|
HC HLA - B27
|
Facility
|
IP
|
$982.00
|
|
|
Service Code
|
CPT 81373
|
| Hospital Charge Code |
903901903
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$196.40 |
| Max. Negotiated Rate |
$883.80 |
| Rate for Payer: Adventist Health Commercial |
$196.40
|
| Rate for Payer: Cash Price |
$441.90
|
| Rate for Payer: Central Health Plan Commercial |
$785.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$687.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$392.80
|
| Rate for Payer: EPIC Health Plan Senior |
$392.80
|
| Rate for Payer: Galaxy Health WC |
$834.70
|
| Rate for Payer: Global Benefits Group Commercial |
$589.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$883.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$623.57
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$579.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$196.40
|
| Rate for Payer: Multiplan Commercial |
$736.50
|
| Rate for Payer: Networks By Design Commercial |
$638.30
|
| Rate for Payer: Prime Health Services Commercial |
$834.70
|
|
|
HC HLA - B27
|
Facility
|
OP
|
$326.00
|
|
|
Service Code
|
CPT 81373
|
| Hospital Charge Code |
903901903
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$65.20 |
| Max. Negotiated Rate |
$1,221.94 |
| Rate for Payer: Adventist Health Commercial |
$65.20
|
| Rate for Payer: Adventist Health Commercial |
$196.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$127.43
|
| Rate for Payer: Adventist Health Medi-Cal |
$127.43
|
| Rate for Payer: Aetna of CA HMO/PPO |
$597.06
|
| Rate for Payer: Aetna of CA HMO/PPO |
$597.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$191.15
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$191.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$140.17
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$140.17
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$127.43
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$127.43
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$878.94
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$878.94
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,221.94
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,221.94
|
| Rate for Payer: Blue Shield of California Commercial |
$618.66
|
| Rate for Payer: Blue Shield of California Commercial |
$205.38
|
| Rate for Payer: Blue Shield of California EPN |
$389.85
|
| Rate for Payer: Blue Shield of California EPN |
$129.42
|
| Rate for Payer: Cash Price |
$441.90
|
| Rate for Payer: Cash Price |
$441.90
|
| Rate for Payer: Cash Price |
$146.70
|
| Rate for Payer: Cash Price |
$146.70
|
| Rate for Payer: Central Health Plan Commercial |
$260.80
|
| Rate for Payer: Central Health Plan Commercial |
$785.60
|
| Rate for Payer: Cigna of CA HMO |
$628.48
|
| Rate for Payer: Cigna of CA HMO |
$208.64
|
| Rate for Payer: Cigna of CA PPO |
$726.68
|
| Rate for Payer: Cigna of CA PPO |
$241.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$191.15
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$191.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$140.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$140.17
|
| Rate for Payer: Dignity Health Medicare Advantage |
$127.43
|
| Rate for Payer: Dignity Health Medicare Advantage |
$127.43
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$228.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$687.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$210.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$210.26
|
| Rate for Payer: EPIC Health Plan Senior |
$140.17
|
| Rate for Payer: EPIC Health Plan Senior |
$140.17
|
| Rate for Payer: Galaxy Health WC |
$834.70
|
| Rate for Payer: Galaxy Health WC |
$277.10
|
| Rate for Payer: Global Benefits Group Commercial |
$589.20
|
| Rate for Payer: Global Benefits Group Commercial |
$195.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$883.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$293.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$208.99
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$208.99
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$175.34
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$175.34
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$127.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$127.43
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$207.01
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$623.57
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$193.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$193.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$178.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$178.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$65.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$196.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$170.76
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$170.76
|
| Rate for Payer: Multiplan Commercial |
$736.50
|
| Rate for Payer: Multiplan Commercial |
$244.50
|
| Rate for Payer: Networks By Design Commercial |
$211.90
|
| Rate for Payer: Networks By Design Commercial |
$638.30
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$127.43
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$127.43
|
| Rate for Payer: Prime Health Services Commercial |
$834.70
|
| Rate for Payer: Prime Health Services Commercial |
$277.10
|
| Rate for Payer: Prime Health Services Medicare |
$135.08
|
| Rate for Payer: Prime Health Services Medicare |
$135.08
|
| Rate for Payer: Riverside University Health System MISP |
$140.17
|
| Rate for Payer: Riverside University Health System MISP |
$140.17
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$195.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$589.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$589.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$195.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$103.22
|
| Rate for Payer: United Healthcare All Other Commercial |
$103.22
|
| Rate for Payer: United Healthcare All Other HMO |
$103.22
|
| Rate for Payer: United Healthcare All Other HMO |
$103.22
|
| Rate for Payer: United Healthcare HMO Rider |
$103.22
|
| Rate for Payer: United Healthcare HMO Rider |
$103.22
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$103.22
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$103.22
|
| Rate for Payer: Upland Medical Group Pediatric |
$127.43
|
| Rate for Payer: Upland Medical Group Pediatric |
$127.43
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$191.15
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$191.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$140.17
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$140.17
|
| Rate for Payer: Vantage Medical Group Senior |
$127.43
|
| Rate for Payer: Vantage Medical Group Senior |
$127.43
|
|
|
HC HLA B MOLECULAR HI RESOLUTION
|
Facility
|
OP
|
$217.00
|
|
|
Service Code
|
CPT 81380
|
| Hospital Charge Code |
903901989
|
|
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
|
|
|
HC HLA B MOLECULAR HI RESOLUTION
|
Facility
|
IP
|
$984.00
|
|
|
Service Code
|
CPT 81380
|
| Hospital Charge Code |
903901989
|
|
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 C1Q I
|
Facility
|
OP
|
$810.00
|
|
|
Service Code
|
CPT 86832
|
| Hospital Charge Code |
900913205
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$17.66 |
| Max. Negotiated Rate |
$817.49 |
| Rate for Payer: Adventist Health Commercial |
$162.00
|
| Rate for Payer: Adventist Health Commercial |
$185.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$323.75
|
| Rate for Payer: Adventist Health Medi-Cal |
$323.75
|
| Rate for Payer: Aetna of CA HMO/PPO |
$732.05
|
| Rate for Payer: Aetna of CA HMO/PPO |
$732.05
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$485.62
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$485.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$356.12
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$356.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$323.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$323.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$588.02
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$588.02
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$817.49
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$817.49
|
| Rate for Payer: Blue Shield of California Commercial |
$582.75
|
| Rate for Payer: Blue Shield of California Commercial |
$510.30
|
| Rate for Payer: Blue Shield of California EPN |
$367.23
|
| Rate for Payer: Blue Shield of California EPN |
$321.57
|
| Rate for Payer: Cash Price |
$416.25
|
| Rate for Payer: Cash Price |
$416.25
|
| Rate for Payer: Cash Price |
$364.50
|
| Rate for Payer: Cash Price |
$364.50
|
| Rate for Payer: Central Health Plan Commercial |
$648.00
|
| Rate for Payer: Central Health Plan Commercial |
$740.00
|
| Rate for Payer: Cigna of CA HMO |
$592.00
|
| Rate for Payer: Cigna of CA HMO |
$518.40
|
| Rate for Payer: Cigna of CA PPO |
$684.50
|
| Rate for Payer: Cigna of CA PPO |
$599.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$485.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$485.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$356.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$356.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$323.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$323.75
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$567.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$647.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$534.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$534.19
|
| Rate for Payer: EPIC Health Plan Senior |
$356.12
|
| Rate for Payer: EPIC Health Plan Senior |
$356.12
|
| Rate for Payer: Galaxy Health WC |
$786.25
|
| Rate for Payer: Galaxy Health WC |
$688.50
|
| Rate for Payer: Global Benefits Group Commercial |
$555.00
|
| Rate for Payer: Global Benefits Group Commercial |
$486.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$832.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$729.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$530.95
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$530.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$17.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$17.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$323.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$323.75
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$514.35
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$587.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$19.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$19.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$453.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$453.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$162.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$185.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$433.82
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$433.82
|
| Rate for Payer: Multiplan Commercial |
$693.75
|
| Rate for Payer: Multiplan Commercial |
$607.50
|
| Rate for Payer: Networks By Design Commercial |
$526.50
|
| Rate for Payer: Networks By Design Commercial |
$601.25
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$323.75
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$323.75
|
| Rate for Payer: Prime Health Services Commercial |
$786.25
|
| Rate for Payer: Prime Health Services Commercial |
$688.50
|
| Rate for Payer: Prime Health Services Medicare |
$343.18
|
| Rate for Payer: Prime Health Services Medicare |
$343.18
|
| Rate for Payer: Riverside University Health System MISP |
$356.12
|
| Rate for Payer: Riverside University Health System MISP |
$356.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$486.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$555.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$555.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$486.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$262.24
|
| Rate for Payer: United Healthcare All Other Commercial |
$262.24
|
| Rate for Payer: United Healthcare All Other HMO |
$262.24
|
| Rate for Payer: United Healthcare All Other HMO |
$262.24
|
| Rate for Payer: United Healthcare HMO Rider |
$262.24
|
| Rate for Payer: United Healthcare HMO Rider |
$262.24
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$262.24
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$262.24
|
| Rate for Payer: Upland Medical Group Pediatric |
$323.75
|
| Rate for Payer: Upland Medical Group Pediatric |
$323.75
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$485.62
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$485.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$356.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$356.12
|
| Rate for Payer: Vantage Medical Group Senior |
$323.75
|
| Rate for Payer: Vantage Medical Group Senior |
$323.75
|
|
|
HC HLA C1Q I
|
Facility
|
IP
|
$925.00
|
|
|
Service Code
|
CPT 86832
|
| Hospital Charge Code |
903913205
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$185.00 |
| Max. Negotiated Rate |
$832.50 |
| Rate for Payer: Adventist Health Commercial |
$185.00
|
| Rate for Payer: Cash Price |
$416.25
|
| Rate for Payer: Central Health Plan Commercial |
$740.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$647.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$370.00
|
| Rate for Payer: EPIC Health Plan Senior |
$370.00
|
| Rate for Payer: Galaxy Health WC |
$786.25
|
| Rate for Payer: Global Benefits Group Commercial |
$555.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$832.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$587.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$545.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$185.00
|
| Rate for Payer: Multiplan Commercial |
$693.75
|
| Rate for Payer: Networks By Design Commercial |
$601.25
|
| Rate for Payer: Prime Health Services Commercial |
$786.25
|
|
|
HC HLA C1Q I
|
Facility
|
IP
|
$925.00
|
|
|
Service Code
|
CPT 86832
|
| Hospital Charge Code |
900913205
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$185.00 |
| Max. Negotiated Rate |
$832.50 |
| Rate for Payer: Adventist Health Commercial |
$185.00
|
| Rate for Payer: Cash Price |
$416.25
|
| Rate for Payer: Central Health Plan Commercial |
$740.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$647.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$370.00
|
| Rate for Payer: EPIC Health Plan Senior |
$370.00
|
| Rate for Payer: Galaxy Health WC |
$786.25
|
| Rate for Payer: Global Benefits Group Commercial |
$555.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$832.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$587.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$545.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$185.00
|
| Rate for Payer: Multiplan Commercial |
$693.75
|
| Rate for Payer: Networks By Design Commercial |
$601.25
|
| Rate for Payer: Prime Health Services Commercial |
$786.25
|
|
|
HC HLA C1Q I
|
Facility
|
OP
|
$810.00
|
|
|
Service Code
|
CPT 86832
|
| Hospital Charge Code |
903913205
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$17.66 |
| Max. Negotiated Rate |
$817.49 |
| Rate for Payer: Adventist Health Commercial |
$162.00
|
| Rate for Payer: Adventist Health Commercial |
$185.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$323.75
|
| Rate for Payer: Adventist Health Medi-Cal |
$323.75
|
| Rate for Payer: Aetna of CA HMO/PPO |
$732.05
|
| Rate for Payer: Aetna of CA HMO/PPO |
$732.05
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$485.62
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$485.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$356.12
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$356.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$323.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$323.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$588.02
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$588.02
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$817.49
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$817.49
|
| Rate for Payer: Blue Shield of California Commercial |
$582.75
|
| Rate for Payer: Blue Shield of California Commercial |
$510.30
|
| Rate for Payer: Blue Shield of California EPN |
$367.23
|
| Rate for Payer: Blue Shield of California EPN |
$321.57
|
| Rate for Payer: Cash Price |
$416.25
|
| Rate for Payer: Cash Price |
$416.25
|
| Rate for Payer: Cash Price |
$364.50
|
| Rate for Payer: Cash Price |
$364.50
|
| Rate for Payer: Central Health Plan Commercial |
$648.00
|
| Rate for Payer: Central Health Plan Commercial |
$740.00
|
| Rate for Payer: Cigna of CA HMO |
$592.00
|
| Rate for Payer: Cigna of CA HMO |
$518.40
|
| Rate for Payer: Cigna of CA PPO |
$684.50
|
| Rate for Payer: Cigna of CA PPO |
$599.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$485.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$485.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$356.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$356.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$323.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$323.75
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$567.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$647.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$534.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$534.19
|
| Rate for Payer: EPIC Health Plan Senior |
$356.12
|
| Rate for Payer: EPIC Health Plan Senior |
$356.12
|
| Rate for Payer: Galaxy Health WC |
$786.25
|
| Rate for Payer: Galaxy Health WC |
$688.50
|
| Rate for Payer: Global Benefits Group Commercial |
$555.00
|
| Rate for Payer: Global Benefits Group Commercial |
$486.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$832.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$729.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$530.95
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$530.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$17.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$17.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$323.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$323.75
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$514.35
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$587.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$19.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$19.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$453.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$453.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$162.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$185.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$433.82
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$433.82
|
| Rate for Payer: Multiplan Commercial |
$693.75
|
| Rate for Payer: Multiplan Commercial |
$607.50
|
| Rate for Payer: Networks By Design Commercial |
$526.50
|
| Rate for Payer: Networks By Design Commercial |
$601.25
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$323.75
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$323.75
|
| Rate for Payer: Prime Health Services Commercial |
$786.25
|
| Rate for Payer: Prime Health Services Commercial |
$688.50
|
| Rate for Payer: Prime Health Services Medicare |
$343.18
|
| Rate for Payer: Prime Health Services Medicare |
$343.18
|
| Rate for Payer: Riverside University Health System MISP |
$356.12
|
| Rate for Payer: Riverside University Health System MISP |
$356.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$486.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$555.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$555.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$486.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$262.24
|
| Rate for Payer: United Healthcare All Other Commercial |
$262.24
|
| Rate for Payer: United Healthcare All Other HMO |
$262.24
|
| Rate for Payer: United Healthcare All Other HMO |
$262.24
|
| Rate for Payer: United Healthcare HMO Rider |
$262.24
|
| Rate for Payer: United Healthcare HMO Rider |
$262.24
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$262.24
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$262.24
|
| Rate for Payer: Upland Medical Group Pediatric |
$323.75
|
| Rate for Payer: Upland Medical Group Pediatric |
$323.75
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$485.62
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$485.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$356.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$356.12
|
| Rate for Payer: Vantage Medical Group Senior |
$323.75
|
| Rate for Payer: Vantage Medical Group Senior |
$323.75
|
|
|
HC HLA C1Q II
|
Facility
|
IP
|
$925.00
|
|
|
Service Code
|
CPT 86833
|
| Hospital Charge Code |
900913206
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$185.00 |
| Max. Negotiated Rate |
$832.50 |
| Rate for Payer: Adventist Health Commercial |
$185.00
|
| Rate for Payer: Cash Price |
$416.25
|
| Rate for Payer: Central Health Plan Commercial |
$740.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$647.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$370.00
|
| Rate for Payer: EPIC Health Plan Senior |
$370.00
|
| Rate for Payer: Galaxy Health WC |
$786.25
|
| Rate for Payer: Global Benefits Group Commercial |
$555.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$832.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$587.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$545.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$185.00
|
| Rate for Payer: Multiplan Commercial |
$693.75
|
| Rate for Payer: Networks By Design Commercial |
$601.25
|
| Rate for Payer: Prime Health Services Commercial |
$786.25
|
|
|
HC HLA C1Q II
|
Facility
|
OP
|
$786.00
|
|
|
Service Code
|
CPT 86833
|
| Hospital Charge Code |
900913206
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$17.66 |
| Max. Negotiated Rate |
$743.13 |
| Rate for Payer: Adventist Health Commercial |
$157.20
|
| Rate for Payer: Adventist Health Commercial |
$185.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$325.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$325.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$665.48
|
| Rate for Payer: Aetna of CA HMO/PPO |
$665.48
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$488.70
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$488.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$358.38
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$358.38
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$325.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$325.80
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$534.53
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$534.53
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$743.13
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$743.13
|
| Rate for Payer: Blue Shield of California Commercial |
$582.75
|
| Rate for Payer: Blue Shield of California Commercial |
$495.18
|
| Rate for Payer: Blue Shield of California EPN |
$367.23
|
| Rate for Payer: Blue Shield of California EPN |
$312.04
|
| Rate for Payer: Cash Price |
$416.25
|
| Rate for Payer: Cash Price |
$416.25
|
| Rate for Payer: Cash Price |
$353.70
|
| Rate for Payer: Cash Price |
$353.70
|
| Rate for Payer: Central Health Plan Commercial |
$628.80
|
| Rate for Payer: Central Health Plan Commercial |
$740.00
|
| Rate for Payer: Cigna of CA HMO |
$592.00
|
| Rate for Payer: Cigna of CA HMO |
$503.04
|
| Rate for Payer: Cigna of CA PPO |
$684.50
|
| Rate for Payer: Cigna of CA PPO |
$581.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$488.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$488.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$358.38
|
| Rate for Payer: Dignity Health Medi-Cal |
$358.38
|
| Rate for Payer: Dignity Health Medicare Advantage |
$325.80
|
| Rate for Payer: Dignity Health Medicare Advantage |
$325.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$550.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$647.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$537.57
|
| Rate for Payer: EPIC Health Plan Commercial |
$537.57
|
| Rate for Payer: EPIC Health Plan Senior |
$358.38
|
| Rate for Payer: EPIC Health Plan Senior |
$358.38
|
| Rate for Payer: Galaxy Health WC |
$786.25
|
| Rate for Payer: Galaxy Health WC |
$668.10
|
| Rate for Payer: Global Benefits Group Commercial |
$555.00
|
| Rate for Payer: Global Benefits Group Commercial |
$471.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$832.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$707.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$534.31
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$534.31
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$17.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$17.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$325.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$325.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$499.11
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$587.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$19.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$19.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$456.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$456.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$157.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$185.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$436.57
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$436.57
|
| Rate for Payer: Multiplan Commercial |
$693.75
|
| Rate for Payer: Multiplan Commercial |
$589.50
|
| Rate for Payer: Networks By Design Commercial |
$510.90
|
| Rate for Payer: Networks By Design Commercial |
$601.25
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$325.80
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$325.80
|
| Rate for Payer: Prime Health Services Commercial |
$786.25
|
| Rate for Payer: Prime Health Services Commercial |
$668.10
|
| Rate for Payer: Prime Health Services Medicare |
$345.35
|
| Rate for Payer: Prime Health Services Medicare |
$345.35
|
| Rate for Payer: Riverside University Health System MISP |
$358.38
|
| Rate for Payer: Riverside University Health System MISP |
$358.38
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$471.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$555.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$555.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$471.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$263.90
|
| Rate for Payer: United Healthcare All Other Commercial |
$263.90
|
| Rate for Payer: United Healthcare All Other HMO |
$263.90
|
| Rate for Payer: United Healthcare All Other HMO |
$263.90
|
| Rate for Payer: United Healthcare HMO Rider |
$263.90
|
| Rate for Payer: United Healthcare HMO Rider |
$263.90
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$263.90
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$263.90
|
| Rate for Payer: Upland Medical Group Pediatric |
$325.80
|
| Rate for Payer: Upland Medical Group Pediatric |
$325.80
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$488.70
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$488.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$358.38
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$358.38
|
| Rate for Payer: Vantage Medical Group Senior |
$325.80
|
| Rate for Payer: Vantage Medical Group Senior |
$325.80
|
|
|
HC HLA C1Q II
|
Facility
|
OP
|
$786.00
|
|
|
Service Code
|
CPT 86833
|
| Hospital Charge Code |
903913206
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$17.66 |
| Max. Negotiated Rate |
$743.13 |
| Rate for Payer: Adventist Health Commercial |
$157.20
|
| Rate for Payer: Adventist Health Commercial |
$185.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$325.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$325.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$665.48
|
| Rate for Payer: Aetna of CA HMO/PPO |
$665.48
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$488.70
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$488.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$358.38
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$358.38
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$325.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$325.80
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$534.53
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$534.53
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$743.13
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$743.13
|
| Rate for Payer: Blue Shield of California Commercial |
$582.75
|
| Rate for Payer: Blue Shield of California Commercial |
$495.18
|
| Rate for Payer: Blue Shield of California EPN |
$367.23
|
| Rate for Payer: Blue Shield of California EPN |
$312.04
|
| Rate for Payer: Cash Price |
$416.25
|
| Rate for Payer: Cash Price |
$416.25
|
| Rate for Payer: Cash Price |
$353.70
|
| Rate for Payer: Cash Price |
$353.70
|
| Rate for Payer: Central Health Plan Commercial |
$628.80
|
| Rate for Payer: Central Health Plan Commercial |
$740.00
|
| Rate for Payer: Cigna of CA HMO |
$592.00
|
| Rate for Payer: Cigna of CA HMO |
$503.04
|
| Rate for Payer: Cigna of CA PPO |
$684.50
|
| Rate for Payer: Cigna of CA PPO |
$581.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$488.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$488.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$358.38
|
| Rate for Payer: Dignity Health Medi-Cal |
$358.38
|
| Rate for Payer: Dignity Health Medicare Advantage |
$325.80
|
| Rate for Payer: Dignity Health Medicare Advantage |
$325.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$550.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$647.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$537.57
|
| Rate for Payer: EPIC Health Plan Commercial |
$537.57
|
| Rate for Payer: EPIC Health Plan Senior |
$358.38
|
| Rate for Payer: EPIC Health Plan Senior |
$358.38
|
| Rate for Payer: Galaxy Health WC |
$786.25
|
| Rate for Payer: Galaxy Health WC |
$668.10
|
| Rate for Payer: Global Benefits Group Commercial |
$555.00
|
| Rate for Payer: Global Benefits Group Commercial |
$471.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$832.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$707.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$534.31
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$534.31
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$17.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$17.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$325.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$325.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$499.11
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$587.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$19.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$19.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$456.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$456.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$157.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$185.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$436.57
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$436.57
|
| Rate for Payer: Multiplan Commercial |
$693.75
|
| Rate for Payer: Multiplan Commercial |
$589.50
|
| Rate for Payer: Networks By Design Commercial |
$510.90
|
| Rate for Payer: Networks By Design Commercial |
$601.25
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$325.80
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$325.80
|
| Rate for Payer: Prime Health Services Commercial |
$786.25
|
| Rate for Payer: Prime Health Services Commercial |
$668.10
|
| Rate for Payer: Prime Health Services Medicare |
$345.35
|
| Rate for Payer: Prime Health Services Medicare |
$345.35
|
| Rate for Payer: Riverside University Health System MISP |
$358.38
|
| Rate for Payer: Riverside University Health System MISP |
$358.38
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$471.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$555.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$555.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$471.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$263.90
|
| Rate for Payer: United Healthcare All Other Commercial |
$263.90
|
| Rate for Payer: United Healthcare All Other HMO |
$263.90
|
| Rate for Payer: United Healthcare All Other HMO |
$263.90
|
| Rate for Payer: United Healthcare HMO Rider |
$263.90
|
| Rate for Payer: United Healthcare HMO Rider |
$263.90
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$263.90
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$263.90
|
| Rate for Payer: Upland Medical Group Pediatric |
$325.80
|
| Rate for Payer: Upland Medical Group Pediatric |
$325.80
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$488.70
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$488.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$358.38
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$358.38
|
| Rate for Payer: Vantage Medical Group Senior |
$325.80
|
| Rate for Payer: Vantage Medical Group Senior |
$325.80
|
|
|
HC HLA C1Q II
|
Facility
|
IP
|
$925.00
|
|
|
Service Code
|
CPT 86833
|
| Hospital Charge Code |
903913206
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$185.00 |
| Max. Negotiated Rate |
$832.50 |
| Rate for Payer: Adventist Health Commercial |
$185.00
|
| Rate for Payer: Cash Price |
$416.25
|
| Rate for Payer: Central Health Plan Commercial |
$740.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$647.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$370.00
|
| Rate for Payer: EPIC Health Plan Senior |
$370.00
|
| Rate for Payer: Galaxy Health WC |
$786.25
|
| Rate for Payer: Global Benefits Group Commercial |
$555.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$832.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$587.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$545.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$185.00
|
| Rate for Payer: Multiplan Commercial |
$693.75
|
| Rate for Payer: Networks By Design Commercial |
$601.25
|
| Rate for Payer: Prime Health Services Commercial |
$786.25
|
|
|
HC HLA CELL STORAGE
|
Facility
|
OP
|
$108.00
|
|
|
Service Code
|
CPT 86849
|
| Hospital Charge Code |
903901971
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$21.60 |
| Max. Negotiated Rate |
$97.20 |
| Rate for Payer: Adventist Health Commercial |
$21.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$65.59
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$91.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$59.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$81.00
|
| Rate for Payer: Blue Shield of California Commercial |
$68.04
|
| Rate for Payer: Blue Shield of California EPN |
$42.88
|
| Rate for Payer: Cash Price |
$48.60
|
| Rate for Payer: Central Health Plan Commercial |
$86.40
|
| Rate for Payer: Cigna of CA HMO |
$69.12
|
| Rate for Payer: Cigna of CA PPO |
$79.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$91.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$91.80
|
| Rate for Payer: Dignity Health Medicare Advantage |
$91.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$75.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$43.20
|
| Rate for Payer: EPIC Health Plan Senior |
$43.20
|
| Rate for Payer: Galaxy Health WC |
$91.80
|
| Rate for Payer: Global Benefits Group Commercial |
$64.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$97.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$68.58
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$63.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$21.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$75.60
|
| Rate for Payer: Multiplan Commercial |
$81.00
|
| Rate for Payer: Networks By Design Commercial |
$70.20
|
| Rate for Payer: Prime Health Services Commercial |
$91.80
|
| Rate for Payer: Riverside University Health System MISP |
$43.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$64.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$64.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$54.00
|
| Rate for Payer: United Healthcare All Other HMO |
$54.00
|
| Rate for Payer: United Healthcare HMO Rider |
$54.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$54.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$91.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$91.80
|
| Rate for Payer: Vantage Medical Group Senior |
$91.80
|
|
|
HC HLA CELL STORAGE
|
Facility
|
IP
|
$108.00
|
|
|
Service Code
|
CPT 86849
|
| Hospital Charge Code |
903901971
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$21.60 |
| Max. Negotiated Rate |
$97.20 |
| Rate for Payer: Adventist Health Commercial |
$21.60
|
| Rate for Payer: Cash Price |
$48.60
|
| Rate for Payer: Central Health Plan Commercial |
$86.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$75.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$43.20
|
| Rate for Payer: EPIC Health Plan Senior |
$43.20
|
| Rate for Payer: Galaxy Health WC |
$91.80
|
| Rate for Payer: Global Benefits Group Commercial |
$64.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$97.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$68.58
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$63.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$21.60
|
| Rate for Payer: Multiplan Commercial |
$81.00
|
| Rate for Payer: Networks By Design Commercial |
$70.20
|
| Rate for Payer: Prime Health Services Commercial |
$91.80
|
|
|
HC HLA C MOLECULAR HI RESOLUTION
|
Facility
|
OP
|
$217.00
|
|
|
Service Code
|
CPT 81380
|
| Hospital Charge Code |
903901990
|
|
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
|
|
|
HC HLA C MOLECULAR HI RESOLUTION
|
Facility
|
IP
|
$984.00
|
|
|
Service Code
|
CPT 81380
|
| Hospital Charge Code |
903901990
|
|
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 DISEASE ASSOCIATION
|
Facility
|
IP
|
$1,292.00
|
|
|
Service Code
|
CPT 81373
|
| Hospital Charge Code |
903913209
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$258.40 |
| Max. Negotiated Rate |
$1,162.80 |
| Rate for Payer: Adventist Health Commercial |
$258.40
|
| Rate for Payer: Cash Price |
$581.40
|
| Rate for Payer: Central Health Plan Commercial |
$1,033.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$904.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$516.80
|
| Rate for Payer: EPIC Health Plan Senior |
$516.80
|
| Rate for Payer: Galaxy Health WC |
$1,098.20
|
| Rate for Payer: Global Benefits Group Commercial |
$775.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,162.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$820.42
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$762.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$258.40
|
| Rate for Payer: Multiplan Commercial |
$969.00
|
| Rate for Payer: Networks By Design Commercial |
$839.80
|
| Rate for Payer: Prime Health Services Commercial |
$1,098.20
|
|
|
HC HLA DISEASE ASSOCIATION
|
Facility
|
OP
|
$856.00
|
|
|
Service Code
|
CPT 81830
|
| Hospital Charge Code |
900913209
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$171.20 |
| Max. Negotiated Rate |
$770.40 |
| Rate for Payer: Adventist Health Commercial |
$171.20
|
| Rate for Payer: Adventist Health Commercial |
$37.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$519.85
|
| Rate for Payer: Aetna of CA HMO/PPO |
$114.78
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$727.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$160.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$103.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$470.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$141.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$642.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$414.48
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$91.51
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$109.94
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$497.94
|
| Rate for Payer: Blue Shield of California Commercial |
$119.07
|
| Rate for Payer: Blue Shield of California Commercial |
$539.28
|
| Rate for Payer: Blue Shield of California EPN |
$339.83
|
| Rate for Payer: Blue Shield of California EPN |
$75.03
|
| Rate for Payer: Cash Price |
$385.20
|
| Rate for Payer: Cash Price |
$85.05
|
| Rate for Payer: Central Health Plan Commercial |
$684.80
|
| Rate for Payer: Central Health Plan Commercial |
$151.20
|
| Rate for Payer: Cigna of CA HMO |
$120.96
|
| Rate for Payer: Cigna of CA HMO |
$547.84
|
| Rate for Payer: Cigna of CA PPO |
$139.86
|
| Rate for Payer: Cigna of CA PPO |
$633.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$160.65
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$727.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$160.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$727.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$727.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$160.65
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$132.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$599.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$75.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$342.40
|
| Rate for Payer: EPIC Health Plan Senior |
$342.40
|
| Rate for Payer: EPIC Health Plan Senior |
$75.60
|
| Rate for Payer: Galaxy Health WC |
$727.60
|
| Rate for Payer: Galaxy Health WC |
$160.65
|
| Rate for Payer: Global Benefits Group Commercial |
$113.40
|
| Rate for Payer: Global Benefits Group Commercial |
$513.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$170.10
|
| Rate for Payer: Health Management Network EPO/PPO |
$770.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$543.56
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$120.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$310.73
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$68.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$111.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$505.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$37.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$171.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$599.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$132.30
|
| Rate for Payer: Multiplan Commercial |
$642.00
|
| Rate for Payer: Multiplan Commercial |
$141.75
|
| Rate for Payer: Networks By Design Commercial |
$122.85
|
| Rate for Payer: Networks By Design Commercial |
$556.40
|
| Rate for Payer: Prime Health Services Commercial |
$160.65
|
| Rate for Payer: Prime Health Services Commercial |
$727.60
|
| Rate for Payer: Riverside University Health System MISP |
$342.40
|
| Rate for Payer: Riverside University Health System MISP |
$75.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$113.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$513.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$513.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$113.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$94.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$428.00
|
| Rate for Payer: United Healthcare All Other HMO |
$94.50
|
| Rate for Payer: United Healthcare All Other HMO |
$428.00
|
| Rate for Payer: United Healthcare HMO Rider |
$94.50
|
| Rate for Payer: United Healthcare HMO Rider |
$428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$94.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$428.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$727.60
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$160.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$160.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$727.60
|
| Rate for Payer: Vantage Medical Group Senior |
$727.60
|
| Rate for Payer: Vantage Medical Group Senior |
$160.65
|
|
|
HC HLA DISEASE ASSOCIATION
|
Facility
|
IP
|
$856.00
|
|
|
Service Code
|
CPT 81830
|
| Hospital Charge Code |
900913209
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$171.20 |
| Max. Negotiated Rate |
$770.40 |
| Rate for Payer: Adventist Health Commercial |
$171.20
|
| Rate for Payer: Cash Price |
$385.20
|
| Rate for Payer: Central Health Plan Commercial |
$684.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$599.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$342.40
|
| Rate for Payer: EPIC Health Plan Senior |
$342.40
|
| Rate for Payer: Galaxy Health WC |
$727.60
|
| Rate for Payer: Global Benefits Group Commercial |
$513.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$770.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$543.56
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$505.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$171.20
|
| Rate for Payer: Multiplan Commercial |
$642.00
|
| Rate for Payer: Networks By Design Commercial |
$556.40
|
| Rate for Payer: Prime Health Services Commercial |
$727.60
|
|
|
HC HLA DISEASE ASSOCIATION
|
Facility
|
OP
|
$1,292.00
|
|
|
Service Code
|
CPT 81373
|
| Hospital Charge Code |
903913209
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$103.22 |
| Max. Negotiated Rate |
$1,221.94 |
| Rate for Payer: Adventist Health Commercial |
$258.40
|
| Rate for Payer: Adventist Health Commercial |
$88.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$127.43
|
| Rate for Payer: Adventist Health Medi-Cal |
$127.43
|
| Rate for Payer: Aetna of CA HMO/PPO |
$597.06
|
| Rate for Payer: Aetna of CA HMO/PPO |
$597.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$191.15
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$191.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$140.17
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$140.17
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$127.43
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$127.43
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$878.94
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$878.94
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,221.94
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,221.94
|
| Rate for Payer: Blue Shield of California Commercial |
$279.72
|
| Rate for Payer: Blue Shield of California Commercial |
$813.96
|
| Rate for Payer: Blue Shield of California EPN |
$176.27
|
| Rate for Payer: Blue Shield of California EPN |
$512.92
|
| Rate for Payer: Cash Price |
$199.80
|
| Rate for Payer: Cash Price |
$199.80
|
| Rate for Payer: Cash Price |
$581.40
|
| Rate for Payer: Cash Price |
$581.40
|
| Rate for Payer: Central Health Plan Commercial |
$1,033.60
|
| Rate for Payer: Central Health Plan Commercial |
$355.20
|
| Rate for Payer: Cigna of CA HMO |
$284.16
|
| Rate for Payer: Cigna of CA HMO |
$826.88
|
| Rate for Payer: Cigna of CA PPO |
$328.56
|
| Rate for Payer: Cigna of CA PPO |
$956.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$191.15
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$191.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$140.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$140.17
|
| Rate for Payer: Dignity Health Medicare Advantage |
$127.43
|
| Rate for Payer: Dignity Health Medicare Advantage |
$127.43
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$904.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$310.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$210.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$210.26
|
| Rate for Payer: EPIC Health Plan Senior |
$140.17
|
| Rate for Payer: EPIC Health Plan Senior |
$140.17
|
| Rate for Payer: Galaxy Health WC |
$377.40
|
| Rate for Payer: Galaxy Health WC |
$1,098.20
|
| Rate for Payer: Global Benefits Group Commercial |
$266.40
|
| Rate for Payer: Global Benefits Group Commercial |
$775.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$399.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,162.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$208.99
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$208.99
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$175.34
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$175.34
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$127.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$127.43
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$820.42
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$281.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$193.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$193.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$178.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$178.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$258.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$88.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$170.76
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$170.76
|
| Rate for Payer: Multiplan Commercial |
$333.00
|
| Rate for Payer: Multiplan Commercial |
$969.00
|
| Rate for Payer: Networks By Design Commercial |
$839.80
|
| Rate for Payer: Networks By Design Commercial |
$288.60
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$127.43
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$127.43
|
| Rate for Payer: Prime Health Services Commercial |
$377.40
|
| Rate for Payer: Prime Health Services Commercial |
$1,098.20
|
| Rate for Payer: Prime Health Services Medicare |
$135.08
|
| Rate for Payer: Prime Health Services Medicare |
$135.08
|
| Rate for Payer: Riverside University Health System MISP |
$140.17
|
| Rate for Payer: Riverside University Health System MISP |
$140.17
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$775.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$266.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$266.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$775.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$103.22
|
| Rate for Payer: United Healthcare All Other Commercial |
$103.22
|
| Rate for Payer: United Healthcare All Other HMO |
$103.22
|
| Rate for Payer: United Healthcare All Other HMO |
$103.22
|
| Rate for Payer: United Healthcare HMO Rider |
$103.22
|
| Rate for Payer: United Healthcare HMO Rider |
$103.22
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$103.22
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$103.22
|
| Rate for Payer: Upland Medical Group Pediatric |
$127.43
|
| Rate for Payer: Upland Medical Group Pediatric |
$127.43
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$191.15
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$191.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$140.17
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$140.17
|
| Rate for Payer: Vantage Medical Group Senior |
$127.43
|
| Rate for Payer: Vantage Medical Group Senior |
$127.43
|
|
|
HC HLA DISEASE ASSOCIATION 81376 CLASS II
|
Facility
|
OP
|
$1,334.00
|
|
|
Service Code
|
CPT 81376
|
| Hospital Charge Code |
903913210
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$99.00 |
| Max. Negotiated Rate |
$1,200.60 |
| Rate for Payer: Adventist Health Commercial |
$266.80
|
| Rate for Payer: Adventist Health Commercial |
$88.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$122.22
|
| Rate for Payer: Adventist Health Medi-Cal |
$122.22
|
| Rate for Payer: Aetna of CA HMO/PPO |
$348.75
|
| 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 Commercial/Exchange |
$183.33
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$134.44
|
| 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: 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 Exchange |
$550.16
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$764.85
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$764.85
|
| Rate for Payer: Blue Shield of California Commercial |
$279.72
|
| Rate for Payer: Blue Shield of California Commercial |
$840.42
|
| Rate for Payer: Blue Shield of California EPN |
$176.27
|
| Rate for Payer: Blue Shield of California EPN |
$529.60
|
| Rate for Payer: Cash Price |
$199.80
|
| Rate for Payer: Cash Price |
$199.80
|
| Rate for Payer: Cash Price |
$600.30
|
| Rate for Payer: Cash Price |
$600.30
|
| Rate for Payer: Central Health Plan Commercial |
$1,067.20
|
| Rate for Payer: Central Health Plan Commercial |
$355.20
|
| Rate for Payer: Cigna of CA HMO |
$284.16
|
| Rate for Payer: Cigna of CA HMO |
$853.76
|
| Rate for Payer: Cigna of CA PPO |
$328.56
|
| Rate for Payer: Cigna of CA PPO |
$987.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$183.33
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$183.33
|
| Rate for Payer: Dignity Health Medi-Cal |
$134.44
|
| Rate for Payer: Dignity Health Medi-Cal |
$134.44
|
| Rate for Payer: Dignity Health Medicare Advantage |
$122.22
|
| Rate for Payer: Dignity Health Medicare Advantage |
$122.22
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$933.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$310.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$201.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$201.66
|
| Rate for Payer: EPIC Health Plan Senior |
$134.44
|
| Rate for Payer: EPIC Health Plan Senior |
$134.44
|
| Rate for Payer: Galaxy Health WC |
$377.40
|
| Rate for Payer: Galaxy Health WC |
$1,133.90
|
| Rate for Payer: Global Benefits Group Commercial |
$266.40
|
| Rate for Payer: Global Benefits Group Commercial |
$800.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$399.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,200.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$200.44
|
| 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) medi-cal |
$186.86
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$122.22
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$122.22
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$847.09
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$281.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$206.42
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$206.42
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$171.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$171.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$266.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$88.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$163.77
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$163.77
|
| Rate for Payer: Multiplan Commercial |
$333.00
|
| Rate for Payer: Multiplan Commercial |
$1,000.50
|
| Rate for Payer: Networks By Design Commercial |
$867.10
|
| Rate for Payer: Networks By Design Commercial |
$288.60
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$122.22
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$122.22
|
| Rate for Payer: Prime Health Services Commercial |
$377.40
|
| Rate for Payer: Prime Health Services Commercial |
$1,133.90
|
| Rate for Payer: Prime Health Services Medicare |
$129.55
|
| Rate for Payer: Prime Health Services Medicare |
$129.55
|
| Rate for Payer: Riverside University Health System MISP |
$134.44
|
| Rate for Payer: Riverside University Health System MISP |
$134.44
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$800.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$266.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$266.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$800.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$99.00
|
| 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 All Other HMO |
$99.00
|
| Rate for Payer: United Healthcare HMO Rider |
$99.00
|
| Rate for Payer: United Healthcare HMO Rider |
$99.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$99.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$99.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$122.22
|
| 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 Commercial/Exchange |
$183.33
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$134.44
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$134.44
|
| Rate for Payer: Vantage Medical Group Senior |
$122.22
|
| Rate for Payer: Vantage Medical Group Senior |
$122.22
|
|
|
HC HLA DISEASE ASSOCIATION 81376 CLASS II
|
Facility
|
IP
|
$1,334.00
|
|
|
Service Code
|
CPT 81376
|
| Hospital Charge Code |
903913210
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$266.80 |
| Max. Negotiated Rate |
$1,200.60 |
| Rate for Payer: Adventist Health Commercial |
$266.80
|
| Rate for Payer: Cash Price |
$600.30
|
| Rate for Payer: Central Health Plan Commercial |
$1,067.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$933.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$533.60
|
| Rate for Payer: EPIC Health Plan Senior |
$533.60
|
| Rate for Payer: Galaxy Health WC |
$1,133.90
|
| Rate for Payer: Global Benefits Group Commercial |
$800.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,200.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$847.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$787.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$266.80
|
| Rate for Payer: Multiplan Commercial |
$1,000.50
|
| Rate for Payer: Networks By Design Commercial |
$867.10
|
| Rate for Payer: Prime Health Services Commercial |
$1,133.90
|
|
|
HC HLA-DP MOLECULAR
|
Facility
|
IP
|
$694.00
|
|
|
Service Code
|
CPT 81382
|
| Hospital Charge Code |
903902017
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$138.80 |
| Max. Negotiated Rate |
$624.60 |
| Rate for Payer: Adventist Health Commercial |
$138.80
|
| Rate for Payer: Cash Price |
$312.30
|
| Rate for Payer: Central Health Plan Commercial |
$555.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$485.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$277.60
|
| Rate for Payer: EPIC Health Plan Senior |
$277.60
|
| Rate for Payer: Galaxy Health WC |
$589.90
|
| Rate for Payer: Global Benefits Group Commercial |
$416.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$624.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$440.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$409.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$138.80
|
| Rate for Payer: Multiplan Commercial |
$520.50
|
| Rate for Payer: Networks By Design Commercial |
$451.10
|
| Rate for Payer: Prime Health Services Commercial |
$589.90
|
|
|
HC HLA-DP MOLECULAR
|
Facility
|
OP
|
$241.00
|
|
|
Service Code
|
CPT 81382
|
| Hospital Charge Code |
903902017
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$48.20 |
| Max. Negotiated Rate |
$851.81 |
| Rate for Payer: Adventist Health Commercial |
$48.20
|
| Rate for Payer: Adventist Health Commercial |
$138.80
|
| 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 |
$437.22
|
| Rate for Payer: Blue Shield of California Commercial |
$151.83
|
| Rate for Payer: Blue Shield of California EPN |
$275.52
|
| Rate for Payer: Blue Shield of California EPN |
$95.68
|
| Rate for Payer: Cash Price |
$312.30
|
| Rate for Payer: Cash Price |
$312.30
|
| Rate for Payer: Cash Price |
$108.45
|
| Rate for Payer: Cash Price |
$108.45
|
| Rate for Payer: Central Health Plan Commercial |
$192.80
|
| Rate for Payer: Central Health Plan Commercial |
$555.20
|
| Rate for Payer: Cigna of CA HMO |
$444.16
|
| Rate for Payer: Cigna of CA HMO |
$154.24
|
| Rate for Payer: Cigna of CA PPO |
$513.56
|
| Rate for Payer: Cigna of CA PPO |
$178.34
|
| 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 |
$168.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$485.80
|
| 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 |
$589.90
|
| Rate for Payer: Galaxy Health WC |
$204.85
|
| Rate for Payer: Global Benefits Group Commercial |
$416.40
|
| Rate for Payer: Global Benefits Group Commercial |
$144.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$624.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$216.90
|
| 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 |
$153.03
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$440.69
|
| 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 |
$48.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$138.80
|
| 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 |
$520.50
|
| Rate for Payer: Multiplan Commercial |
$180.75
|
| Rate for Payer: Networks By Design Commercial |
$156.65
|
| Rate for Payer: Networks By Design Commercial |
$451.10
|
| 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 |
$589.90
|
| Rate for Payer: Prime Health Services Commercial |
$204.85
|
| 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 |
$144.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$416.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$416.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$144.60
|
| 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-DP MOLECULAR HI RESOLUTION
|
Facility
|
IP
|
$894.00
|
|
|
Service Code
|
CPT 86817
|
| Hospital Charge Code |
903902018
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$178.80 |
| Max. Negotiated Rate |
$804.60 |
| Rate for Payer: Adventist Health Commercial |
$178.80
|
| Rate for Payer: Cash Price |
$402.30
|
| Rate for Payer: Central Health Plan Commercial |
$715.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$625.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$357.60
|
| Rate for Payer: EPIC Health Plan Senior |
$357.60
|
| Rate for Payer: Galaxy Health WC |
$759.90
|
| Rate for Payer: Global Benefits Group Commercial |
$536.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$804.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$567.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$527.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$178.80
|
| Rate for Payer: Multiplan Commercial |
$670.50
|
| Rate for Payer: Networks By Design Commercial |
$581.10
|
| Rate for Payer: Prime Health Services Commercial |
$759.90
|
|
