|
HC GI TRC IMG INTRAL COLON INT AND RPT
|
Facility
|
IP
|
$2,745.00
|
|
|
Service Code
|
CPT 91113
|
| Hospital Charge Code |
906701113
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$549.00 |
| Max. Negotiated Rate |
$2,470.50 |
| Rate for Payer: Adventist Health Commercial |
$549.00
|
| Rate for Payer: Cash Price |
$1,235.25
|
| Rate for Payer: Central Health Plan Commercial |
$2,196.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,098.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,098.00
|
| Rate for Payer: Galaxy Health WC |
$2,333.25
|
| Rate for Payer: Global Benefits Group Commercial |
$1,647.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,470.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,830.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,045.85
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,699.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$549.00
|
| Rate for Payer: Multiplan Commercial |
$2,058.75
|
| Rate for Payer: Networks By Design Commercial |
$1,784.25
|
| Rate for Payer: Prime Health Services Commercial |
$2,333.25
|
|
|
HC GI TRC IMG INTRAL COLON INT AND RPT
|
Facility
|
OP
|
$2,745.00
|
|
|
Service Code
|
CPT 91113
|
| Hospital Charge Code |
906701113
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$549.00 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$549.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,158.42
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,737.63
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,274.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,158.42
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,695.61
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,612.14
|
| Rate for Payer: Blue Shield of California Commercial |
$7,837.47
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$1,235.25
|
| Rate for Payer: Cash Price |
$1,235.25
|
| Rate for Payer: Cash Price |
$1,235.25
|
| Rate for Payer: Central Health Plan Commercial |
$2,196.00
|
| Rate for Payer: Cigna of CA HMO |
$1,756.80
|
| Rate for Payer: Cigna of CA PPO |
$2,031.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,737.63
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,274.26
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,158.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,563.87
|
| Rate for Payer: EPIC Health Plan Senior |
$1,158.42
|
| Rate for Payer: Galaxy Health WC |
$2,333.25
|
| Rate for Payer: Global Benefits Group Commercial |
$1,647.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,470.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,899.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,529.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,158.42
|
| Rate for Payer: InnovAge PACE Commercial |
$1,737.63
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,830.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,689.58
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,158.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$549.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,552.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,552.28
|
| Rate for Payer: Multiplan Commercial |
$2,058.75
|
| Rate for Payer: Networks By Design Commercial |
$1,784.25
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,158.42
|
| Rate for Payer: Prime Health Services Commercial |
$2,333.25
|
| Rate for Payer: Prime Health Services Medicare |
$1,227.93
|
| Rate for Payer: Riverside University Health System MISP |
$1,274.26
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,647.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,390.10
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,372.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,372.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,372.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,372.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,158.42
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,737.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,274.26
|
| Rate for Payer: Vantage Medical Group Senior |
$1,158.42
|
|
|
HC GIVEN ENDO IMAGING
|
Facility
|
OP
|
$9,577.00
|
|
|
Service Code
|
CPT 91110
|
| Hospital Charge Code |
906776499
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,191.26 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$1,915.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,191.26
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,786.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,310.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,191.26
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,332.17
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,624.57
|
| Rate for Payer: Blue Shield of California Commercial |
$7,837.47
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$4,309.65
|
| Rate for Payer: Cash Price |
$4,309.65
|
| Rate for Payer: Cash Price |
$4,309.65
|
| Rate for Payer: Central Health Plan Commercial |
$7,661.60
|
| Rate for Payer: Cigna of CA HMO |
$6,129.28
|
| Rate for Payer: Cigna of CA PPO |
$7,086.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,786.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,310.39
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,191.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,608.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,191.26
|
| Rate for Payer: Galaxy Health WC |
$8,140.45
|
| Rate for Payer: Global Benefits Group Commercial |
$5,746.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,619.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,953.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,383.38
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,191.26
|
| Rate for Payer: InnovAge PACE Commercial |
$1,786.89
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,387.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,528.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,191.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,915.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,596.29
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,596.29
|
| Rate for Payer: Multiplan Commercial |
$7,182.75
|
| Rate for Payer: Networks By Design Commercial |
$6,225.05
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,191.26
|
| Rate for Payer: Prime Health Services Commercial |
$8,140.45
|
| Rate for Payer: Prime Health Services Medicare |
$1,262.74
|
| Rate for Payer: Riverside University Health System MISP |
$1,310.39
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,746.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,429.51
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,208.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,191.26
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,786.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,310.39
|
| Rate for Payer: Vantage Medical Group Senior |
$1,191.26
|
|
|
HC GIVEN ENDO IMAGING
|
Facility
|
IP
|
$10,121.00
|
|
|
Service Code
|
CPT 91110
|
| Hospital Charge Code |
906776499
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$2,024.20 |
| Max. Negotiated Rate |
$9,108.90 |
| Rate for Payer: Adventist Health Commercial |
$2,024.20
|
| Rate for Payer: Cash Price |
$4,554.45
|
| Rate for Payer: Central Health Plan Commercial |
$8,096.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,048.40
|
| Rate for Payer: EPIC Health Plan Senior |
$4,048.40
|
| Rate for Payer: Galaxy Health WC |
$8,602.85
|
| Rate for Payer: Global Benefits Group Commercial |
$6,072.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,108.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,750.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,856.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6,264.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,024.20
|
| Rate for Payer: Multiplan Commercial |
$7,590.75
|
| Rate for Payer: Networks By Design Commercial |
$6,578.65
|
| Rate for Payer: Prime Health Services Commercial |
$8,602.85
|
|
|
HC GLIADIN AB IGA
|
Facility
|
OP
|
$54.00
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
900913558
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.34 |
| Max. Negotiated Rate |
$170.20 |
| Rate for Payer: Adventist Health Commercial |
$10.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$11.53
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32.79
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$17.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$12.68
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11.53
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$170.20
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34.54
|
| Rate for Payer: Blue Shield of California Commercial |
$32.78
|
| Rate for Payer: Blue Shield of California EPN |
$21.44
|
| Rate for Payer: Cash Price |
$24.30
|
| Rate for Payer: Cash Price |
$24.30
|
| Rate for Payer: Central Health Plan Commercial |
$43.20
|
| Rate for Payer: Cigna of CA HMO |
$34.56
|
| Rate for Payer: Cigna of CA PPO |
$39.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$17.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$12.68
|
| Rate for Payer: Dignity Health Medicare Advantage |
$11.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.57
|
| Rate for Payer: EPIC Health Plan Senior |
$11.53
|
| Rate for Payer: Galaxy Health WC |
$45.90
|
| Rate for Payer: Global Benefits Group Commercial |
$32.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$48.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$18.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$14.79
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$11.53
|
| Rate for Payer: InnovAge PACE Commercial |
$17.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$36.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$16.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$11.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$15.45
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$15.45
|
| Rate for Payer: Multiplan Commercial |
$40.50
|
| Rate for Payer: Networks By Design Commercial |
$35.10
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$11.53
|
| Rate for Payer: Prime Health Services Commercial |
$45.90
|
| Rate for Payer: Prime Health Services Medicare |
$12.22
|
| Rate for Payer: Riverside University Health System MISP |
$12.68
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$32.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$32.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.34
|
| Rate for Payer: United Healthcare All Other HMO |
$9.34
|
| Rate for Payer: United Healthcare HMO Rider |
$9.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.34
|
| Rate for Payer: Upland Medical Group Pediatric |
$11.53
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$17.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$12.68
|
| Rate for Payer: Vantage Medical Group Senior |
$11.53
|
|
|
HC GLIADIN AB IGA
|
Facility
|
IP
|
$78.00
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
900913558
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.60 |
| Max. Negotiated Rate |
$70.20 |
| Rate for Payer: Adventist Health Commercial |
$15.60
|
| Rate for Payer: Cash Price |
$35.10
|
| Rate for Payer: Central Health Plan Commercial |
$62.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$31.20
|
| Rate for Payer: EPIC Health Plan Senior |
$31.20
|
| Rate for Payer: Galaxy Health WC |
$66.30
|
| Rate for Payer: Global Benefits Group Commercial |
$46.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$70.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$52.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$29.72
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$48.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.60
|
| Rate for Payer: Multiplan Commercial |
$58.50
|
| Rate for Payer: Networks By Design Commercial |
$50.70
|
| Rate for Payer: Prime Health Services Commercial |
$66.30
|
|
|
HC GLIADIN AB IGG
|
Facility
|
OP
|
$54.00
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
900913557
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.34 |
| Max. Negotiated Rate |
$170.20 |
| Rate for Payer: Adventist Health Commercial |
$10.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$11.53
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32.79
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$17.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$12.68
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11.53
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$170.20
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34.54
|
| Rate for Payer: Blue Shield of California Commercial |
$32.78
|
| Rate for Payer: Blue Shield of California EPN |
$21.44
|
| Rate for Payer: Cash Price |
$24.30
|
| Rate for Payer: Cash Price |
$24.30
|
| Rate for Payer: Central Health Plan Commercial |
$43.20
|
| Rate for Payer: Cigna of CA HMO |
$34.56
|
| Rate for Payer: Cigna of CA PPO |
$39.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$17.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$12.68
|
| Rate for Payer: Dignity Health Medicare Advantage |
$11.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.57
|
| Rate for Payer: EPIC Health Plan Senior |
$11.53
|
| Rate for Payer: Galaxy Health WC |
$45.90
|
| Rate for Payer: Global Benefits Group Commercial |
$32.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$48.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$18.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$14.79
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$11.53
|
| Rate for Payer: InnovAge PACE Commercial |
$17.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$36.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$16.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$11.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$15.45
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$15.45
|
| Rate for Payer: Multiplan Commercial |
$40.50
|
| Rate for Payer: Networks By Design Commercial |
$35.10
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$11.53
|
| Rate for Payer: Prime Health Services Commercial |
$45.90
|
| Rate for Payer: Prime Health Services Medicare |
$12.22
|
| Rate for Payer: Riverside University Health System MISP |
$12.68
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$32.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$32.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.34
|
| Rate for Payer: United Healthcare All Other HMO |
$9.34
|
| Rate for Payer: United Healthcare HMO Rider |
$9.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.34
|
| Rate for Payer: Upland Medical Group Pediatric |
$11.53
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$17.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$12.68
|
| Rate for Payer: Vantage Medical Group Senior |
$11.53
|
|
|
HC GLIADIN AB IGG
|
Facility
|
IP
|
$78.00
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
900913557
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.60 |
| Max. Negotiated Rate |
$70.20 |
| Rate for Payer: Adventist Health Commercial |
$15.60
|
| Rate for Payer: Cash Price |
$35.10
|
| Rate for Payer: Central Health Plan Commercial |
$62.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$31.20
|
| Rate for Payer: EPIC Health Plan Senior |
$31.20
|
| Rate for Payer: Galaxy Health WC |
$66.30
|
| Rate for Payer: Global Benefits Group Commercial |
$46.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$70.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$52.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$29.72
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$48.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.60
|
| Rate for Payer: Multiplan Commercial |
$58.50
|
| Rate for Payer: Networks By Design Commercial |
$50.70
|
| Rate for Payer: Prime Health Services Commercial |
$66.30
|
|
|
HC GLIADIN IGA
|
Facility
|
OP
|
$49.00
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
900913658
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.34 |
| Max. Negotiated Rate |
$170.20 |
| Rate for Payer: Adventist Health Commercial |
$9.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$11.53
|
| Rate for Payer: Aetna of CA HMO/PPO |
$29.76
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$17.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$12.68
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11.53
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$170.20
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34.54
|
| Rate for Payer: Blue Shield of California Commercial |
$29.74
|
| Rate for Payer: Blue Shield of California EPN |
$19.45
|
| Rate for Payer: Cash Price |
$22.05
|
| Rate for Payer: Cash Price |
$22.05
|
| Rate for Payer: Central Health Plan Commercial |
$39.20
|
| Rate for Payer: Cigna of CA HMO |
$31.36
|
| Rate for Payer: Cigna of CA PPO |
$36.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$17.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$12.68
|
| Rate for Payer: Dignity Health Medicare Advantage |
$11.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.57
|
| Rate for Payer: EPIC Health Plan Senior |
$11.53
|
| Rate for Payer: Galaxy Health WC |
$41.65
|
| Rate for Payer: Global Benefits Group Commercial |
$29.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$44.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$18.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$14.79
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$11.53
|
| Rate for Payer: InnovAge PACE Commercial |
$17.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$32.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$16.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$11.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$15.45
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$15.45
|
| Rate for Payer: Multiplan Commercial |
$36.75
|
| Rate for Payer: Networks By Design Commercial |
$31.85
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$11.53
|
| Rate for Payer: Prime Health Services Commercial |
$41.65
|
| Rate for Payer: Prime Health Services Medicare |
$12.22
|
| Rate for Payer: Riverside University Health System MISP |
$12.68
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$29.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$29.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.34
|
| Rate for Payer: United Healthcare All Other HMO |
$9.34
|
| Rate for Payer: United Healthcare HMO Rider |
$9.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.34
|
| Rate for Payer: Upland Medical Group Pediatric |
$11.53
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$17.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$12.68
|
| Rate for Payer: Vantage Medical Group Senior |
$11.53
|
|
|
HC GLIADIN IGA
|
Facility
|
IP
|
$64.00
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
900913658
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.80 |
| Max. Negotiated Rate |
$57.60 |
| Rate for Payer: Adventist Health Commercial |
$12.80
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Central Health Plan Commercial |
$51.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$25.60
|
| Rate for Payer: EPIC Health Plan Senior |
$25.60
|
| Rate for Payer: Galaxy Health WC |
$54.40
|
| Rate for Payer: Global Benefits Group Commercial |
$38.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$57.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$42.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$24.38
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$39.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.80
|
| Rate for Payer: Multiplan Commercial |
$48.00
|
| Rate for Payer: Networks By Design Commercial |
$41.60
|
| Rate for Payer: Prime Health Services Commercial |
$54.40
|
|
|
HC GLIADIN IGG
|
Facility
|
IP
|
$64.00
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
900913659
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.80 |
| Max. Negotiated Rate |
$57.60 |
| Rate for Payer: Adventist Health Commercial |
$12.80
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Central Health Plan Commercial |
$51.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$25.60
|
| Rate for Payer: EPIC Health Plan Senior |
$25.60
|
| Rate for Payer: Galaxy Health WC |
$54.40
|
| Rate for Payer: Global Benefits Group Commercial |
$38.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$57.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$42.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$24.38
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$39.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.80
|
| Rate for Payer: Multiplan Commercial |
$48.00
|
| Rate for Payer: Networks By Design Commercial |
$41.60
|
| Rate for Payer: Prime Health Services Commercial |
$54.40
|
|
|
HC GLIADIN IGG
|
Facility
|
OP
|
$49.00
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
900913659
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.34 |
| Max. Negotiated Rate |
$170.20 |
| Rate for Payer: Adventist Health Commercial |
$9.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$11.53
|
| Rate for Payer: Aetna of CA HMO/PPO |
$29.76
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$17.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$12.68
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11.53
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$170.20
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34.54
|
| Rate for Payer: Blue Shield of California Commercial |
$29.74
|
| Rate for Payer: Blue Shield of California EPN |
$19.45
|
| Rate for Payer: Cash Price |
$22.05
|
| Rate for Payer: Cash Price |
$22.05
|
| Rate for Payer: Central Health Plan Commercial |
$39.20
|
| Rate for Payer: Cigna of CA HMO |
$31.36
|
| Rate for Payer: Cigna of CA PPO |
$36.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$17.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$12.68
|
| Rate for Payer: Dignity Health Medicare Advantage |
$11.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.57
|
| Rate for Payer: EPIC Health Plan Senior |
$11.53
|
| Rate for Payer: Galaxy Health WC |
$41.65
|
| Rate for Payer: Global Benefits Group Commercial |
$29.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$44.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$18.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$14.79
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$11.53
|
| Rate for Payer: InnovAge PACE Commercial |
$17.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$32.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$16.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$11.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$15.45
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$15.45
|
| Rate for Payer: Multiplan Commercial |
$36.75
|
| Rate for Payer: Networks By Design Commercial |
$31.85
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$11.53
|
| Rate for Payer: Prime Health Services Commercial |
$41.65
|
| Rate for Payer: Prime Health Services Medicare |
$12.22
|
| Rate for Payer: Riverside University Health System MISP |
$12.68
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$29.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$29.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.34
|
| Rate for Payer: United Healthcare All Other HMO |
$9.34
|
| Rate for Payer: United Healthcare HMO Rider |
$9.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.34
|
| Rate for Payer: Upland Medical Group Pediatric |
$11.53
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$17.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$12.68
|
| Rate for Payer: Vantage Medical Group Senior |
$11.53
|
|
|
HC GLOMERULAR BASEMNT AB
|
Facility
|
IP
|
$78.00
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
900913676
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.60 |
| Max. Negotiated Rate |
$70.20 |
| Rate for Payer: Adventist Health Commercial |
$15.60
|
| Rate for Payer: Cash Price |
$35.10
|
| Rate for Payer: Central Health Plan Commercial |
$62.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$31.20
|
| Rate for Payer: EPIC Health Plan Senior |
$31.20
|
| Rate for Payer: Galaxy Health WC |
$66.30
|
| Rate for Payer: Global Benefits Group Commercial |
$46.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$70.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$52.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$29.72
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$48.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.60
|
| Rate for Payer: Multiplan Commercial |
$58.50
|
| Rate for Payer: Networks By Design Commercial |
$50.70
|
| Rate for Payer: Prime Health Services Commercial |
$66.30
|
|
|
HC GLOMERULAR BASEMNT AB
|
Facility
|
OP
|
$70.00
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
900913676
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.34 |
| Max. Negotiated Rate |
$170.20 |
| Rate for Payer: Adventist Health Commercial |
$14.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$11.53
|
| Rate for Payer: Aetna of CA HMO/PPO |
$42.51
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$17.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$12.68
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11.53
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$170.20
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34.54
|
| Rate for Payer: Blue Shield of California Commercial |
$42.49
|
| Rate for Payer: Blue Shield of California EPN |
$27.79
|
| Rate for Payer: Cash Price |
$31.50
|
| Rate for Payer: Cash Price |
$31.50
|
| Rate for Payer: Central Health Plan Commercial |
$56.00
|
| Rate for Payer: Cigna of CA HMO |
$44.80
|
| Rate for Payer: Cigna of CA PPO |
$51.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$17.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$12.68
|
| Rate for Payer: Dignity Health Medicare Advantage |
$11.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.57
|
| Rate for Payer: EPIC Health Plan Senior |
$11.53
|
| Rate for Payer: Galaxy Health WC |
$59.50
|
| Rate for Payer: Global Benefits Group Commercial |
$42.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$63.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$18.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$14.79
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$11.53
|
| Rate for Payer: InnovAge PACE Commercial |
$17.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$46.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$16.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$11.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$15.45
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$15.45
|
| Rate for Payer: Multiplan Commercial |
$52.50
|
| Rate for Payer: Networks By Design Commercial |
$45.50
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$11.53
|
| Rate for Payer: Prime Health Services Commercial |
$59.50
|
| Rate for Payer: Prime Health Services Medicare |
$12.22
|
| Rate for Payer: Riverside University Health System MISP |
$12.68
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$42.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$42.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.34
|
| Rate for Payer: United Healthcare All Other HMO |
$9.34
|
| Rate for Payer: United Healthcare HMO Rider |
$9.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.34
|
| Rate for Payer: Upland Medical Group Pediatric |
$11.53
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$17.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$12.68
|
| Rate for Payer: Vantage Medical Group Senior |
$11.53
|
|
|
HC GLUCOSE
|
Facility
|
OP
|
$42.00
|
|
|
Service Code
|
CPT 82947
|
| Hospital Charge Code |
900910498
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.19 |
| Max. Negotiated Rate |
$37.80 |
| Rate for Payer: Adventist Health Commercial |
$8.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$3.93
|
| Rate for Payer: Aetna of CA HMO/PPO |
$25.51
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4.32
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3.93
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$28.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5.80
|
| Rate for Payer: Blue Shield of California Commercial |
$25.49
|
| Rate for Payer: Blue Shield of California EPN |
$16.67
|
| Rate for Payer: Cash Price |
$18.90
|
| Rate for Payer: Cash Price |
$18.90
|
| Rate for Payer: Central Health Plan Commercial |
$33.60
|
| Rate for Payer: Cigna of CA HMO |
$26.88
|
| Rate for Payer: Cigna of CA PPO |
$31.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$4.32
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.31
|
| Rate for Payer: EPIC Health Plan Senior |
$3.93
|
| Rate for Payer: Galaxy Health WC |
$35.70
|
| Rate for Payer: Global Benefits Group Commercial |
$25.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$37.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$5.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3.93
|
| Rate for Payer: InnovAge PACE Commercial |
$5.89
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$28.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6.27
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5.27
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5.27
|
| Rate for Payer: Multiplan Commercial |
$31.50
|
| Rate for Payer: Networks By Design Commercial |
$27.30
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$3.93
|
| Rate for Payer: Prime Health Services Commercial |
$35.70
|
| Rate for Payer: Prime Health Services Medicare |
$4.17
|
| Rate for Payer: Riverside University Health System MISP |
$4.32
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$25.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$25.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.19
|
| Rate for Payer: United Healthcare All Other HMO |
$3.19
|
| Rate for Payer: United Healthcare HMO Rider |
$3.19
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.19
|
| Rate for Payer: Upland Medical Group Pediatric |
$3.93
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4.32
|
| Rate for Payer: Vantage Medical Group Senior |
$3.93
|
|
|
HC GLUCOSE
|
Facility
|
IP
|
$98.00
|
|
|
Service Code
|
CPT 82947
|
| Hospital Charge Code |
900910498
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$19.60 |
| Max. Negotiated Rate |
$88.20 |
| Rate for Payer: Adventist Health Commercial |
$19.60
|
| Rate for Payer: Cash Price |
$44.10
|
| Rate for Payer: Central Health Plan Commercial |
$78.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$39.20
|
| Rate for Payer: EPIC Health Plan Senior |
$39.20
|
| Rate for Payer: Galaxy Health WC |
$83.30
|
| Rate for Payer: Global Benefits Group Commercial |
$58.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$88.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$65.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$37.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$60.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.60
|
| Rate for Payer: Multiplan Commercial |
$73.50
|
| Rate for Payer: Networks By Design Commercial |
$63.70
|
| Rate for Payer: Prime Health Services Commercial |
$83.30
|
|
|
HC GLUCOSE ADDITIONAL
|
Facility
|
OP
|
$42.00
|
|
|
Service Code
|
CPT 82952
|
| Hospital Charge Code |
900910444
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.18 |
| Max. Negotiated Rate |
$37.80 |
| Rate for Payer: Adventist Health Commercial |
$8.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$3.92
|
| Rate for Payer: Aetna of CA HMO/PPO |
$25.51
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4.31
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3.92
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$28.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5.80
|
| Rate for Payer: Blue Shield of California Commercial |
$25.49
|
| Rate for Payer: Blue Shield of California EPN |
$16.67
|
| Rate for Payer: Cash Price |
$18.90
|
| Rate for Payer: Cash Price |
$18.90
|
| Rate for Payer: Central Health Plan Commercial |
$33.60
|
| Rate for Payer: Cigna of CA HMO |
$26.88
|
| Rate for Payer: Cigna of CA PPO |
$31.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5.88
|
| Rate for Payer: Dignity Health Medi-Cal |
$4.31
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3.92
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.29
|
| Rate for Payer: EPIC Health Plan Senior |
$3.92
|
| Rate for Payer: Galaxy Health WC |
$35.70
|
| Rate for Payer: Global Benefits Group Commercial |
$25.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$37.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$5.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3.92
|
| Rate for Payer: InnovAge PACE Commercial |
$5.88
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$28.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5.25
|
| Rate for Payer: Multiplan Commercial |
$31.50
|
| Rate for Payer: Networks By Design Commercial |
$27.30
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$3.92
|
| Rate for Payer: Prime Health Services Commercial |
$35.70
|
| Rate for Payer: Prime Health Services Medicare |
$4.16
|
| Rate for Payer: Riverside University Health System MISP |
$4.31
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$25.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$25.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.18
|
| Rate for Payer: United Healthcare All Other HMO |
$3.18
|
| Rate for Payer: United Healthcare HMO Rider |
$3.18
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.18
|
| Rate for Payer: Upland Medical Group Pediatric |
$3.92
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4.31
|
| Rate for Payer: Vantage Medical Group Senior |
$3.92
|
|
|
HC GLUCOSE ADDITIONAL
|
Facility
|
IP
|
$86.00
|
|
|
Service Code
|
CPT 82952
|
| Hospital Charge Code |
900910444
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$17.20 |
| Max. Negotiated Rate |
$77.40 |
| Rate for Payer: Adventist Health Commercial |
$17.20
|
| Rate for Payer: Cash Price |
$38.70
|
| Rate for Payer: Central Health Plan Commercial |
$68.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$34.40
|
| Rate for Payer: EPIC Health Plan Senior |
$34.40
|
| Rate for Payer: Galaxy Health WC |
$73.10
|
| Rate for Payer: Global Benefits Group Commercial |
$51.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$77.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$57.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$32.77
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$53.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$17.20
|
| Rate for Payer: Multiplan Commercial |
$64.50
|
| Rate for Payer: Networks By Design Commercial |
$55.90
|
| Rate for Payer: Prime Health Services Commercial |
$73.10
|
|
|
HC GLUCOSE BODY FLUID
|
Facility
|
IP
|
$42.00
|
|
|
Service Code
|
CPT 82945
|
| Hospital Charge Code |
900912249
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.40 |
| Max. Negotiated Rate |
$37.80 |
| Rate for Payer: Adventist Health Commercial |
$8.40
|
| Rate for Payer: Cash Price |
$18.90
|
| Rate for Payer: Central Health Plan Commercial |
$33.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.80
|
| Rate for Payer: EPIC Health Plan Senior |
$16.80
|
| Rate for Payer: Galaxy Health WC |
$35.70
|
| Rate for Payer: Global Benefits Group Commercial |
$25.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$37.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$28.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$16.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$26.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.40
|
| Rate for Payer: Multiplan Commercial |
$31.50
|
| Rate for Payer: Networks By Design Commercial |
$27.30
|
| Rate for Payer: Prime Health Services Commercial |
$35.70
|
|
|
HC GLUCOSE BODY FLUID
|
Facility
|
OP
|
$37.00
|
|
|
Service Code
|
CPT 82945
|
| Hospital Charge Code |
900912249
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.19 |
| Max. Negotiated Rate |
$33.30 |
| Rate for Payer: Adventist Health Commercial |
$7.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$3.93
|
| Rate for Payer: Aetna of CA HMO/PPO |
$22.47
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4.32
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3.93
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$28.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5.79
|
| Rate for Payer: Blue Shield of California Commercial |
$22.46
|
| Rate for Payer: Blue Shield of California EPN |
$14.69
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Central Health Plan Commercial |
$29.60
|
| Rate for Payer: Cigna of CA HMO |
$23.68
|
| Rate for Payer: Cigna of CA PPO |
$27.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$4.32
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.31
|
| Rate for Payer: EPIC Health Plan Senior |
$3.93
|
| Rate for Payer: Galaxy Health WC |
$31.45
|
| Rate for Payer: Global Benefits Group Commercial |
$22.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$33.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$5.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3.93
|
| Rate for Payer: InnovAge PACE Commercial |
$5.89
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$24.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5.27
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5.27
|
| Rate for Payer: Multiplan Commercial |
$27.75
|
| Rate for Payer: Networks By Design Commercial |
$24.05
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$3.93
|
| Rate for Payer: Prime Health Services Commercial |
$31.45
|
| Rate for Payer: Prime Health Services Medicare |
$4.17
|
| Rate for Payer: Riverside University Health System MISP |
$4.32
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$22.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$22.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.19
|
| Rate for Payer: United Healthcare All Other HMO |
$3.19
|
| Rate for Payer: United Healthcare HMO Rider |
$3.19
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.19
|
| Rate for Payer: Upland Medical Group Pediatric |
$3.93
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4.32
|
| Rate for Payer: Vantage Medical Group Senior |
$3.93
|
|
|
HC GLUCOSE CSF
|
Facility
|
IP
|
$42.00
|
|
|
Service Code
|
CPT 82945
|
| Hospital Charge Code |
900910305
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.40 |
| Max. Negotiated Rate |
$37.80 |
| Rate for Payer: Adventist Health Commercial |
$8.40
|
| Rate for Payer: Cash Price |
$18.90
|
| Rate for Payer: Central Health Plan Commercial |
$33.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.80
|
| Rate for Payer: EPIC Health Plan Senior |
$16.80
|
| Rate for Payer: Galaxy Health WC |
$35.70
|
| Rate for Payer: Global Benefits Group Commercial |
$25.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$37.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$28.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$16.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$26.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.40
|
| Rate for Payer: Multiplan Commercial |
$31.50
|
| Rate for Payer: Networks By Design Commercial |
$27.30
|
| Rate for Payer: Prime Health Services Commercial |
$35.70
|
|
|
HC GLUCOSE CSF
|
Facility
|
OP
|
$37.00
|
|
|
Service Code
|
CPT 82945
|
| Hospital Charge Code |
900910305
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.19 |
| Max. Negotiated Rate |
$33.30 |
| Rate for Payer: Adventist Health Commercial |
$7.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$3.93
|
| Rate for Payer: Aetna of CA HMO/PPO |
$22.47
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4.32
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3.93
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$28.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5.79
|
| Rate for Payer: Blue Shield of California Commercial |
$22.46
|
| Rate for Payer: Blue Shield of California EPN |
$14.69
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Central Health Plan Commercial |
$29.60
|
| Rate for Payer: Cigna of CA HMO |
$23.68
|
| Rate for Payer: Cigna of CA PPO |
$27.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$4.32
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.31
|
| Rate for Payer: EPIC Health Plan Senior |
$3.93
|
| Rate for Payer: Galaxy Health WC |
$31.45
|
| Rate for Payer: Global Benefits Group Commercial |
$22.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$33.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$5.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3.93
|
| Rate for Payer: InnovAge PACE Commercial |
$5.89
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$24.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5.27
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5.27
|
| Rate for Payer: Multiplan Commercial |
$27.75
|
| Rate for Payer: Networks By Design Commercial |
$24.05
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$3.93
|
| Rate for Payer: Prime Health Services Commercial |
$31.45
|
| Rate for Payer: Prime Health Services Medicare |
$4.17
|
| Rate for Payer: Riverside University Health System MISP |
$4.32
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$22.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$22.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.19
|
| Rate for Payer: United Healthcare All Other HMO |
$3.19
|
| Rate for Payer: United Healthcare HMO Rider |
$3.19
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.19
|
| Rate for Payer: Upland Medical Group Pediatric |
$3.93
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4.32
|
| Rate for Payer: Vantage Medical Group Senior |
$3.93
|
|
|
HC GLUCOSE FASTING
|
Facility
|
IP
|
$98.00
|
|
|
Service Code
|
CPT 82947
|
| Hospital Charge Code |
900910306
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$19.60 |
| Max. Negotiated Rate |
$88.20 |
| Rate for Payer: Adventist Health Commercial |
$19.60
|
| Rate for Payer: Cash Price |
$44.10
|
| Rate for Payer: Central Health Plan Commercial |
$78.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$39.20
|
| Rate for Payer: EPIC Health Plan Senior |
$39.20
|
| Rate for Payer: Galaxy Health WC |
$83.30
|
| Rate for Payer: Global Benefits Group Commercial |
$58.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$88.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$65.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$37.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$60.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.60
|
| Rate for Payer: Multiplan Commercial |
$73.50
|
| Rate for Payer: Networks By Design Commercial |
$63.70
|
| Rate for Payer: Prime Health Services Commercial |
$83.30
|
|
|
HC GLUCOSE FASTING
|
Facility
|
OP
|
$42.00
|
|
|
Service Code
|
CPT 82947
|
| Hospital Charge Code |
900910306
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.19 |
| Max. Negotiated Rate |
$37.80 |
| Rate for Payer: Adventist Health Commercial |
$8.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$3.93
|
| Rate for Payer: Aetna of CA HMO/PPO |
$25.51
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4.32
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3.93
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$28.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5.80
|
| Rate for Payer: Blue Shield of California Commercial |
$25.49
|
| Rate for Payer: Blue Shield of California EPN |
$16.67
|
| Rate for Payer: Cash Price |
$18.90
|
| Rate for Payer: Cash Price |
$18.90
|
| Rate for Payer: Central Health Plan Commercial |
$33.60
|
| Rate for Payer: Cigna of CA HMO |
$26.88
|
| Rate for Payer: Cigna of CA PPO |
$31.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$4.32
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.31
|
| Rate for Payer: EPIC Health Plan Senior |
$3.93
|
| Rate for Payer: Galaxy Health WC |
$35.70
|
| Rate for Payer: Global Benefits Group Commercial |
$25.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$37.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$5.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3.93
|
| Rate for Payer: InnovAge PACE Commercial |
$5.89
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$28.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6.27
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5.27
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5.27
|
| Rate for Payer: Multiplan Commercial |
$31.50
|
| Rate for Payer: Networks By Design Commercial |
$27.30
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$3.93
|
| Rate for Payer: Prime Health Services Commercial |
$35.70
|
| Rate for Payer: Prime Health Services Medicare |
$4.17
|
| Rate for Payer: Riverside University Health System MISP |
$4.32
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$25.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$25.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.19
|
| Rate for Payer: United Healthcare All Other HMO |
$3.19
|
| Rate for Payer: United Healthcare HMO Rider |
$3.19
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.19
|
| Rate for Payer: Upland Medical Group Pediatric |
$3.93
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4.32
|
| Rate for Payer: Vantage Medical Group Senior |
$3.93
|
|
|
HC GLUCOSE FAST RANDOM
|
Facility
|
IP
|
$108.00
|
|
|
Service Code
|
CPT 82947
|
| Hospital Charge Code |
900201848
|
|
Hospital Revenue Code
|
301
|
| 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: 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 Permanente of CA Commercial/Self Funded |
$72.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$41.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$66.85
|
| 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
|
|
