| Rate for Payer: Multiplan Commercial |
$643.50
|
| Rate for Payer: Networks By Design Commercial |
$557.70
|
| Rate for Payer: Prime Health Services Commercial |
$729.30
|
| Rate for Payer: United Healthcare All Other Commercial |
$322.01
|
| Rate for Payer: United Healthcare All Other HMO |
$313.43
|
| Rate for Payer: United Healthcare HMO Rider |
$306.65
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$281.00
|
|
|
HC HLA A B C DR DQ DP HI RES MOLECULAR
|
Facility
|
OP
|
$295.17
|
|
|
Service Code
|
CPT 81382
|
| Hospital Charge Code |
903913201
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$59.03 |
| Max. Negotiated Rate |
$851.81 |
| Rate for Payer: Adventist Health Commercial |
$59.03
|
| Rate for Payer: Adventist Health Medi-Cal |
$123.68
|
| Rate for Payer: Aetna of CA HMO/PPO |
$353.23
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$185.52
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$136.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$123.68
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$612.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$851.81
|
| Rate for Payer: Blue Shield of California Commercial |
$185.96
|
| Rate for Payer: Blue Shield of California EPN |
$117.18
|
| Rate for Payer: Cash Price |
$132.83
|
| Rate for Payer: Cash Price |
$132.83
|
| Rate for Payer: Central Health Plan Commercial |
$236.14
|
| Rate for Payer: Cigna of CA HMO |
$188.91
|
| Rate for Payer: Cigna of CA PPO |
$218.43
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$185.52
|
| Rate for Payer: Dignity Health Medi-Cal |
$136.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$123.68
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$206.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$204.07
|
| Rate for Payer: EPIC Health Plan Senior |
$136.05
|
| Rate for Payer: Galaxy Health WC |
$250.89
|
| Rate for Payer: Global Benefits Group Commercial |
$177.10
|
| Rate for Payer: Health Management Network EPO/PPO |
$265.65
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$202.84
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$189.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$123.68
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$187.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$208.89
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$173.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$59.03
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$165.73
|
| Rate for Payer: Multiplan Commercial |
$221.38
|
| Rate for Payer: Networks By Design Commercial |
$191.86
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$123.68
|
| Rate for Payer: Prime Health Services Commercial |
$250.89
|
| Rate for Payer: Prime Health Services Medicare |
$131.10
|
| Rate for Payer: Riverside University Health System MISP |
$136.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$177.10
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$177.10
|
| Rate for Payer: United Healthcare All Other Commercial |
$100.18
|
| Rate for Payer: United Healthcare All Other HMO |
$100.18
|
| Rate for Payer: United Healthcare HMO Rider |
$100.18
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$100.18
|
| Rate for Payer: Upland Medical Group Pediatric |
$123.68
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$185.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$136.05
|
| Rate for Payer: Vantage Medical Group Senior |
$123.68
|
|
|
HC HLA A B C DR DQ DP HI RES MOLECULAR
|
Facility
|
IP
|
$4,007.00
|
|
|
Service Code
|
CPT 81379
|
| Hospital Charge Code |
903913202
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$801.40 |
| Max. Negotiated Rate |
$3,606.30 |
| Rate for Payer: Adventist Health Commercial |
$801.40
|
| Rate for Payer: Cash Price |
$1,803.15
|
| Rate for Payer: Central Health Plan Commercial |
$3,205.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,804.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,602.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,602.80
|
| Rate for Payer: Galaxy Health WC |
$3,405.95
|
| Rate for Payer: Global Benefits Group Commercial |
$2,404.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,606.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,544.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,364.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$801.40
|
| Rate for Payer: Multiplan Commercial |
$3,005.25
|
| Rate for Payer: Networks By Design Commercial |
$2,604.55
|
| Rate for Payer: Prime Health Services Commercial |
$3,405.95
|
|
|
HC HLA A B C DR DQ DP HI RES MOLECULAR
|
Facility
|
OP
|
$3,340.00
|
|
|
Service Code
|
CPT 81379
|
| Hospital Charge Code |
903913202
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$271.66 |
| Max. Negotiated Rate |
$3,788.26 |
| Rate for Payer: Adventist Health Commercial |
$668.00
|
| Rate for Payer: Adventist Health Commercial |
$801.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$335.38
|
| Rate for Payer: Adventist Health Medi-Cal |
$335.38
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,431.70
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,431.70
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$503.07
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$503.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$368.92
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$368.92
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$335.38
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$335.38
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,724.88
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,724.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,788.26
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,788.26
|
| Rate for Payer: Blue Shield of California Commercial |
$2,524.41
|
| Rate for Payer: Blue Shield of California Commercial |
$2,104.20
|
| Rate for Payer: Blue Shield of California EPN |
$1,590.78
|
| Rate for Payer: Blue Shield of California EPN |
$1,325.98
|
| Rate for Payer: Cash Price |
$1,803.15
|
| Rate for Payer: Cash Price |
$1,803.15
|
| Rate for Payer: Cash Price |
$1,503.00
|
| Rate for Payer: Cash Price |
$1,503.00
|
| Rate for Payer: Central Health Plan Commercial |
$2,672.00
|
| Rate for Payer: Central Health Plan Commercial |
$3,205.60
|
| Rate for Payer: Cigna of CA HMO |
$2,564.48
|
| Rate for Payer: Cigna of CA HMO |
$2,137.60
|
| Rate for Payer: Cigna of CA PPO |
$2,965.18
|
| Rate for Payer: Cigna of CA PPO |
$2,471.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$503.07
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$503.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$368.92
|
| Rate for Payer: Dignity Health Medi-Cal |
$368.92
|
| Rate for Payer: Dignity Health Medicare Advantage |
$335.38
|
| Rate for Payer: Dignity Health Medicare Advantage |
$335.38
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,338.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,804.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$553.38
|
| Rate for Payer: EPIC Health Plan Commercial |
$553.38
|
| Rate for Payer: EPIC Health Plan Senior |
$368.92
|
| Rate for Payer: EPIC Health Plan Senior |
$368.92
|
| Rate for Payer: Galaxy Health WC |
$3,405.95
|
| Rate for Payer: Galaxy Health WC |
$2,839.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,404.20
|
| Rate for Payer: Global Benefits Group Commercial |
$2,004.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,606.30
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,006.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$550.02
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$550.02
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$512.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$512.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$335.38
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$335.38
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,120.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,544.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$566.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$566.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$469.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$469.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$668.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$801.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$449.41
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$449.41
|
| Rate for Payer: Multiplan Commercial |
$3,005.25
|
| Rate for Payer: Multiplan Commercial |
$2,505.00
|
| Rate for Payer: Networks By Design Commercial |
$2,171.00
|
| Rate for Payer: Networks By Design Commercial |
$2,604.55
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$335.38
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$335.38
|
| Rate for Payer: Prime Health Services Commercial |
$3,405.95
|
| Rate for Payer: Prime Health Services Commercial |
$2,839.00
|
| Rate for Payer: Prime Health Services Medicare |
$355.50
|
| Rate for Payer: Prime Health Services Medicare |
$355.50
|
| Rate for Payer: Riverside University Health System MISP |
$368.92
|
| Rate for Payer: Riverside University Health System MISP |
$368.92
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,004.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,404.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,404.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,004.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$271.66
|
| Rate for Payer: United Healthcare All Other Commercial |
$271.66
|
| Rate for Payer: United Healthcare All Other HMO |
$271.66
|
| Rate for Payer: United Healthcare All Other HMO |
$271.66
|
| Rate for Payer: United Healthcare HMO Rider |
$271.66
|
| Rate for Payer: United Healthcare HMO Rider |
$271.66
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$271.66
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$271.66
|
| Rate for Payer: Upland Medical Group Pediatric |
$335.38
|
| Rate for Payer: Upland Medical Group Pediatric |
$335.38
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$503.07
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$503.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$368.92
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$368.92
|
| Rate for Payer: Vantage Medical Group Senior |
$335.38
|
| Rate for Payer: Vantage Medical Group Senior |
$335.38
|
|
|
HC HLA A B C DR DQ DP HI RES MOLECULAR
|
Facility
|
IP
|
$295.17
|
|
|
Service Code
|
CPT 81382
|
| Hospital Charge Code |
903913201
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$59.03 |
| Max. Negotiated Rate |
$265.65 |
| Rate for Payer: Adventist Health Commercial |
$59.03
|
| Rate for Payer: Cash Price |
$132.83
|
| Rate for Payer: Central Health Plan Commercial |
$236.14
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$206.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$118.07
|
| Rate for Payer: EPIC Health Plan Senior |
$118.07
|
| Rate for Payer: Galaxy Health WC |
$250.89
|
| Rate for Payer: Global Benefits Group Commercial |
$177.10
|
| Rate for Payer: Health Management Network EPO/PPO |
$265.65
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$187.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$174.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$59.03
|
| Rate for Payer: Multiplan Commercial |
$221.38
|
| Rate for Payer: Networks By Design Commercial |
$191.86
|
| Rate for Payer: Prime Health Services Commercial |
$250.89
|
|
|
HC HLA A, B, C, DR, DQ, DP HI-RES MOLECULAR
|
Facility
|
IP
|
$1,771.00
|
|
|
Service Code
|
CPT 81979
|
| Hospital Charge Code |
900913201
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$354.20 |
| Max. Negotiated Rate |
$1,593.90 |
| Rate for Payer: Adventist Health Commercial |
$354.20
|
| Rate for Payer: Cash Price |
$796.95
|
| Rate for Payer: Central Health Plan Commercial |
$1,416.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,239.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$708.40
|
| Rate for Payer: EPIC Health Plan Senior |
$708.40
|
| Rate for Payer: Galaxy Health WC |
$1,505.35
|
| Rate for Payer: Global Benefits Group Commercial |
$1,062.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,593.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,124.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,044.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$354.20
|
| Rate for Payer: Multiplan Commercial |
$1,328.25
|
| Rate for Payer: Networks By Design Commercial |
$1,151.15
|
| Rate for Payer: Prime Health Services Commercial |
$1,505.35
|
|
|
HC HLA A, B, C, DR, DQ, DP HI-RES MOLECULAR
|
Facility
|
OP
|
$1,771.00
|
|
|
Service Code
|
CPT 81979
|
| Hospital Charge Code |
900913201
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$354.20 |
| Max. Negotiated Rate |
$1,593.90 |
| Rate for Payer: Adventist Health Commercial |
$354.20
|
| Rate for Payer: Adventist Health Commercial |
$284.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,075.53
|
| Rate for Payer: Aetna of CA HMO/PPO |
$862.37
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,505.35
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,207.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$781.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$974.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,065.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,328.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$857.52
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$687.56
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$826.01
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,030.19
|
| Rate for Payer: Blue Shield of California Commercial |
$894.60
|
| Rate for Payer: Blue Shield of California Commercial |
$1,115.73
|
| Rate for Payer: Blue Shield of California EPN |
$703.09
|
| Rate for Payer: Blue Shield of California EPN |
$563.74
|
| Rate for Payer: Cash Price |
$796.95
|
| Rate for Payer: Cash Price |
$639.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,416.80
|
| Rate for Payer: Central Health Plan Commercial |
$1,136.00
|
| Rate for Payer: Cigna of CA HMO |
$908.80
|
| Rate for Payer: Cigna of CA HMO |
$1,133.44
|
| Rate for Payer: Cigna of CA PPO |
$1,050.80
|
| Rate for Payer: Cigna of CA PPO |
$1,310.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,207.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,505.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,207.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,505.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,505.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,207.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$994.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,239.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$568.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$708.40
|
| Rate for Payer: EPIC Health Plan Senior |
$708.40
|
| Rate for Payer: EPIC Health Plan Senior |
$568.00
|
| Rate for Payer: Galaxy Health WC |
$1,505.35
|
| Rate for Payer: Galaxy Health WC |
$1,207.00
|
| Rate for Payer: Global Benefits Group Commercial |
$852.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,062.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,278.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,593.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,124.59
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$901.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$642.87
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$515.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$837.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,044.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$284.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$354.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,239.70
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$994.00
|
| Rate for Payer: Multiplan Commercial |
$1,328.25
|
| Rate for Payer: Multiplan Commercial |
$1,065.00
|
| Rate for Payer: Networks By Design Commercial |
$923.00
|
| Rate for Payer: Networks By Design Commercial |
$1,151.15
|
| Rate for Payer: Prime Health Services Commercial |
$1,207.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,505.35
|
| Rate for Payer: Riverside University Health System MISP |
$708.40
|
| Rate for Payer: Riverside University Health System MISP |
$568.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$852.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,062.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,062.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$852.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$710.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$885.50
|
| Rate for Payer: United Healthcare All Other HMO |
$710.00
|
| Rate for Payer: United Healthcare All Other HMO |
$885.50
|
| Rate for Payer: United Healthcare HMO Rider |
$710.00
|
| Rate for Payer: United Healthcare HMO Rider |
$885.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$710.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$885.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,505.35
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,207.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,207.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,505.35
|
| Rate for Payer: Vantage Medical Group Senior |
$1,505.35
|
| Rate for Payer: Vantage Medical Group Senior |
$1,207.00
|
|
|
HC HLA A, B, C, DR, DQ, DP HI-RES MOLECULAR
|
Facility
|
OP
|
$1,420.00
|
|
|
Service Code
|
CPT 81382
|
| Hospital Charge Code |
900913202
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$100.18 |
| Max. Negotiated Rate |
$1,278.00 |
| Rate for Payer: Adventist Health Commercial |
$284.00
|
| Rate for Payer: Adventist Health Commercial |
$354.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$123.68
|
| Rate for Payer: Adventist Health Medi-Cal |
$123.68
|
| Rate for Payer: Aetna of CA HMO/PPO |
$353.23
|
| Rate for Payer: Aetna of CA HMO/PPO |
$353.23
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$185.52
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$185.52
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$136.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$136.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$123.68
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$123.68
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$612.70
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$612.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$851.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$851.81
|
| Rate for Payer: Blue Shield of California Commercial |
$1,115.73
|
| Rate for Payer: Blue Shield of California Commercial |
$894.60
|
| Rate for Payer: Blue Shield of California EPN |
$703.09
|
| Rate for Payer: Blue Shield of California EPN |
$563.74
|
| Rate for Payer: Cash Price |
$796.95
|
| Rate for Payer: Cash Price |
$796.95
|
| Rate for Payer: Cash Price |
$639.00
|
| Rate for Payer: Cash Price |
$639.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,136.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,416.80
|
| Rate for Payer: Cigna of CA HMO |
$1,133.44
|
| Rate for Payer: Cigna of CA HMO |
$908.80
|
| Rate for Payer: Cigna of CA PPO |
$1,310.54
|
| Rate for Payer: Cigna of CA PPO |
$1,050.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$185.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$185.52
|
| Rate for Payer: Dignity Health Medi-Cal |
$136.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$136.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$123.68
|
| Rate for Payer: Dignity Health Medicare Advantage |
$123.68
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$994.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,239.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$204.07
|
| Rate for Payer: EPIC Health Plan Commercial |
$204.07
|
| Rate for Payer: EPIC Health Plan Senior |
$136.05
|
| Rate for Payer: EPIC Health Plan Senior |
$136.05
|
| Rate for Payer: Galaxy Health WC |
$1,505.35
|
| Rate for Payer: Galaxy Health WC |
$1,207.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,062.60
|
| Rate for Payer: Global Benefits Group Commercial |
$852.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,593.90
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,278.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$202.84
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$202.84
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$189.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$189.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$123.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$123.68
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$901.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,124.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$208.89
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$208.89
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$173.15
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$173.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$284.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$354.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$165.73
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$165.73
|
| Rate for Payer: Multiplan Commercial |
$1,328.25
|
| Rate for Payer: Multiplan Commercial |
$1,065.00
|
| Rate for Payer: Networks By Design Commercial |
$923.00
|
| Rate for Payer: Networks By Design Commercial |
$1,151.15
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$123.68
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$123.68
|
| Rate for Payer: Prime Health Services Commercial |
$1,505.35
|
| Rate for Payer: Prime Health Services Commercial |
$1,207.00
|
| Rate for Payer: Prime Health Services Medicare |
$131.10
|
| Rate for Payer: Prime Health Services Medicare |
$131.10
|
| Rate for Payer: Riverside University Health System MISP |
$136.05
|
| Rate for Payer: Riverside University Health System MISP |
$136.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$852.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,062.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,062.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$852.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$100.18
|
| Rate for Payer: United Healthcare All Other Commercial |
$100.18
|
| Rate for Payer: United Healthcare All Other HMO |
$100.18
|
| Rate for Payer: United Healthcare All Other HMO |
$100.18
|
| Rate for Payer: United Healthcare HMO Rider |
$100.18
|
| Rate for Payer: United Healthcare HMO Rider |
$100.18
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$100.18
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$100.18
|
| Rate for Payer: Upland Medical Group Pediatric |
$123.68
|
| Rate for Payer: Upland Medical Group Pediatric |
$123.68
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$185.52
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$185.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$136.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$136.05
|
| Rate for Payer: Vantage Medical Group Senior |
$123.68
|
| Rate for Payer: Vantage Medical Group Senior |
$123.68
|
|
|
HC HLA A, B, C, DR, DQ, DP HI-RES MOLECULAR
|
Facility
|
IP
|
$1,771.00
|
|
|
Service Code
|
CPT 81382
|
| Hospital Charge Code |
900913202
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$354.20 |
| Max. Negotiated Rate |
$1,593.90 |
| Rate for Payer: Adventist Health Commercial |
$354.20
|
| Rate for Payer: Cash Price |
$796.95
|
| Rate for Payer: Central Health Plan Commercial |
$1,416.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,239.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$708.40
|
| Rate for Payer: EPIC Health Plan Senior |
$708.40
|
| Rate for Payer: Galaxy Health WC |
$1,505.35
|
| Rate for Payer: Global Benefits Group Commercial |
$1,062.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,593.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,124.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,044.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$354.20
|
| Rate for Payer: Multiplan Commercial |
$1,328.25
|
| Rate for Payer: Networks By Design Commercial |
$1,151.15
|
| Rate for Payer: Prime Health Services Commercial |
$1,505.35
|
|
|
HC HLA A B C DR DQ DP MOLECULA
|
Facility
|
OP
|
$2,341.00
|
|
|
Service Code
|
CPT 81370
|
| Hospital Charge Code |
903902023
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$325.72 |
| Max. Negotiated Rate |
$2,106.90 |
| Rate for Payer: Adventist Health Commercial |
$468.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$402.12
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,716.71
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$603.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$442.33
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$402.12
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,202.43
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,671.68
|
| Rate for Payer: Blue Shield of California Commercial |
$1,474.83
|
| Rate for Payer: Blue Shield of California EPN |
$929.38
|
| Rate for Payer: Cash Price |
$1,053.45
|
| Rate for Payer: Cash Price |
$1,053.45
|
| Rate for Payer: Central Health Plan Commercial |
$1,872.80
|
| Rate for Payer: Cigna of CA HMO |
$1,498.24
|
| Rate for Payer: Cigna of CA PPO |
$1,732.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$603.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$442.33
|
| Rate for Payer: Dignity Health Medicare Advantage |
$402.12
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,638.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$663.50
|
| Rate for Payer: EPIC Health Plan Senior |
$442.33
|
| Rate for Payer: Galaxy Health WC |
$1,989.85
|
| Rate for Payer: Global Benefits Group Commercial |
$1,404.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,106.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$659.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$614.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$402.12
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,486.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$679.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$562.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$468.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$538.84
|
| Rate for Payer: Multiplan Commercial |
$1,755.75
|
| Rate for Payer: Networks By Design Commercial |
$1,521.65
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$402.12
|
| Rate for Payer: Prime Health Services Commercial |
$1,989.85
|
| Rate for Payer: Prime Health Services Medicare |
$426.25
|
| Rate for Payer: Riverside University Health System MISP |
$442.33
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,404.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,404.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$325.72
|
| Rate for Payer: United Healthcare All Other HMO |
$325.72
|
| Rate for Payer: United Healthcare HMO Rider |
$325.72
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$325.72
|
| Rate for Payer: Upland Medical Group Pediatric |
$402.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$603.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$442.33
|
| Rate for Payer: Vantage Medical Group Senior |
$402.12
|
|
|
HC HLA A B C DR DQ DP MOLECULA
|
Facility
|
IP
|
$2,341.00
|
|
|
Service Code
|
CPT 81370
|
| Hospital Charge Code |
903902023
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$468.20 |
| Max. Negotiated Rate |
$2,106.90 |
| Rate for Payer: Adventist Health Commercial |
$468.20
|
| Rate for Payer: Cash Price |
$1,053.45
|
| Rate for Payer: Central Health Plan Commercial |
$1,872.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,638.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$936.40
|
| Rate for Payer: EPIC Health Plan Senior |
$936.40
|
| Rate for Payer: Galaxy Health WC |
$1,989.85
|
| Rate for Payer: Global Benefits Group Commercial |
$1,404.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,106.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,486.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,381.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$468.20
|
| Rate for Payer: Multiplan Commercial |
$1,755.75
|
| Rate for Payer: Networks By Design Commercial |
$1,521.65
|
| Rate for Payer: Prime Health Services Commercial |
$1,989.85
|
|
|
HC HLA A B C DR DQ DP MOLECULAR
|
Facility
|
IP
|
$678.67
|
|
|
Service Code
|
CPT 81376
|
| Hospital Charge Code |
903913200
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$135.73 |
| Max. Negotiated Rate |
$610.80 |
| Rate for Payer: Adventist Health Commercial |
$135.73
|
| Rate for Payer: Cash Price |
$305.40
|
| Rate for Payer: Central Health Plan Commercial |
$542.94
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$475.07
|
| Rate for Payer: EPIC Health Plan Commercial |
$271.47
|
| Rate for Payer: EPIC Health Plan Senior |
$271.47
|
| Rate for Payer: Galaxy Health WC |
$576.87
|
| Rate for Payer: Global Benefits Group Commercial |
$407.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$610.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$430.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$400.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$135.73
|
| Rate for Payer: Multiplan Commercial |
$509.00
|
| Rate for Payer: Networks By Design Commercial |
$441.14
|
| Rate for Payer: Prime Health Services Commercial |
$576.87
|
|
|
HC HLA A B C DR DQ DP MOLECULAR
|
Facility
|
IP
|
$2,036.00
|
|
|
Service Code
|
CPT 81376
|
| Hospital Charge Code |
900913200
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$407.20 |
| Max. Negotiated Rate |
$1,832.40 |
| Rate for Payer: Adventist Health Commercial |
$407.20
|
| Rate for Payer: Cash Price |
$916.20
|
| Rate for Payer: Central Health Plan Commercial |
$1,628.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,425.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$814.40
|
| Rate for Payer: EPIC Health Plan Senior |
$814.40
|
| Rate for Payer: Galaxy Health WC |
$1,730.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,221.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,832.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,292.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,201.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$407.20
|
| Rate for Payer: Multiplan Commercial |
$1,527.00
|
| Rate for Payer: Networks By Design Commercial |
$1,323.40
|
| Rate for Payer: Prime Health Services Commercial |
$1,730.60
|
|
|
HC HLA A B C DR DQ DP MOLECULAR
|
Facility
|
OP
|
$2,036.00
|
|
|
Service Code
|
CPT 81376
|
| Hospital Charge Code |
900913200
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$99.00 |
| Max. Negotiated Rate |
$1,832.40 |
| Rate for Payer: Adventist Health Commercial |
$407.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$122.22
|
| Rate for Payer: Aetna of CA HMO/PPO |
$348.75
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$183.33
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$134.44
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$122.22
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$550.16
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$764.85
|
| Rate for Payer: Blue Shield of California Commercial |
$1,282.68
|
| Rate for Payer: Blue Shield of California EPN |
$808.29
|
| Rate for Payer: Cash Price |
$916.20
|
| Rate for Payer: Cash Price |
$916.20
|
| Rate for Payer: Central Health Plan Commercial |
$1,628.80
|
| Rate for Payer: Cigna of CA HMO |
$1,303.04
|
| Rate for Payer: Cigna of CA PPO |
$1,506.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$183.33
|
| Rate for Payer: Dignity Health Medi-Cal |
$134.44
|
| Rate for Payer: Dignity Health Medicare Advantage |
$122.22
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,425.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$201.66
|
| Rate for Payer: EPIC Health Plan Senior |
$134.44
|
| Rate for Payer: Galaxy Health WC |
$1,730.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,221.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,832.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$200.44
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$186.86
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$122.22
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,292.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$206.42
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$171.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$407.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$163.77
|
| Rate for Payer: Multiplan Commercial |
$1,527.00
|
| Rate for Payer: Networks By Design Commercial |
$1,323.40
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$122.22
|
| Rate for Payer: Prime Health Services Commercial |
$1,730.60
|
| Rate for Payer: Prime Health Services Medicare |
$129.55
|
| Rate for Payer: Riverside University Health System MISP |
$134.44
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,221.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,221.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$99.00
|
| Rate for Payer: United Healthcare All Other HMO |
$99.00
|
| Rate for Payer: United Healthcare HMO Rider |
$99.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$99.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$122.22
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$183.33
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$134.44
|
| Rate for Payer: Vantage Medical Group Senior |
$122.22
|
|
|
HC HLA A B C DR DQ DP MOLECULAR
|
Facility
|
OP
|
$678.67
|
|
|
Service Code
|
CPT 81376
|
| Hospital Charge Code |
903913200
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$99.00 |
| Max. Negotiated Rate |
$764.85 |
| Rate for Payer: Adventist Health Commercial |
$135.73
|
| Rate for Payer: Adventist Health Medi-Cal |
$122.22
|
| Rate for Payer: Aetna of CA HMO/PPO |
$348.75
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$183.33
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$134.44
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$122.22
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$550.16
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$764.85
|
| Rate for Payer: Blue Shield of California Commercial |
$427.56
|
| Rate for Payer: Blue Shield of California EPN |
$269.43
|
| Rate for Payer: Cash Price |
$305.40
|
| Rate for Payer: Cash Price |
$305.40
|
| Rate for Payer: Central Health Plan Commercial |
$542.94
|
| Rate for Payer: Cigna of CA HMO |
$434.35
|
| Rate for Payer: Cigna of CA PPO |
$502.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$183.33
|
| Rate for Payer: Dignity Health Medi-Cal |
$134.44
|
| Rate for Payer: Dignity Health Medicare Advantage |
$122.22
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$475.07
|
| Rate for Payer: EPIC Health Plan Commercial |
$201.66
|
| Rate for Payer: EPIC Health Plan Senior |
$134.44
|
| Rate for Payer: Galaxy Health WC |
$576.87
|
| Rate for Payer: Global Benefits Group Commercial |
$407.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$610.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$200.44
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$186.86
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$122.22
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$430.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$206.42
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$171.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$135.73
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$163.77
|
| Rate for Payer: Multiplan Commercial |
$509.00
|
| Rate for Payer: Networks By Design Commercial |
$441.14
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$122.22
|
| Rate for Payer: Prime Health Services Commercial |
$576.87
|
| Rate for Payer: Prime Health Services Medicare |
$129.55
|
| Rate for Payer: Riverside University Health System MISP |
$134.44
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$407.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$407.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$99.00
|
| Rate for Payer: United Healthcare All Other HMO |
$99.00
|
| Rate for Payer: United Healthcare HMO Rider |
$99.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$99.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$122.22
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$183.33
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$134.44
|
| Rate for Payer: Vantage Medical Group Senior |
$122.22
|
|
|
HC HLA-A B C HI-RES MOLECULAR
|
Facility
|
IP
|
$4,007.00
|
|
|
Service Code
|
CPT 81379
|
| Hospital Charge Code |
903902022
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$801.40 |
| Max. Negotiated Rate |
$3,606.30 |
| Rate for Payer: Adventist Health Commercial |
$801.40
|
| Rate for Payer: Cash Price |
$1,803.15
|
| Rate for Payer: Central Health Plan Commercial |
$3,205.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,804.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,602.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,602.80
|
| Rate for Payer: Galaxy Health WC |
$3,405.95
|
| Rate for Payer: Global Benefits Group Commercial |
$2,404.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,606.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,544.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,364.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$801.40
|
| Rate for Payer: Multiplan Commercial |
$3,005.25
|
| Rate for Payer: Networks By Design Commercial |
$2,604.55
|
| Rate for Payer: Prime Health Services Commercial |
$3,405.95
|
|
|
HC HLA-A B C HI-RES MOLECULAR
|
Facility
|
OP
|
$4,007.00
|
|
|
Service Code
|
CPT 81379
|
| Hospital Charge Code |
903902022
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$271.66 |
| Max. Negotiated Rate |
$3,788.26 |
| Rate for Payer: Adventist Health Commercial |
$801.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$335.38
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,431.70
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$503.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$368.92
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$335.38
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,724.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,788.26
|
| Rate for Payer: Blue Shield of California Commercial |
$2,524.41
|
| Rate for Payer: Blue Shield of California EPN |
$1,590.78
|
| Rate for Payer: Cash Price |
$1,803.15
|
| Rate for Payer: Cash Price |
$1,803.15
|
| Rate for Payer: Central Health Plan Commercial |
$3,205.60
|
| Rate for Payer: Cigna of CA HMO |
$2,564.48
|
| Rate for Payer: Cigna of CA PPO |
$2,965.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$503.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$368.92
|
| Rate for Payer: Dignity Health Medicare Advantage |
$335.38
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,804.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$553.38
|
| Rate for Payer: EPIC Health Plan Senior |
$368.92
|
| Rate for Payer: Galaxy Health WC |
$3,405.95
|
| Rate for Payer: Global Benefits Group Commercial |
$2,404.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,606.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$550.02
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$512.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$335.38
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,544.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$566.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$469.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$801.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$449.41
|
| Rate for Payer: Multiplan Commercial |
$3,005.25
|
| Rate for Payer: Networks By Design Commercial |
$2,604.55
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$335.38
|
| Rate for Payer: Prime Health Services Commercial |
$3,405.95
|
| Rate for Payer: Prime Health Services Medicare |
$355.50
|
| Rate for Payer: Riverside University Health System MISP |
$368.92
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,404.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,404.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$271.66
|
| Rate for Payer: United Healthcare All Other HMO |
$271.66
|
| Rate for Payer: United Healthcare HMO Rider |
$271.66
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$271.66
|
| Rate for Payer: Upland Medical Group Pediatric |
$335.38
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$503.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$368.92
|
| Rate for Payer: Vantage Medical Group Senior |
$335.38
|
|
|
HC HLA AB SCREEN I/II
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
CPT 86828
|
| Hospital Charge Code |
903901995
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$78.00 |
| Max. Negotiated Rate |
$351.00 |
| Rate for Payer: Adventist Health Commercial |
$78.00
|
| Rate for Payer: Cash Price |
$175.50
|
| Rate for Payer: Central Health Plan Commercial |
$312.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$273.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$156.00
|
| Rate for Payer: EPIC Health Plan Senior |
$156.00
|
| Rate for Payer: Galaxy Health WC |
$331.50
|
| Rate for Payer: Global Benefits Group Commercial |
$234.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$351.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$247.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$230.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$78.00
|
| Rate for Payer: Multiplan Commercial |
$292.50
|
| Rate for Payer: Networks By Design Commercial |
$253.50
|
| Rate for Payer: Prime Health Services Commercial |
$331.50
|
|
|
HC HLA AB SCREEN I/II
|
Facility
|
OP
|
$276.00
|
|
|
Service Code
|
CPT 86828
|
| Hospital Charge Code |
903901995
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$51.99 |
| Max. Negotiated Rate |
$316.82 |
| Rate for Payer: Adventist Health Commercial |
$55.20
|
| Rate for Payer: Adventist Health Commercial |
$78.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$64.19
|
| Rate for Payer: Adventist Health Medi-Cal |
$64.19
|
| Rate for Payer: Aetna of CA HMO/PPO |
$283.71
|
| Rate for Payer: Aetna of CA HMO/PPO |
$283.71
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$96.28
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$96.28
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$70.61
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$70.61
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$64.19
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$64.19
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$227.89
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$227.89
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$316.82
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$316.82
|
| Rate for Payer: Blue Shield of California Commercial |
$245.70
|
| Rate for Payer: Blue Shield of California Commercial |
$173.88
|
| Rate for Payer: Blue Shield of California EPN |
$154.83
|
| Rate for Payer: Blue Shield of California EPN |
$109.57
|
| Rate for Payer: Cash Price |
$175.50
|
| Rate for Payer: Cash Price |
$175.50
|
| Rate for Payer: Cash Price |
$124.20
|
| Rate for Payer: Cash Price |
$124.20
|
| Rate for Payer: Central Health Plan Commercial |
$220.80
|
| Rate for Payer: Central Health Plan Commercial |
$312.00
|
| Rate for Payer: Cigna of CA HMO |
$249.60
|
| Rate for Payer: Cigna of CA HMO |
$176.64
|
| Rate for Payer: Cigna of CA PPO |
$288.60
|
| Rate for Payer: Cigna of CA PPO |
$204.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$96.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$96.28
|
| Rate for Payer: Dignity Health Medi-Cal |
$70.61
|
| Rate for Payer: Dignity Health Medi-Cal |
$70.61
|
| Rate for Payer: Dignity Health Medicare Advantage |
$64.19
|
| Rate for Payer: Dignity Health Medicare Advantage |
$64.19
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$193.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$273.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$105.91
|
| Rate for Payer: EPIC Health Plan Commercial |
$105.91
|
| Rate for Payer: EPIC Health Plan Senior |
$70.61
|
| Rate for Payer: EPIC Health Plan Senior |
$70.61
|
| Rate for Payer: Galaxy Health WC |
$331.50
|
| Rate for Payer: Galaxy Health WC |
$234.60
|
| Rate for Payer: Global Benefits Group Commercial |
$234.00
|
| Rate for Payer: Global Benefits Group Commercial |
$165.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$351.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$248.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$105.27
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$105.27
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$74.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$74.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$64.19
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$64.19
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$175.26
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$247.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$81.87
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$81.87
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$89.87
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$89.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$55.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$78.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$86.01
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$86.01
|
| Rate for Payer: Multiplan Commercial |
$292.50
|
| Rate for Payer: Multiplan Commercial |
$207.00
|
| Rate for Payer: Networks By Design Commercial |
$179.40
|
| Rate for Payer: Networks By Design Commercial |
$253.50
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$64.19
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$64.19
|
| Rate for Payer: Prime Health Services Commercial |
$331.50
|
| Rate for Payer: Prime Health Services Commercial |
$234.60
|
| Rate for Payer: Prime Health Services Medicare |
$68.04
|
| Rate for Payer: Prime Health Services Medicare |
$68.04
|
| Rate for Payer: Riverside University Health System MISP |
$70.61
|
| Rate for Payer: Riverside University Health System MISP |
$70.61
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$165.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$234.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$234.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$165.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$51.99
|
| Rate for Payer: United Healthcare All Other Commercial |
$51.99
|
| Rate for Payer: United Healthcare All Other HMO |
$51.99
|
| Rate for Payer: United Healthcare All Other HMO |
$51.99
|
| Rate for Payer: United Healthcare HMO Rider |
$51.99
|
| Rate for Payer: United Healthcare HMO Rider |
$51.99
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$51.99
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$51.99
|
| Rate for Payer: Upland Medical Group Pediatric |
$64.19
|
| Rate for Payer: Upland Medical Group Pediatric |
$64.19
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$96.28
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$96.28
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$70.61
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$70.61
|
| Rate for Payer: Vantage Medical Group Senior |
$64.19
|
| Rate for Payer: Vantage Medical Group Senior |
$64.19
|
|
|
HC HLA A-C MOLECULAR
|
Facility
|
OP
|
$1,466.00
|
|
|
Service Code
|
CPT 81372
|
| Hospital Charge Code |
903901902
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$293.20 |
| Max. Negotiated Rate |
$3,610.00 |
| Rate for Payer: Adventist Health Commercial |
$293.20
|
| Rate for Payer: Adventist Health Commercial |
$148.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$403.59
|
| Rate for Payer: Adventist Health Medi-Cal |
$403.59
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,761.68
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,761.68
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$605.38
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$605.38
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$443.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$443.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$403.59
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$403.59
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,596.66
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,596.66
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,610.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,610.00
|
| Rate for Payer: Blue Shield of California Commercial |
$468.09
|
| Rate for Payer: Blue Shield of California Commercial |
$923.58
|
| Rate for Payer: Blue Shield of California EPN |
$294.97
|
| Rate for Payer: Blue Shield of California EPN |
$582.00
|
| Rate for Payer: Cash Price |
$334.35
|
| Rate for Payer: Cash Price |
$334.35
|
| Rate for Payer: Cash Price |
$659.70
|
| Rate for Payer: Cash Price |
$659.70
|
| Rate for Payer: Central Health Plan Commercial |
$1,172.80
|
| Rate for Payer: Central Health Plan Commercial |
$594.40
|
| Rate for Payer: Cigna of CA HMO |
$475.52
|
| Rate for Payer: Cigna of CA HMO |
$938.24
|
| Rate for Payer: Cigna of CA PPO |
$549.82
|
| Rate for Payer: Cigna of CA PPO |
$1,084.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$605.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$605.38
|
| Rate for Payer: Dignity Health Medi-Cal |
$443.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$443.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$403.59
|
| Rate for Payer: Dignity Health Medicare Advantage |
$403.59
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,026.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$520.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$665.92
|
| Rate for Payer: EPIC Health Plan Commercial |
$665.92
|
| Rate for Payer: EPIC Health Plan Senior |
$443.95
|
| Rate for Payer: EPIC Health Plan Senior |
$443.95
|
| Rate for Payer: Galaxy Health WC |
$631.55
|
| Rate for Payer: Galaxy Health WC |
$1,246.10
|
| Rate for Payer: Global Benefits Group Commercial |
$445.80
|
| Rate for Payer: Global Benefits Group Commercial |
$879.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$668.70
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,319.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$661.89
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$661.89
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$413.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$413.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$403.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$403.59
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$930.91
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$471.81
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$456.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$456.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$565.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$565.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$293.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$148.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$540.81
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$540.81
|
| Rate for Payer: Multiplan Commercial |
$557.25
|
| Rate for Payer: Multiplan Commercial |
$1,099.50
|
| Rate for Payer: Networks By Design Commercial |
$952.90
|
| Rate for Payer: Networks By Design Commercial |
$482.95
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$403.59
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$403.59
|
| Rate for Payer: Prime Health Services Commercial |
$631.55
|
| Rate for Payer: Prime Health Services Commercial |
$1,246.10
|
| Rate for Payer: Prime Health Services Medicare |
$427.81
|
| Rate for Payer: Prime Health Services Medicare |
$427.81
|
| Rate for Payer: Riverside University Health System MISP |
$443.95
|
| Rate for Payer: Riverside University Health System MISP |
$443.95
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$879.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$445.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$445.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$879.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$326.91
|
| Rate for Payer: United Healthcare All Other Commercial |
$326.91
|
| Rate for Payer: United Healthcare All Other HMO |
$326.91
|
| Rate for Payer: United Healthcare All Other HMO |
$326.91
|
| Rate for Payer: United Healthcare HMO Rider |
$326.91
|
| Rate for Payer: United Healthcare HMO Rider |
$326.91
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$326.91
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$326.91
|
| Rate for Payer: Upland Medical Group Pediatric |
$403.59
|
| Rate for Payer: Upland Medical Group Pediatric |
$403.59
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$605.38
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$605.38
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$443.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$443.95
|
| Rate for Payer: Vantage Medical Group Senior |
$403.59
|
| Rate for Payer: Vantage Medical Group Senior |
$403.59
|
|
|
HC HLA A-C MOLECULAR
|
Facility
|
IP
|
$1,466.00
|
|
|
Service Code
|
CPT 81372
|
| Hospital Charge Code |
903901902
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$293.20 |
| Max. Negotiated Rate |
$1,319.40 |
| Rate for Payer: Adventist Health Commercial |
$293.20
|
| Rate for Payer: Cash Price |
$659.70
|
| Rate for Payer: Central Health Plan Commercial |
$1,172.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,026.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$586.40
|
| Rate for Payer: EPIC Health Plan Senior |
$586.40
|
| Rate for Payer: Galaxy Health WC |
$1,246.10
|
| Rate for Payer: Global Benefits Group Commercial |
$879.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,319.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$930.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$864.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$293.20
|
| Rate for Payer: Multiplan Commercial |
$1,099.50
|
| Rate for Payer: Networks By Design Commercial |
$952.90
|
| Rate for Payer: Prime Health Services Commercial |
$1,246.10
|
|
|
HC HLA A-C SEROLOGY
|
Facility
|
IP
|
$627.00
|
|
|
Service Code
|
CPT 86813
|
| Hospital Charge Code |
903901988
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$125.40 |
| Max. Negotiated Rate |
$564.30 |
| Rate for Payer: Adventist Health Commercial |
$125.40
|
| Rate for Payer: Cash Price |
$282.15
|
| Rate for Payer: Central Health Plan Commercial |
$501.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$438.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$250.80
|
| Rate for Payer: EPIC Health Plan Senior |
$250.80
|
| Rate for Payer: Galaxy Health WC |
$532.95
|
| Rate for Payer: Global Benefits Group Commercial |
$376.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$564.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$398.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$369.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$125.40
|
| Rate for Payer: Multiplan Commercial |
$470.25
|
| Rate for Payer: Networks By Design Commercial |
$407.55
|
| Rate for Payer: Prime Health Services Commercial |
$532.95
|
|
|
HC HLA A-C SEROLOGY
|
Facility
|
OP
|
$293.00
|
|
|
Service Code
|
CPT 86813
|
| Hospital Charge Code |
903901988
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$46.98 |
| Max. Negotiated Rate |
$586.46 |
| Rate for Payer: Adventist Health Commercial |
$58.60
|
| Rate for Payer: Adventist Health Commercial |
$125.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$58.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$58.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$300.47
|
| Rate for Payer: Aetna of CA HMO/PPO |
$300.47
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$87.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$87.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$63.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$63.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$58.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$58.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$421.84
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$421.84
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$586.46
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$586.46
|
| Rate for Payer: Blue Shield of California Commercial |
$395.01
|
| Rate for Payer: Blue Shield of California Commercial |
$184.59
|
| Rate for Payer: Blue Shield of California EPN |
$248.92
|
| Rate for Payer: Blue Shield of California EPN |
$116.32
|
| Rate for Payer: Cash Price |
$282.15
|
| Rate for Payer: Cash Price |
$282.15
|
| Rate for Payer: Cash Price |
$131.85
|
| Rate for Payer: Cash Price |
$131.85
|
| Rate for Payer: Central Health Plan Commercial |
$234.40
|
| Rate for Payer: Central Health Plan Commercial |
$501.60
|
| Rate for Payer: Cigna of CA HMO |
$401.28
|
| Rate for Payer: Cigna of CA HMO |
$187.52
|
| Rate for Payer: Cigna of CA PPO |
$463.98
|
| Rate for Payer: Cigna of CA PPO |
$216.82
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$87.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$87.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$63.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$63.80
|
| Rate for Payer: Dignity Health Medicare Advantage |
$58.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$58.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$205.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$438.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$95.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$95.70
|
| Rate for Payer: EPIC Health Plan Senior |
$63.80
|
| Rate for Payer: EPIC Health Plan Senior |
$63.80
|
| Rate for Payer: Galaxy Health WC |
$532.95
|
| Rate for Payer: Galaxy Health WC |
$249.05
|
| Rate for Payer: Global Benefits Group Commercial |
$376.20
|
| Rate for Payer: Global Benefits Group Commercial |
$175.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$564.30
|
| Rate for Payer: Health Management Network EPO/PPO |
$263.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$95.12
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$95.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$88.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$88.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$58.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$58.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$186.06
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$398.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$97.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$97.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$81.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$81.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$58.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$125.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$77.72
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$77.72
|
| Rate for Payer: Multiplan Commercial |
$470.25
|
| Rate for Payer: Multiplan Commercial |
$219.75
|
| Rate for Payer: Networks By Design Commercial |
$190.45
|
| Rate for Payer: Networks By Design Commercial |
$407.55
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$58.00
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$58.00
|
| Rate for Payer: Prime Health Services Commercial |
$532.95
|
| Rate for Payer: Prime Health Services Commercial |
$249.05
|
| Rate for Payer: Prime Health Services Medicare |
$61.48
|
| Rate for Payer: Prime Health Services Medicare |
$61.48
|
| Rate for Payer: Riverside University Health System MISP |
$63.80
|
| Rate for Payer: Riverside University Health System MISP |
$63.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$175.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$376.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$376.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$175.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$46.98
|
| Rate for Payer: United Healthcare All Other Commercial |
$46.98
|
| Rate for Payer: United Healthcare All Other HMO |
$46.98
|
| Rate for Payer: United Healthcare All Other HMO |
$46.98
|
| Rate for Payer: United Healthcare HMO Rider |
$46.98
|
| Rate for Payer: United Healthcare HMO Rider |
$46.98
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$46.98
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$46.98
|
| Rate for Payer: Upland Medical Group Pediatric |
$58.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$58.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$87.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$87.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$63.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$63.80
|
| Rate for Payer: Vantage Medical Group Senior |
$58.00
|
| Rate for Payer: Vantage Medical Group Senior |
$58.00
|
|
|
HC HLA A MOLECULAR HI RESOLUTION
|
Facility
|
IP
|
$984.00
|
|
|
Service Code
|
CPT 81380
|
| Hospital Charge Code |
903901985
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$196.80 |
| Max. Negotiated Rate |
$885.60 |
| Rate for Payer: Adventist Health Commercial |
$196.80
|
| Rate for Payer: Cash Price |
$442.80
|
| Rate for Payer: Central Health Plan Commercial |
$787.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$688.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$393.60
|
| Rate for Payer: EPIC Health Plan Senior |
$393.60
|
| Rate for Payer: Galaxy Health WC |
$836.40
|
| Rate for Payer: Global Benefits Group Commercial |
$590.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$885.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$624.84
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$580.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$196.80
|
| Rate for Payer: Multiplan Commercial |
$738.00
|
| Rate for Payer: Networks By Design Commercial |
$639.60
|
| Rate for Payer: Prime Health Services Commercial |
$836.40
|
|
|
HC HLA A MOLECULAR HI RESOLUTION
|
Facility
|
OP
|
$217.00
|
|
|
Service Code
|
CPT 81380
|
| Hospital Charge Code |
903901985
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$43.40 |
| Max. Negotiated Rate |
$1,084.95 |
| Rate for Payer: Adventist Health Commercial |
$43.40
|
| Rate for Payer: Adventist Health Commercial |
$196.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$177.25
|
| Rate for Payer: Adventist Health Medi-Cal |
$177.25
|
| Rate for Payer: Aetna of CA HMO/PPO |
$524.54
|
| Rate for Payer: Aetna of CA HMO/PPO |
$524.54
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$265.88
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$265.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$194.97
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$194.97
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$177.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$177.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$780.40
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$780.40
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,084.95
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,084.95
|
| Rate for Payer: Blue Shield of California Commercial |
$619.92
|
| Rate for Payer: Blue Shield of California Commercial |
$136.71
|
| Rate for Payer: Blue Shield of California EPN |
$390.65
|
| Rate for Payer: Blue Shield of California EPN |
$86.15
|
| Rate for Payer: Cash Price |
$442.80
|
| Rate for Payer: Cash Price |
$442.80
|
| Rate for Payer: Cash Price |
$97.65
|
| Rate for Payer: Cash Price |
$97.65
|
| Rate for Payer: Central Health Plan Commercial |
$173.60
|
| Rate for Payer: Central Health Plan Commercial |
$787.20
|
| Rate for Payer: Cigna of CA HMO |
$629.76
|
| Rate for Payer: Cigna of CA HMO |
$138.88
|
| Rate for Payer: Cigna of CA PPO |
$728.16
|
| Rate for Payer: Cigna of CA PPO |
$160.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$265.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$265.88
|
| Rate for Payer: Dignity Health Medi-Cal |
$194.97
|
| Rate for Payer: Dignity Health Medi-Cal |
$194.97
|
| Rate for Payer: Dignity Health Medicare Advantage |
$177.25
|
| Rate for Payer: Dignity Health Medicare Advantage |
$177.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$151.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$688.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$292.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$292.46
|
| Rate for Payer: EPIC Health Plan Senior |
$194.97
|
| Rate for Payer: EPIC Health Plan Senior |
$194.97
|
| Rate for Payer: Galaxy Health WC |
$836.40
|
| Rate for Payer: Galaxy Health WC |
$184.45
|
| Rate for Payer: Global Benefits Group Commercial |
$590.40
|
| Rate for Payer: Global Benefits Group Commercial |
$130.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$885.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$195.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$290.69
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$290.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$270.99
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$270.99
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$177.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$177.25
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$137.79
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$624.84
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$299.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$299.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$248.15
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$248.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$43.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$196.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$237.51
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$237.51
|
| Rate for Payer: Multiplan Commercial |
$738.00
|
| Rate for Payer: Multiplan Commercial |
$162.75
|
| Rate for Payer: Networks By Design Commercial |
$141.05
|
| Rate for Payer: Networks By Design Commercial |
$639.60
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$177.25
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$177.25
|
| Rate for Payer: Prime Health Services Commercial |
$836.40
|
| Rate for Payer: Prime Health Services Commercial |
$184.45
|
| Rate for Payer: Prime Health Services Medicare |
$187.88
|
| Rate for Payer: Prime Health Services Medicare |
$187.88
|
| Rate for Payer: Riverside University Health System MISP |
$194.97
|
| Rate for Payer: Riverside University Health System MISP |
$194.97
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$130.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$590.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$590.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$130.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$143.58
|
| Rate for Payer: United Healthcare All Other Commercial |
$143.58
|
| Rate for Payer: United Healthcare All Other HMO |
$143.58
|
| Rate for Payer: United Healthcare All Other HMO |
$143.58
|
| Rate for Payer: United Healthcare HMO Rider |
$143.58
|
| Rate for Payer: United Healthcare HMO Rider |
$143.58
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$143.58
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$143.58
|
| Rate for Payer: Upland Medical Group Pediatric |
$177.25
|
| Rate for Payer: Upland Medical Group Pediatric |
$177.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$265.88
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$265.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$194.97
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$194.97
|
| Rate for Payer: Vantage Medical Group Senior |
$177.25
|
| Rate for Payer: Vantage Medical Group Senior |
$177.25
|
|
