|
HC IMMUNOHISTO ANTIBOD ADD SLID
|
Facility
|
IP
|
$724.00
|
|
|
Service Code
|
CPT 88344
|
| Hospital Charge Code |
903800241
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$144.80 |
| Max. Negotiated Rate |
$651.60 |
| Rate for Payer: Adventist Health Commercial |
$144.80
|
| Rate for Payer: Cash Price |
$325.80
|
| Rate for Payer: Central Health Plan Commercial |
$579.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$506.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$289.60
|
| Rate for Payer: EPIC Health Plan Senior |
$289.60
|
| Rate for Payer: Galaxy Health WC |
$615.40
|
| Rate for Payer: Global Benefits Group Commercial |
$434.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$651.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$459.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$427.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$144.80
|
| Rate for Payer: Multiplan Commercial |
$543.00
|
| Rate for Payer: Networks By Design Commercial |
$470.60
|
| Rate for Payer: Prime Health Services Commercial |
$615.40
|
|
|
HC IMMUNOHISTOCHEM OR IMMUNOCYTOCHEM EA ABY STAIN
|
Facility
|
OP
|
$174.00
|
|
|
Service Code
|
CPT 88342
|
| Hospital Charge Code |
903800031
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$34.80 |
| Max. Negotiated Rate |
$399.07 |
| Rate for Payer: Adventist Health Commercial |
$34.80
|
| Rate for Payer: Adventist Health Commercial |
$126.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$219.12
|
| Rate for Payer: Adventist Health Medi-Cal |
$219.12
|
| Rate for Payer: Aetna of CA HMO/PPO |
$399.07
|
| Rate for Payer: Aetna of CA HMO/PPO |
$399.07
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$328.68
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$328.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$241.03
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$241.03
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$219.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$219.12
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$69.35
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$69.35
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$96.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$96.42
|
| Rate for Payer: Blue Shield of California Commercial |
$399.42
|
| Rate for Payer: Blue Shield of California Commercial |
$109.62
|
| Rate for Payer: Blue Shield of California EPN |
$251.70
|
| Rate for Payer: Blue Shield of California EPN |
$69.08
|
| Rate for Payer: Cash Price |
$285.30
|
| Rate for Payer: Cash Price |
$285.30
|
| Rate for Payer: Cash Price |
$78.30
|
| Rate for Payer: Cash Price |
$78.30
|
| Rate for Payer: Central Health Plan Commercial |
$139.20
|
| Rate for Payer: Central Health Plan Commercial |
$507.20
|
| Rate for Payer: Cigna of CA HMO |
$405.76
|
| Rate for Payer: Cigna of CA HMO |
$111.36
|
| Rate for Payer: Cigna of CA PPO |
$469.16
|
| Rate for Payer: Cigna of CA PPO |
$128.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$328.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$328.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$241.03
|
| Rate for Payer: Dignity Health Medi-Cal |
$241.03
|
| Rate for Payer: Dignity Health Medicare Advantage |
$219.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$219.12
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$121.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$443.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$361.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$361.55
|
| Rate for Payer: EPIC Health Plan Senior |
$241.03
|
| Rate for Payer: EPIC Health Plan Senior |
$241.03
|
| Rate for Payer: Galaxy Health WC |
$538.90
|
| Rate for Payer: Galaxy Health WC |
$147.90
|
| Rate for Payer: Global Benefits Group Commercial |
$380.40
|
| Rate for Payer: Global Benefits Group Commercial |
$104.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$570.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$156.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$359.36
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$359.36
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$92.52
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$92.52
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$219.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$219.12
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$110.49
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$402.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$102.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$102.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$306.77
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$306.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$34.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$126.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$293.62
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$293.62
|
| Rate for Payer: Multiplan Commercial |
$475.50
|
| Rate for Payer: Multiplan Commercial |
$130.50
|
| Rate for Payer: Networks By Design Commercial |
$113.10
|
| Rate for Payer: Networks By Design Commercial |
$412.10
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$219.12
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$219.12
|
| Rate for Payer: Prime Health Services Commercial |
$538.90
|
| Rate for Payer: Prime Health Services Commercial |
$147.90
|
| Rate for Payer: Prime Health Services Medicare |
$232.27
|
| Rate for Payer: Prime Health Services Medicare |
$232.27
|
| Rate for Payer: Riverside University Health System MISP |
$241.03
|
| Rate for Payer: Riverside University Health System MISP |
$241.03
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$104.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$380.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$380.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$104.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$123.38
|
| Rate for Payer: United Healthcare All Other Commercial |
$123.38
|
| Rate for Payer: United Healthcare All Other HMO |
$123.38
|
| Rate for Payer: United Healthcare All Other HMO |
$123.38
|
| Rate for Payer: United Healthcare HMO Rider |
$123.38
|
| Rate for Payer: United Healthcare HMO Rider |
$123.38
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$123.38
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$123.38
|
| Rate for Payer: Upland Medical Group Pediatric |
$219.12
|
| Rate for Payer: Upland Medical Group Pediatric |
$219.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$328.68
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$328.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$241.03
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$241.03
|
| Rate for Payer: Vantage Medical Group Senior |
$219.12
|
| Rate for Payer: Vantage Medical Group Senior |
$219.12
|
|
|
HC IMMUNOHISTOCHEM OR IMMUNOCYTOCHEM EA ABY STAIN
|
Facility
|
IP
|
$634.00
|
|
|
Service Code
|
CPT 88342
|
| Hospital Charge Code |
903800031
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$126.80 |
| Max. Negotiated Rate |
$570.60 |
| Rate for Payer: Adventist Health Commercial |
$126.80
|
| Rate for Payer: Cash Price |
$285.30
|
| Rate for Payer: Central Health Plan Commercial |
$507.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$443.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$253.60
|
| Rate for Payer: EPIC Health Plan Senior |
$253.60
|
| Rate for Payer: Galaxy Health WC |
$538.90
|
| Rate for Payer: Global Benefits Group Commercial |
$380.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$570.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$402.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$374.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$126.80
|
| Rate for Payer: Multiplan Commercial |
$475.50
|
| Rate for Payer: Networks By Design Commercial |
$412.10
|
| Rate for Payer: Prime Health Services Commercial |
$538.90
|
|
|
HC IMMUNOHISTOCHEM OR IMMUNOCYTOCHEM EA ADDITIONAL ABY STAIN
|
Facility
|
IP
|
$479.00
|
|
|
Service Code
|
CPT 88341
|
| Hospital Charge Code |
903800252
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$95.80 |
| Max. Negotiated Rate |
$431.10 |
| Rate for Payer: Adventist Health Commercial |
$95.80
|
| Rate for Payer: Cash Price |
$215.55
|
| Rate for Payer: Central Health Plan Commercial |
$383.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$335.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$191.60
|
| Rate for Payer: EPIC Health Plan Senior |
$191.60
|
| Rate for Payer: Galaxy Health WC |
$407.15
|
| Rate for Payer: Global Benefits Group Commercial |
$287.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$431.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$304.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$282.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$95.80
|
| Rate for Payer: Multiplan Commercial |
$359.25
|
| Rate for Payer: Networks By Design Commercial |
$311.35
|
| Rate for Payer: Prime Health Services Commercial |
$407.15
|
|
|
HC IMMUNOHISTOCHEM OR IMMUNOCYTOCHEM EA ADDITIONAL ABY STAIN
|
Facility
|
OP
|
$479.00
|
|
|
Service Code
|
CPT 88341
|
| Hospital Charge Code |
903800252
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$49.90 |
| Max. Negotiated Rate |
$449.19 |
| Rate for Payer: Adventist Health Commercial |
$95.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$276.66
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$407.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$263.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$359.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$323.10
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$449.19
|
| Rate for Payer: Blue Shield of California Commercial |
$301.77
|
| Rate for Payer: Blue Shield of California EPN |
$190.16
|
| Rate for Payer: Cash Price |
$215.55
|
| Rate for Payer: Cash Price |
$215.55
|
| Rate for Payer: Central Health Plan Commercial |
$383.20
|
| Rate for Payer: Cigna of CA HMO |
$306.56
|
| Rate for Payer: Cigna of CA PPO |
$354.46
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$407.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$407.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$407.15
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$335.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$191.60
|
| Rate for Payer: EPIC Health Plan Senior |
$191.60
|
| Rate for Payer: Galaxy Health WC |
$407.15
|
| Rate for Payer: Global Benefits Group Commercial |
$287.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$431.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$104.27
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$304.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$115.18
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$282.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$95.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$335.30
|
| Rate for Payer: Multiplan Commercial |
$359.25
|
| Rate for Payer: Networks By Design Commercial |
$311.35
|
| Rate for Payer: Prime Health Services Commercial |
$407.15
|
| Rate for Payer: Riverside University Health System MISP |
$191.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$287.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$287.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$49.90
|
| Rate for Payer: United Healthcare All Other HMO |
$49.90
|
| Rate for Payer: United Healthcare HMO Rider |
$49.90
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$49.90
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$407.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$407.15
|
| Rate for Payer: Vantage Medical Group Senior |
$407.15
|
|
|
HC IMMUNOHISTOCHEM STAIN ER/PR
|
Facility
|
OP
|
$192.00
|
|
|
Service Code
|
CPT 88360
|
| Hospital Charge Code |
903800179
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$38.40 |
| Max. Negotiated Rate |
$450.91 |
| Rate for Payer: Adventist Health Commercial |
$38.40
|
| Rate for Payer: Adventist Health Commercial |
$155.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$219.12
|
| Rate for Payer: Adventist Health Medi-Cal |
$219.12
|
| Rate for Payer: Aetna of CA HMO/PPO |
$450.91
|
| Rate for Payer: Aetna of CA HMO/PPO |
$450.91
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$328.68
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$328.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$241.03
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$241.03
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$219.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$219.12
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$271.04
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$271.04
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$376.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$376.81
|
| Rate for Payer: Blue Shield of California Commercial |
$489.51
|
| Rate for Payer: Blue Shield of California Commercial |
$120.96
|
| Rate for Payer: Blue Shield of California EPN |
$308.47
|
| Rate for Payer: Blue Shield of California EPN |
$76.22
|
| Rate for Payer: Cash Price |
$349.65
|
| Rate for Payer: Cash Price |
$349.65
|
| Rate for Payer: Cash Price |
$86.40
|
| Rate for Payer: Cash Price |
$86.40
|
| Rate for Payer: Central Health Plan Commercial |
$153.60
|
| Rate for Payer: Central Health Plan Commercial |
$621.60
|
| Rate for Payer: Cigna of CA HMO |
$497.28
|
| Rate for Payer: Cigna of CA HMO |
$122.88
|
| Rate for Payer: Cigna of CA PPO |
$574.98
|
| Rate for Payer: Cigna of CA PPO |
$142.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$328.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$328.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$241.03
|
| Rate for Payer: Dignity Health Medi-Cal |
$241.03
|
| Rate for Payer: Dignity Health Medicare Advantage |
$219.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$219.12
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$134.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$543.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$361.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$361.55
|
| Rate for Payer: EPIC Health Plan Senior |
$241.03
|
| Rate for Payer: EPIC Health Plan Senior |
$241.03
|
| Rate for Payer: Galaxy Health WC |
$660.45
|
| Rate for Payer: Galaxy Health WC |
$163.20
|
| Rate for Payer: Global Benefits Group Commercial |
$466.20
|
| Rate for Payer: Global Benefits Group Commercial |
$115.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$699.30
|
| Rate for Payer: Health Management Network EPO/PPO |
$172.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$359.36
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$359.36
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$97.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$97.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$219.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$219.12
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$121.92
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$493.39
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$107.81
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$107.81
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$306.77
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$306.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$38.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$155.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$293.62
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$293.62
|
| Rate for Payer: Multiplan Commercial |
$582.75
|
| Rate for Payer: Multiplan Commercial |
$144.00
|
| Rate for Payer: Networks By Design Commercial |
$124.80
|
| Rate for Payer: Networks By Design Commercial |
$505.05
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$219.12
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$219.12
|
| Rate for Payer: Prime Health Services Commercial |
$660.45
|
| Rate for Payer: Prime Health Services Commercial |
$163.20
|
| Rate for Payer: Prime Health Services Medicare |
$232.27
|
| Rate for Payer: Prime Health Services Medicare |
$232.27
|
| Rate for Payer: Riverside University Health System MISP |
$241.03
|
| Rate for Payer: Riverside University Health System MISP |
$241.03
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$115.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$466.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$466.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$115.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$123.38
|
| Rate for Payer: United Healthcare All Other Commercial |
$123.38
|
| Rate for Payer: United Healthcare All Other HMO |
$123.38
|
| Rate for Payer: United Healthcare All Other HMO |
$123.38
|
| Rate for Payer: United Healthcare HMO Rider |
$123.38
|
| Rate for Payer: United Healthcare HMO Rider |
$123.38
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$123.38
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$123.38
|
| Rate for Payer: Upland Medical Group Pediatric |
$219.12
|
| Rate for Payer: Upland Medical Group Pediatric |
$219.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$328.68
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$328.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$241.03
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$241.03
|
| Rate for Payer: Vantage Medical Group Senior |
$219.12
|
| Rate for Payer: Vantage Medical Group Senior |
$219.12
|
|
|
HC IMMUNOHISTOCHEM STAIN ER/PR
|
Facility
|
IP
|
$777.00
|
|
|
Service Code
|
CPT 88360
|
| Hospital Charge Code |
903800179
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$155.40 |
| Max. Negotiated Rate |
$699.30 |
| Rate for Payer: Adventist Health Commercial |
$155.40
|
| Rate for Payer: Cash Price |
$349.65
|
| Rate for Payer: Central Health Plan Commercial |
$621.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$543.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$310.80
|
| Rate for Payer: EPIC Health Plan Senior |
$310.80
|
| Rate for Payer: Galaxy Health WC |
$660.45
|
| Rate for Payer: Global Benefits Group Commercial |
$466.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$699.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$493.39
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$458.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$155.40
|
| Rate for Payer: Multiplan Commercial |
$582.75
|
| Rate for Payer: Networks By Design Commercial |
$505.05
|
| Rate for Payer: Prime Health Services Commercial |
$660.45
|
|
|
HC IMMUNOTYPING
|
Facility
|
IP
|
$28.00
|
|
|
Service Code
|
CPT 86334
|
| Hospital Charge Code |
900913720
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.60 |
| Max. Negotiated Rate |
$25.20 |
| Rate for Payer: Adventist Health Commercial |
$5.60
|
| Rate for Payer: Cash Price |
$12.60
|
| Rate for Payer: Central Health Plan Commercial |
$22.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$19.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.20
|
| Rate for Payer: EPIC Health Plan Senior |
$11.20
|
| Rate for Payer: Galaxy Health WC |
$23.80
|
| Rate for Payer: Global Benefits Group Commercial |
$16.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$25.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$17.78
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$16.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.60
|
| Rate for Payer: Multiplan Commercial |
$21.00
|
| Rate for Payer: Networks By Design Commercial |
$18.20
|
| Rate for Payer: Prime Health Services Commercial |
$23.80
|
|
|
HC IMMUNOTYPING
|
Facility
|
OP
|
$23.00
|
|
|
Service Code
|
CPT 86334
|
| Hospital Charge Code |
900913720
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.60 |
| Max. Negotiated Rate |
$225.92 |
| Rate for Payer: Adventist Health Commercial |
$4.60
|
| Rate for Payer: Adventist Health Commercial |
$5.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$22.34
|
| Rate for Payer: Adventist Health Medi-Cal |
$22.34
|
| Rate for Payer: Aetna of CA HMO/PPO |
$163.95
|
| Rate for Payer: Aetna of CA HMO/PPO |
$163.95
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$33.51
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$33.51
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$24.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$24.57
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$22.34
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$22.34
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$162.51
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$162.51
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$225.92
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$225.92
|
| Rate for Payer: Blue Shield of California Commercial |
$17.64
|
| Rate for Payer: Blue Shield of California Commercial |
$14.49
|
| Rate for Payer: Blue Shield of California EPN |
$11.12
|
| Rate for Payer: Blue Shield of California EPN |
$9.13
|
| Rate for Payer: Cash Price |
$12.60
|
| Rate for Payer: Cash Price |
$12.60
|
| Rate for Payer: Cash Price |
$10.35
|
| Rate for Payer: Cash Price |
$10.35
|
| Rate for Payer: Central Health Plan Commercial |
$18.40
|
| Rate for Payer: Central Health Plan Commercial |
$22.40
|
| Rate for Payer: Cigna of CA HMO |
$17.92
|
| Rate for Payer: Cigna of CA HMO |
$14.72
|
| Rate for Payer: Cigna of CA PPO |
$20.72
|
| Rate for Payer: Cigna of CA PPO |
$17.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$33.51
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$33.51
|
| Rate for Payer: Dignity Health Medi-Cal |
$24.57
|
| Rate for Payer: Dignity Health Medi-Cal |
$24.57
|
| Rate for Payer: Dignity Health Medicare Advantage |
$22.34
|
| Rate for Payer: Dignity Health Medicare Advantage |
$22.34
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$16.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$19.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$36.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$36.86
|
| Rate for Payer: EPIC Health Plan Senior |
$24.57
|
| Rate for Payer: EPIC Health Plan Senior |
$24.57
|
| Rate for Payer: Galaxy Health WC |
$23.80
|
| Rate for Payer: Galaxy Health WC |
$19.55
|
| Rate for Payer: Global Benefits Group Commercial |
$16.80
|
| Rate for Payer: Global Benefits Group Commercial |
$13.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$25.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$20.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$36.64
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$36.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$34.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$34.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$22.34
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$22.34
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$14.61
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$17.78
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$37.73
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$37.73
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$31.28
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$31.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$29.94
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$29.94
|
| Rate for Payer: Multiplan Commercial |
$21.00
|
| Rate for Payer: Multiplan Commercial |
$17.25
|
| Rate for Payer: Networks By Design Commercial |
$14.95
|
| Rate for Payer: Networks By Design Commercial |
$18.20
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$22.34
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$22.34
|
| Rate for Payer: Prime Health Services Commercial |
$23.80
|
| Rate for Payer: Prime Health Services Commercial |
$19.55
|
| Rate for Payer: Prime Health Services Medicare |
$23.68
|
| Rate for Payer: Prime Health Services Medicare |
$23.68
|
| Rate for Payer: Riverside University Health System MISP |
$24.57
|
| Rate for Payer: Riverside University Health System MISP |
$24.57
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$13.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$16.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$16.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$13.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$18.10
|
| Rate for Payer: United Healthcare All Other Commercial |
$18.10
|
| Rate for Payer: United Healthcare All Other HMO |
$18.10
|
| Rate for Payer: United Healthcare All Other HMO |
$18.10
|
| Rate for Payer: United Healthcare HMO Rider |
$18.10
|
| Rate for Payer: United Healthcare HMO Rider |
$18.10
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$18.10
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$18.10
|
| Rate for Payer: Upland Medical Group Pediatric |
$22.34
|
| Rate for Payer: Upland Medical Group Pediatric |
$22.34
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$33.51
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$33.51
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$24.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$24.57
|
| Rate for Payer: Vantage Medical Group Senior |
$22.34
|
| Rate for Payer: Vantage Medical Group Senior |
$22.34
|
|
|
HC IMMUNOTYPING ELECTROPHORESIS
|
Facility
|
IP
|
$337.00
|
|
|
Service Code
|
CPT 86334
|
| Hospital Charge Code |
900913611
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$67.40 |
| Max. Negotiated Rate |
$303.30 |
| Rate for Payer: Adventist Health Commercial |
$67.40
|
| Rate for Payer: Cash Price |
$151.65
|
| Rate for Payer: Central Health Plan Commercial |
$269.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$235.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$134.80
|
| Rate for Payer: EPIC Health Plan Senior |
$134.80
|
| Rate for Payer: Galaxy Health WC |
$286.45
|
| Rate for Payer: Global Benefits Group Commercial |
$202.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$303.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$214.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$198.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$67.40
|
| Rate for Payer: Multiplan Commercial |
$252.75
|
| Rate for Payer: Networks By Design Commercial |
$219.05
|
| Rate for Payer: Prime Health Services Commercial |
$286.45
|
|
|
HC IMMUNOTYPING ELECTROPHORESIS
|
Facility
|
OP
|
$196.00
|
|
|
Service Code
|
CPT 86334
|
| Hospital Charge Code |
900913611
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$18.10 |
| Max. Negotiated Rate |
$225.92 |
| Rate for Payer: Adventist Health Commercial |
$39.20
|
| Rate for Payer: Adventist Health Commercial |
$67.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$22.34
|
| Rate for Payer: Adventist Health Medi-Cal |
$22.34
|
| Rate for Payer: Aetna of CA HMO/PPO |
$163.95
|
| Rate for Payer: Aetna of CA HMO/PPO |
$163.95
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$33.51
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$33.51
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$24.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$24.57
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$22.34
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$22.34
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$162.51
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$162.51
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$225.92
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$225.92
|
| Rate for Payer: Blue Shield of California Commercial |
$212.31
|
| Rate for Payer: Blue Shield of California Commercial |
$123.48
|
| Rate for Payer: Blue Shield of California EPN |
$133.79
|
| Rate for Payer: Blue Shield of California EPN |
$77.81
|
| Rate for Payer: Cash Price |
$151.65
|
| Rate for Payer: Cash Price |
$151.65
|
| Rate for Payer: Cash Price |
$88.20
|
| Rate for Payer: Cash Price |
$88.20
|
| Rate for Payer: Central Health Plan Commercial |
$156.80
|
| Rate for Payer: Central Health Plan Commercial |
$269.60
|
| Rate for Payer: Cigna of CA HMO |
$215.68
|
| Rate for Payer: Cigna of CA HMO |
$125.44
|
| Rate for Payer: Cigna of CA PPO |
$249.38
|
| Rate for Payer: Cigna of CA PPO |
$145.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$33.51
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$33.51
|
| Rate for Payer: Dignity Health Medi-Cal |
$24.57
|
| Rate for Payer: Dignity Health Medi-Cal |
$24.57
|
| Rate for Payer: Dignity Health Medicare Advantage |
$22.34
|
| Rate for Payer: Dignity Health Medicare Advantage |
$22.34
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$137.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$235.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$36.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$36.86
|
| Rate for Payer: EPIC Health Plan Senior |
$24.57
|
| Rate for Payer: EPIC Health Plan Senior |
$24.57
|
| Rate for Payer: Galaxy Health WC |
$286.45
|
| Rate for Payer: Galaxy Health WC |
$166.60
|
| Rate for Payer: Global Benefits Group Commercial |
$202.20
|
| Rate for Payer: Global Benefits Group Commercial |
$117.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$303.30
|
| Rate for Payer: Health Management Network EPO/PPO |
$176.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$36.64
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$36.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$34.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$34.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$22.34
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$22.34
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$124.46
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$214.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$37.73
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$37.73
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$31.28
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$31.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$39.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$67.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$29.94
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$29.94
|
| Rate for Payer: Multiplan Commercial |
$252.75
|
| Rate for Payer: Multiplan Commercial |
$147.00
|
| Rate for Payer: Networks By Design Commercial |
$127.40
|
| Rate for Payer: Networks By Design Commercial |
$219.05
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$22.34
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$22.34
|
| Rate for Payer: Prime Health Services Commercial |
$286.45
|
| Rate for Payer: Prime Health Services Commercial |
$166.60
|
| Rate for Payer: Prime Health Services Medicare |
$23.68
|
| Rate for Payer: Prime Health Services Medicare |
$23.68
|
| Rate for Payer: Riverside University Health System MISP |
$24.57
|
| Rate for Payer: Riverside University Health System MISP |
$24.57
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$117.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$202.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$202.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$117.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$18.10
|
| Rate for Payer: United Healthcare All Other Commercial |
$18.10
|
| Rate for Payer: United Healthcare All Other HMO |
$18.10
|
| Rate for Payer: United Healthcare All Other HMO |
$18.10
|
| Rate for Payer: United Healthcare HMO Rider |
$18.10
|
| Rate for Payer: United Healthcare HMO Rider |
$18.10
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$18.10
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$18.10
|
| Rate for Payer: Upland Medical Group Pediatric |
$22.34
|
| Rate for Payer: Upland Medical Group Pediatric |
$22.34
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$33.51
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$33.51
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$24.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$24.57
|
| Rate for Payer: Vantage Medical Group Senior |
$22.34
|
| Rate for Payer: Vantage Medical Group Senior |
$22.34
|
|
|
HC IMPEDANCE TESTING
|
Facility
|
IP
|
$394.00
|
|
|
Service Code
|
CPT 92567
|
| Hospital Charge Code |
908710301
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$78.80 |
| Max. Negotiated Rate |
$354.60 |
| Rate for Payer: Adventist Health Commercial |
$78.80
|
| Rate for Payer: Cash Price |
$177.30
|
| Rate for Payer: Central Health Plan Commercial |
$315.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$275.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$157.60
|
| Rate for Payer: EPIC Health Plan Senior |
$157.60
|
| Rate for Payer: Galaxy Health WC |
$334.90
|
| Rate for Payer: Global Benefits Group Commercial |
$236.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$354.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$250.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$232.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$78.80
|
| Rate for Payer: Multiplan Commercial |
$295.50
|
| Rate for Payer: Networks By Design Commercial |
$256.10
|
| Rate for Payer: Prime Health Services Commercial |
$334.90
|
|
|
HC IMPEDANCE TESTING
|
Facility
|
OP
|
$394.00
|
|
|
Service Code
|
CPT 92567
|
| Hospital Charge Code |
908710301
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$48.04 |
| Max. Negotiated Rate |
$1,833.00 |
| Rate for Payer: Adventist Health Commercial |
$161.54
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$74.43
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$72.06
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$52.84
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$48.04
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$229.19
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$79.47
|
| Rate for Payer: Cash Price |
$177.30
|
| Rate for Payer: Cash Price |
$177.30
|
| Rate for Payer: Cash Price |
$177.30
|
| Rate for Payer: Cash Price |
$177.30
|
| Rate for Payer: Central Health Plan Commercial |
$315.20
|
| Rate for Payer: Cigna of CA HMO |
$252.16
|
| Rate for Payer: Cigna of CA PPO |
$291.56
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$72.06
|
| Rate for Payer: Dignity Health Medi-Cal |
$52.84
|
| Rate for Payer: Dignity Health Medicare Advantage |
$48.04
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$275.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$79.27
|
| Rate for Payer: EPIC Health Plan Senior |
$52.84
|
| Rate for Payer: Galaxy Health WC |
$334.90
|
| Rate for Payer: Global Benefits Group Commercial |
$236.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$354.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$78.79
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$48.04
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$250.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$143.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$51.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$78.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$64.37
|
| Rate for Payer: Multiplan Commercial |
$295.50
|
| Rate for Payer: Multiplan WC |
$79.47
|
| Rate for Payer: Networks By Design Commercial |
$256.10
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$48.04
|
| Rate for Payer: Preferred Health Network WC |
$81.09
|
| Rate for Payer: Prime Health Services Commercial |
$334.90
|
| Rate for Payer: Prime Health Services Medicare |
$50.92
|
| Rate for Payer: Prime Health Services WC |
$78.66
|
| Rate for Payer: Riverside University Health System MISP |
$52.84
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$236.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$236.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$48.04
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$72.06
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$52.84
|
| Rate for Payer: Vantage Medical Group Senior |
$48.04
|
|
|
HC IMPEDANCE TESTING
|
Facility
|
OP
|
$394.00
|
|
|
Service Code
|
CPT 92567
|
| Hospital Charge Code |
908710301
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$48.04 |
| Max. Negotiated Rate |
$354.60 |
| Rate for Payer: Adventist Health Commercial |
$78.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$48.04
|
| Rate for Payer: Aetna of CA HMO/PPO |
$74.43
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$72.06
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$52.84
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$48.04
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$190.77
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$229.19
|
| Rate for Payer: Blue Shield of California Commercial |
$249.80
|
| Rate for Payer: Blue Shield of California EPN |
$157.21
|
| Rate for Payer: Cash Price |
$177.30
|
| Rate for Payer: Cash Price |
$177.30
|
| Rate for Payer: Central Health Plan Commercial |
$315.20
|
| Rate for Payer: Cigna of CA HMO |
$252.16
|
| Rate for Payer: Cigna of CA PPO |
$291.56
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$72.06
|
| Rate for Payer: Dignity Health Medi-Cal |
$52.84
|
| Rate for Payer: Dignity Health Medicare Advantage |
$48.04
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$275.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$79.27
|
| Rate for Payer: EPIC Health Plan Senior |
$52.84
|
| Rate for Payer: Galaxy Health WC |
$334.90
|
| Rate for Payer: Global Benefits Group Commercial |
$236.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$354.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$78.79
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$48.04
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$250.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$143.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$67.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$78.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$64.37
|
| Rate for Payer: Multiplan Commercial |
$295.50
|
| Rate for Payer: Networks By Design Commercial |
$256.10
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$48.04
|
| Rate for Payer: Prime Health Services Commercial |
$334.90
|
| Rate for Payer: Prime Health Services Medicare |
$50.92
|
| Rate for Payer: Riverside University Health System MISP |
$52.84
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$236.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$236.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$197.00
|
| Rate for Payer: United Healthcare All Other HMO |
$197.00
|
| Rate for Payer: United Healthcare HMO Rider |
$197.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$197.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$48.04
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$72.06
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$52.84
|
| Rate for Payer: Vantage Medical Group Senior |
$48.04
|
|
|
HC IMPEDANCE TESTING
|
Facility
|
IP
|
$394.00
|
|
|
Service Code
|
CPT 92567
|
| Hospital Charge Code |
908710301
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$78.80 |
| Max. Negotiated Rate |
$354.60 |
| Rate for Payer: Adventist Health Commercial |
$78.80
|
| Rate for Payer: Cash Price |
$177.30
|
| Rate for Payer: Central Health Plan Commercial |
$315.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$275.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$157.60
|
| Rate for Payer: EPIC Health Plan Senior |
$157.60
|
| Rate for Payer: Galaxy Health WC |
$334.90
|
| Rate for Payer: Global Benefits Group Commercial |
$236.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$354.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$250.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$232.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$78.80
|
| Rate for Payer: Multiplan Commercial |
$295.50
|
| Rate for Payer: Networks By Design Commercial |
$256.10
|
| Rate for Payer: Prime Health Services Commercial |
$334.90
|
|
|
HC IMPELLA LT ART VEN TRANS
|
Facility
|
IP
|
$12,136.00
|
|
|
Service Code
|
CPT 33991
|
| Hospital Charge Code |
906811991
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,427.20 |
| Max. Negotiated Rate |
$10,922.40 |
| Rate for Payer: Adventist Health Commercial |
$2,427.20
|
| Rate for Payer: Cash Price |
$5,461.20
|
| Rate for Payer: Central Health Plan Commercial |
$9,708.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8,495.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,854.40
|
| Rate for Payer: EPIC Health Plan Senior |
$4,854.40
|
| Rate for Payer: Galaxy Health WC |
$10,315.60
|
| Rate for Payer: Global Benefits Group Commercial |
$7,281.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,922.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7,706.36
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7,160.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,427.20
|
| Rate for Payer: Multiplan Commercial |
$9,102.00
|
| Rate for Payer: Networks By Design Commercial |
$7,888.40
|
| Rate for Payer: Prime Health Services Commercial |
$10,315.60
|
|
|
HC IMPELLA LT ART VEN TRANS
|
Facility
|
OP
|
$12,136.00
|
|
|
Service Code
|
CPT 33991
|
| Hospital Charge Code |
906811991
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$175.46 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$2,427.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10,315.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6,674.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9,102.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,461.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,933.00
|
| Rate for Payer: Blue Shield of California Commercial |
$9,579.41
|
| Rate for Payer: Blue Shield of California EPN |
$6,020.76
|
| Rate for Payer: Cash Price |
$5,461.20
|
| Rate for Payer: Cash Price |
$5,461.20
|
| Rate for Payer: Cash Price |
$5,461.20
|
| Rate for Payer: Central Health Plan Commercial |
$9,708.80
|
| Rate for Payer: Cigna of CA HMO |
$7,767.04
|
| Rate for Payer: Cigna of CA PPO |
$8,980.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,315.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$10,315.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10,315.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8,495.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,854.40
|
| Rate for Payer: EPIC Health Plan Senior |
$4,854.40
|
| Rate for Payer: Galaxy Health WC |
$10,315.60
|
| Rate for Payer: Global Benefits Group Commercial |
$7,281.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,922.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$175.46
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7,706.36
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$193.82
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7,160.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,427.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$8,495.20
|
| Rate for Payer: Multiplan Commercial |
$9,102.00
|
| Rate for Payer: Networks By Design Commercial |
$7,888.40
|
| Rate for Payer: Prime Health Services Commercial |
$10,315.60
|
| Rate for Payer: Riverside University Health System MISP |
$4,854.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,281.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,068.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,315.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10,315.60
|
| Rate for Payer: Vantage Medical Group Senior |
$10,315.60
|
|
|
HC IMPLANTABLE PORT FOR MEDS
|
Facility
|
IP
|
$1,620.00
|
|
|
Service Code
|
CPT C1788
|
| Hospital Charge Code |
909081100
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$324.00 |
| Max. Negotiated Rate |
$1,458.00 |
| Rate for Payer: Adventist Health Commercial |
$324.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,299.24
|
| Rate for Payer: Blue Shield of California EPN |
$816.48
|
| Rate for Payer: Cash Price |
$729.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,296.00
|
| Rate for Payer: Cigna of CA HMO |
$1,134.00
|
| Rate for Payer: Cigna of CA PPO |
$1,134.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,134.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$648.00
|
| Rate for Payer: EPIC Health Plan Senior |
$648.00
|
| Rate for Payer: Galaxy Health WC |
$1,377.00
|
| Rate for Payer: Global Benefits Group Commercial |
$972.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,458.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,028.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$955.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$324.00
|
| Rate for Payer: Multiplan Commercial |
$1,215.00
|
| Rate for Payer: Networks By Design Commercial |
$810.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,377.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$607.99
|
| Rate for Payer: United Healthcare All Other HMO |
$591.79
|
| Rate for Payer: United Healthcare HMO Rider |
$578.99
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$530.55
|
|
|
HC IMPLANTABLE PORT FOR MEDS
|
Facility
|
OP
|
$1,620.00
|
|
|
Service Code
|
CPT C1788
|
| Hospital Charge Code |
909081100
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$324.00 |
| Max. Negotiated Rate |
$1,458.00 |
| Rate for Payer: Adventist Health Commercial |
$324.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,377.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$891.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,215.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$739.69
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$888.41
|
| Rate for Payer: Blue Shield of California Commercial |
$1,299.24
|
| Rate for Payer: Blue Shield of California EPN |
$816.48
|
| Rate for Payer: Cash Price |
$729.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,296.00
|
| Rate for Payer: Cigna of CA HMO |
$1,134.00
|
| Rate for Payer: Cigna of CA PPO |
$1,134.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,377.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,377.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,377.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,134.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$648.00
|
| Rate for Payer: EPIC Health Plan Senior |
$648.00
|
| Rate for Payer: Galaxy Health WC |
$1,377.00
|
| Rate for Payer: Global Benefits Group Commercial |
$972.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,458.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,028.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$588.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$955.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$324.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,134.00
|
| Rate for Payer: Multiplan Commercial |
$1,215.00
|
| Rate for Payer: Networks By Design Commercial |
$810.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,377.00
|
| Rate for Payer: Riverside University Health System MISP |
$648.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$972.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$972.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$607.99
|
| Rate for Payer: United Healthcare All Other HMO |
$591.79
|
| Rate for Payer: United Healthcare HMO Rider |
$578.99
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$530.55
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,377.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,377.00
|
| Rate for Payer: Vantage Medical Group Senior |
$1,377.00
|
|
|
HC IMPLANTED GRID/DEPTH
|
Facility
|
OP
|
$2,172.00
|
|
| Hospital Charge Code |
900600801
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$434.40 |
| Max. Negotiated Rate |
$1,954.80 |
| Rate for Payer: Adventist Health Commercial |
$434.40
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,846.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,194.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,629.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$991.74
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,191.12
|
| Rate for Payer: Blue Shield of California Commercial |
$1,741.94
|
| Rate for Payer: Blue Shield of California EPN |
$1,094.69
|
| Rate for Payer: Cash Price |
$977.40
|
| Rate for Payer: Central Health Plan Commercial |
$1,737.60
|
| Rate for Payer: Cigna of CA HMO |
$1,520.40
|
| Rate for Payer: Cigna of CA PPO |
$1,520.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,846.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,846.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,846.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,520.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$868.80
|
| Rate for Payer: EPIC Health Plan Senior |
$868.80
|
| Rate for Payer: Galaxy Health WC |
$1,846.20
|
| Rate for Payer: Global Benefits Group Commercial |
$1,303.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,954.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,379.22
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$788.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,281.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$434.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,520.40
|
| Rate for Payer: Multiplan Commercial |
$1,629.00
|
| Rate for Payer: Networks By Design Commercial |
$1,086.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,846.20
|
| Rate for Payer: Riverside University Health System MISP |
$868.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,303.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,303.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$815.15
|
| Rate for Payer: United Healthcare All Other HMO |
$793.43
|
| Rate for Payer: United Healthcare HMO Rider |
$776.27
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$711.33
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,846.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,846.20
|
| Rate for Payer: Vantage Medical Group Senior |
$1,846.20
|
|
|
HC IMPLANTED GRID/DEPTH
|
Facility
|
IP
|
$2,172.00
|
|
| Hospital Charge Code |
900600801
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$434.40 |
| Max. Negotiated Rate |
$1,954.80 |
| Rate for Payer: Adventist Health Commercial |
$434.40
|
| Rate for Payer: Blue Shield of California Commercial |
$1,741.94
|
| Rate for Payer: Blue Shield of California EPN |
$1,094.69
|
| Rate for Payer: Cash Price |
$977.40
|
| Rate for Payer: Central Health Plan Commercial |
$1,737.60
|
| Rate for Payer: Cigna of CA HMO |
$1,520.40
|
| Rate for Payer: Cigna of CA PPO |
$1,520.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,520.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$868.80
|
| Rate for Payer: EPIC Health Plan Senior |
$868.80
|
| Rate for Payer: Galaxy Health WC |
$1,846.20
|
| Rate for Payer: Global Benefits Group Commercial |
$1,303.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,954.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,379.22
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,281.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$434.40
|
| Rate for Payer: Multiplan Commercial |
$1,629.00
|
| Rate for Payer: Networks By Design Commercial |
$1,086.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,846.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$815.15
|
| Rate for Payer: United Healthcare All Other HMO |
$793.43
|
| Rate for Payer: United Healthcare HMO Rider |
$776.27
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$711.33
|
|
|
HC IMPLANTED PERIONEAL PORT
|
Facility
|
OP
|
$28,856.00
|
|
|
Service Code
|
CPT 49419
|
| Hospital Charge Code |
909001457
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$365.00 |
| Max. Negotiated Rate |
$28,817.00 |
| Rate for Payer: Adventist Health Commercial |
$5,771.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$7,156.86
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10,735.29
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7,872.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,156.86
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$10,943.70
|
| Rate for Payer: Blue Shield of California Commercial |
$13,231.02
|
| Rate for Payer: Blue Shield of California EPN |
$8,315.83
|
| Rate for Payer: Cash Price |
$12,985.20
|
| Rate for Payer: Cash Price |
$12,985.20
|
| Rate for Payer: Cash Price |
$12,985.20
|
| Rate for Payer: Central Health Plan Commercial |
$23,084.80
|
| Rate for Payer: Cigna of CA HMO |
$18,467.84
|
| Rate for Payer: Cigna of CA PPO |
$21,353.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,735.29
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,872.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7,156.86
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$20,199.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$11,808.82
|
| Rate for Payer: EPIC Health Plan Senior |
$7,872.55
|
| Rate for Payer: Galaxy Health WC |
$24,527.60
|
| Rate for Payer: Global Benefits Group Commercial |
$17,313.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$25,970.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$11,737.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$365.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7,156.86
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$18,323.56
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$403.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10,019.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,771.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$9,590.19
|
| Rate for Payer: Multiplan Commercial |
$21,642.00
|
| Rate for Payer: Multiplan WC |
$10,943.70
|
| Rate for Payer: Networks By Design Commercial |
$18,756.40
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$7,156.86
|
| Rate for Payer: Preferred Health Network WC |
$11,167.04
|
| Rate for Payer: Prime Health Services Commercial |
$24,527.60
|
| Rate for Payer: Prime Health Services Medicare |
$7,586.27
|
| Rate for Payer: Prime Health Services WC |
$10,832.03
|
| Rate for Payer: Riverside University Health System MISP |
$7,872.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$17,313.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$14,428.00
|
| Rate for Payer: United Healthcare All Other HMO |
$28,817.00
|
| Rate for Payer: United Healthcare HMO Rider |
$18,075.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16,561.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$7,156.86
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,735.29
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,872.55
|
| Rate for Payer: Vantage Medical Group Senior |
$7,156.86
|
|
|
HC IMPLANTED PERIONEAL PORT
|
Facility
|
IP
|
$28,856.00
|
|
|
Service Code
|
CPT 49419
|
| Hospital Charge Code |
909001457
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,771.20 |
| Max. Negotiated Rate |
$25,970.40 |
| Rate for Payer: Adventist Health Commercial |
$5,771.20
|
| Rate for Payer: Cash Price |
$12,985.20
|
| Rate for Payer: Central Health Plan Commercial |
$23,084.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$20,199.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$11,542.40
|
| Rate for Payer: EPIC Health Plan Senior |
$11,542.40
|
| Rate for Payer: Galaxy Health WC |
$24,527.60
|
| Rate for Payer: Global Benefits Group Commercial |
$17,313.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$25,970.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$18,323.56
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$17,025.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,771.20
|
| Rate for Payer: Multiplan Commercial |
$21,642.00
|
| Rate for Payer: Networks By Design Commercial |
$18,756.40
|
| Rate for Payer: Prime Health Services Commercial |
$24,527.60
|
|
|
HC IMPL AROA MATRIX 10CM W X 10CM L 1MM THK
|
Facility
|
OP
|
$4,501.00
|
|
|
Service Code
|
CPT A2032
|
| Hospital Charge Code |
900104001
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$160.06 |
| Max. Negotiated Rate |
$4,050.90 |
| Rate for Payer: Adventist Health Commercial |
$900.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$160.06
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,733.46
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$240.09
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$176.07
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$160.06
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,179.38
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,618.23
|
| Rate for Payer: Blue Shield of California Commercial |
$2,853.63
|
| Rate for Payer: Blue Shield of California EPN |
$1,795.90
|
| Rate for Payer: Cash Price |
$2,025.45
|
| Rate for Payer: Cash Price |
$2,025.45
|
| Rate for Payer: Central Health Plan Commercial |
$3,600.80
|
| Rate for Payer: Cigna of CA HMO |
$3,150.70
|
| Rate for Payer: Cigna of CA PPO |
$3,150.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$240.09
|
| Rate for Payer: Dignity Health Medi-Cal |
$176.07
|
| Rate for Payer: Dignity Health Medicare Advantage |
$160.06
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,150.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$264.10
|
| Rate for Payer: EPIC Health Plan Senior |
$176.07
|
| Rate for Payer: Galaxy Health WC |
$3,825.85
|
| Rate for Payer: Global Benefits Group Commercial |
$2,700.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,050.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$262.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$160.06
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,858.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$224.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$900.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$214.48
|
| Rate for Payer: Multiplan Commercial |
$3,375.75
|
| Rate for Payer: Networks By Design Commercial |
$2,250.50
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$160.06
|
| Rate for Payer: Prime Health Services Commercial |
$3,825.85
|
| Rate for Payer: Prime Health Services Medicare |
$169.66
|
| Rate for Payer: Riverside University Health System MISP |
$176.07
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,700.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,700.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,689.23
|
| Rate for Payer: United Healthcare All Other HMO |
$1,644.22
|
| Rate for Payer: United Healthcare HMO Rider |
$1,608.66
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,474.08
|
| Rate for Payer: Upland Medical Group Pediatric |
$160.06
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$240.09
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$176.07
|
| Rate for Payer: Vantage Medical Group Senior |
$160.06
|
|
|
HC IMPL AROA MATRIX 10CM W X 10CM L 1MM THK
|
Facility
|
IP
|
$4,501.00
|
|
|
Service Code
|
CPT A2032
|
| Hospital Charge Code |
900104001
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$900.20 |
| Max. Negotiated Rate |
$4,050.90 |
| Rate for Payer: Adventist Health Commercial |
$900.20
|
| Rate for Payer: Blue Shield of California Commercial |
$3,609.80
|
| Rate for Payer: Blue Shield of California EPN |
$2,268.50
|
| Rate for Payer: Cash Price |
$2,025.45
|
| Rate for Payer: Central Health Plan Commercial |
$3,600.80
|
| Rate for Payer: Cigna of CA HMO |
$3,150.70
|
| Rate for Payer: Cigna of CA PPO |
$3,150.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,150.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,800.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,800.40
|
| Rate for Payer: Galaxy Health WC |
$3,825.85
|
| Rate for Payer: Global Benefits Group Commercial |
$2,700.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,050.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,858.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,655.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$900.20
|
| Rate for Payer: Multiplan Commercial |
$3,375.75
|
| Rate for Payer: Networks By Design Commercial |
$2,250.50
|
| Rate for Payer: Prime Health Services Commercial |
$3,825.85
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,689.23
|
| Rate for Payer: United Healthcare All Other HMO |
$1,644.22
|
| Rate for Payer: United Healthcare HMO Rider |
$1,608.66
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,474.08
|
|
