|
HC HEMOGLOBIN (POC)
|
Facility
|
OP
|
$95.00
|
|
|
Service Code
|
CPT 85018
|
| Hospital Charge Code |
900912023
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$1.92 |
| Max. Negotiated Rate |
$85.50 |
| Rate for Payer: Adventist Health Commercial |
$19.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$2.37
|
| Rate for Payer: Aetna of CA HMO/PPO |
$57.69
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3.56
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2.61
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2.37
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$17.19
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3.49
|
| Rate for Payer: Blue Shield of California Commercial |
$57.66
|
| Rate for Payer: Blue Shield of California EPN |
$37.72
|
| Rate for Payer: Cash Price |
$52.25
|
| Rate for Payer: Cash Price |
$52.25
|
| Rate for Payer: Central Health Plan Commercial |
$76.00
|
| Rate for Payer: Cigna of CA HMO |
$60.80
|
| Rate for Payer: Cigna of CA PPO |
$70.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3.56
|
| Rate for Payer: Dignity Health Medi-Cal |
$2.61
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2.37
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.20
|
| Rate for Payer: EPIC Health Plan Senior |
$2.37
|
| Rate for Payer: Galaxy Health WC |
$80.75
|
| Rate for Payer: Global Benefits Group Commercial |
$57.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$85.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3.89
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3.56
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2.37
|
| Rate for Payer: InnovAge PACE Commercial |
$3.56
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$63.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3.18
|
| Rate for Payer: Multiplan Commercial |
$71.25
|
| Rate for Payer: Networks By Design Commercial |
$61.75
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2.37
|
| Rate for Payer: Prime Health Services Commercial |
$80.75
|
| Rate for Payer: Prime Health Services Medicare |
$2.51
|
| Rate for Payer: Riverside University Health System MISP |
$2.61
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$57.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$57.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.92
|
| Rate for Payer: United Healthcare All Other HMO |
$1.92
|
| Rate for Payer: United Healthcare HMO Rider |
$1.92
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.92
|
| Rate for Payer: Upland Medical Group Pediatric |
$2.37
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3.56
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2.61
|
| Rate for Payer: Vantage Medical Group Senior |
$2.37
|
|
|
HC HEMOGLOBIN (POC)
|
Facility
|
IP
|
$95.00
|
|
|
Service Code
|
CPT 85018
|
| Hospital Charge Code |
900912023
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$19.00 |
| Max. Negotiated Rate |
$85.50 |
| Rate for Payer: Adventist Health Commercial |
$19.00
|
| Rate for Payer: Cash Price |
$52.25
|
| Rate for Payer: Central Health Plan Commercial |
$76.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$38.00
|
| Rate for Payer: EPIC Health Plan Senior |
$38.00
|
| Rate for Payer: Galaxy Health WC |
$80.75
|
| Rate for Payer: Global Benefits Group Commercial |
$57.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$85.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$63.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$36.20
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$58.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.00
|
| Rate for Payer: Multiplan Commercial |
$71.25
|
| Rate for Payer: Networks By Design Commercial |
$61.75
|
| Rate for Payer: Prime Health Services Commercial |
$80.75
|
|
|
HC HEMOPH INFLUENZA ADMIN
|
Facility
|
OP
|
$24.00
|
|
| Hospital Charge Code |
902890230
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$4.80 |
| Max. Negotiated Rate |
$1,833.00 |
| Rate for Payer: Adventist Health Commercial |
$9.84
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$14.58
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$18.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14.10
|
| Rate for Payer: Cash Price |
$13.20
|
| Rate for Payer: Cash Price |
$13.20
|
| Rate for Payer: Cash Price |
$13.20
|
| Rate for Payer: Central Health Plan Commercial |
$19.20
|
| Rate for Payer: Cigna of CA HMO |
$15.36
|
| Rate for Payer: Cigna of CA PPO |
$17.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$20.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$20.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.60
|
| Rate for Payer: EPIC Health Plan Senior |
$9.60
|
| Rate for Payer: Galaxy Health WC |
$20.40
|
| Rate for Payer: Global Benefits Group Commercial |
$14.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$21.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: InnovAge PACE Commercial |
$12.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16.80
|
| Rate for Payer: Multiplan Commercial |
$18.00
|
| Rate for Payer: Networks By Design Commercial |
$15.60
|
| Rate for Payer: Prime Health Services Commercial |
$20.40
|
| Rate for Payer: Riverside University Health System MISP |
$9.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$14.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$14.40
|
| 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: Vantage Medical Group Commercial/Exchange |
$20.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$20.40
|
| Rate for Payer: Vantage Medical Group Senior |
$20.40
|
|
|
HC HEMOPH INFLUENZA ADMIN
|
Facility
|
IP
|
$24.00
|
|
| Hospital Charge Code |
902890230
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$4.80 |
| Max. Negotiated Rate |
$21.60 |
| Rate for Payer: Adventist Health Commercial |
$4.80
|
| Rate for Payer: Cash Price |
$13.20
|
| Rate for Payer: Central Health Plan Commercial |
$19.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.60
|
| Rate for Payer: EPIC Health Plan Senior |
$9.60
|
| Rate for Payer: Galaxy Health WC |
$20.40
|
| Rate for Payer: Global Benefits Group Commercial |
$14.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$21.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.80
|
| Rate for Payer: Multiplan Commercial |
$18.00
|
| Rate for Payer: Networks By Design Commercial |
$15.60
|
| Rate for Payer: Prime Health Services Commercial |
$20.40
|
|
|
HC HEMOSTASIS TEST FOR QUANTRA
|
Facility
|
OP
|
$170.00
|
|
|
Service Code
|
CPT 85396
|
| Hospital Charge Code |
900912041
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$15.98 |
| Max. Negotiated Rate |
$153.00 |
| Rate for Payer: Adventist Health Commercial |
$34.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$103.24
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$144.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$93.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$127.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$116.66
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$23.68
|
| Rate for Payer: Blue Shield of California Commercial |
$103.19
|
| Rate for Payer: Blue Shield of California EPN |
$67.49
|
| Rate for Payer: Cash Price |
$93.50
|
| Rate for Payer: Cash Price |
$93.50
|
| Rate for Payer: Central Health Plan Commercial |
$136.00
|
| Rate for Payer: Cigna of CA HMO |
$108.80
|
| Rate for Payer: Cigna of CA PPO |
$125.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$144.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$144.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$144.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$68.00
|
| Rate for Payer: EPIC Health Plan Senior |
$68.00
|
| Rate for Payer: Galaxy Health WC |
$144.50
|
| Rate for Payer: Global Benefits Group Commercial |
$102.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$153.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$30.50
|
| Rate for Payer: InnovAge PACE Commercial |
$85.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$113.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$33.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$105.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$34.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$119.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$119.00
|
| Rate for Payer: Multiplan Commercial |
$127.50
|
| Rate for Payer: Networks By Design Commercial |
$110.50
|
| Rate for Payer: Prime Health Services Commercial |
$144.50
|
| Rate for Payer: Riverside University Health System MISP |
$68.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$102.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$102.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$15.98
|
| Rate for Payer: United Healthcare All Other HMO |
$15.98
|
| Rate for Payer: United Healthcare HMO Rider |
$15.98
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15.98
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$144.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$144.50
|
| Rate for Payer: Vantage Medical Group Senior |
$144.50
|
|
|
HC HEMOSTASIS TEST FOR QUANTRA
|
Facility
|
IP
|
$170.00
|
|
|
Service Code
|
CPT 85396
|
| Hospital Charge Code |
900912041
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$34.00 |
| Max. Negotiated Rate |
$153.00 |
| Rate for Payer: Adventist Health Commercial |
$34.00
|
| Rate for Payer: Cash Price |
$93.50
|
| Rate for Payer: Central Health Plan Commercial |
$136.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$68.00
|
| Rate for Payer: EPIC Health Plan Senior |
$68.00
|
| Rate for Payer: Galaxy Health WC |
$144.50
|
| Rate for Payer: Global Benefits Group Commercial |
$102.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$153.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$113.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$64.77
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$105.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$34.00
|
| Rate for Payer: Multiplan Commercial |
$127.50
|
| Rate for Payer: Networks By Design Commercial |
$110.50
|
| Rate for Payer: Prime Health Services Commercial |
$144.50
|
|
|
HC HEMOSTATIC FLOSEAL 10ML KIT
|
Facility
|
IP
|
$1,858.81
|
|
| Hospital Charge Code |
901698864
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$371.76 |
| Max. Negotiated Rate |
$1,672.93 |
| Rate for Payer: Adventist Health Commercial |
$371.76
|
| Rate for Payer: Blue Shield of California Commercial |
$1,436.86
|
| Rate for Payer: Blue Shield of California EPN |
$936.84
|
| Rate for Payer: Cash Price |
$1,022.35
|
| Rate for Payer: Central Health Plan Commercial |
$1,487.05
|
| Rate for Payer: Cigna of CA HMO |
$1,301.17
|
| Rate for Payer: Cigna of CA PPO |
$1,301.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$743.52
|
| Rate for Payer: EPIC Health Plan Senior |
$743.52
|
| Rate for Payer: Galaxy Health WC |
$1,579.99
|
| Rate for Payer: Global Benefits Group Commercial |
$1,115.29
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,672.93
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,239.83
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$708.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,150.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$371.76
|
| Rate for Payer: Multiplan Commercial |
$1,394.11
|
| Rate for Payer: Networks By Design Commercial |
$929.40
|
| Rate for Payer: Prime Health Services Commercial |
$1,579.99
|
| Rate for Payer: United Healthcare All Other Commercial |
$697.61
|
| Rate for Payer: United Healthcare All Other HMO |
$679.02
|
| Rate for Payer: United Healthcare HMO Rider |
$664.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$608.76
|
|
|
HC HEMOSTATIC FLOSEAL 10ML KIT
|
Facility
|
OP
|
$1,858.81
|
|
| Hospital Charge Code |
901698864
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$371.76 |
| Max. Negotiated Rate |
$1,672.93 |
| Rate for Payer: Adventist Health Commercial |
$371.76
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,579.99
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,022.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,394.11
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$848.73
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,029.22
|
| Rate for Payer: Blue Shield of California Commercial |
$1,436.86
|
| Rate for Payer: Blue Shield of California EPN |
$936.84
|
| Rate for Payer: Cash Price |
$1,022.35
|
| Rate for Payer: Central Health Plan Commercial |
$1,487.05
|
| Rate for Payer: Cigna of CA HMO |
$1,301.17
|
| Rate for Payer: Cigna of CA PPO |
$1,301.17
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,579.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,579.99
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,579.99
|
| Rate for Payer: EPIC Health Plan Commercial |
$743.52
|
| Rate for Payer: EPIC Health Plan Senior |
$743.52
|
| Rate for Payer: Galaxy Health WC |
$1,579.99
|
| Rate for Payer: Global Benefits Group Commercial |
$1,115.29
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,672.93
|
| Rate for Payer: InnovAge PACE Commercial |
$929.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,239.83
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$708.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,150.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$371.76
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,301.17
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,301.17
|
| Rate for Payer: Multiplan Commercial |
$1,394.11
|
| Rate for Payer: Networks By Design Commercial |
$929.40
|
| Rate for Payer: Prime Health Services Commercial |
$1,579.99
|
| Rate for Payer: Riverside University Health System MISP |
$743.52
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,115.29
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,115.29
|
| Rate for Payer: United Healthcare All Other Commercial |
$697.61
|
| Rate for Payer: United Healthcare All Other HMO |
$679.02
|
| Rate for Payer: United Healthcare HMO Rider |
$664.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$608.76
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,579.99
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,579.99
|
| Rate for Payer: Vantage Medical Group Senior |
$1,579.99
|
|
|
HC HEMOSTATIC FLOSEAL 5ML KIT
|
Facility
|
OP
|
$1,016.00
|
|
| Hospital Charge Code |
901698863
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$203.20 |
| Max. Negotiated Rate |
$914.40 |
| Rate for Payer: Adventist Health Commercial |
$203.20
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$863.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$558.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$762.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$463.91
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$562.56
|
| Rate for Payer: Blue Shield of California Commercial |
$785.37
|
| Rate for Payer: Blue Shield of California EPN |
$512.06
|
| Rate for Payer: Cash Price |
$558.80
|
| Rate for Payer: Central Health Plan Commercial |
$812.80
|
| Rate for Payer: Cigna of CA HMO |
$711.20
|
| Rate for Payer: Cigna of CA PPO |
$711.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$863.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$863.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$863.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$406.40
|
| Rate for Payer: EPIC Health Plan Senior |
$406.40
|
| Rate for Payer: Galaxy Health WC |
$863.60
|
| Rate for Payer: Global Benefits Group Commercial |
$609.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$914.40
|
| Rate for Payer: InnovAge PACE Commercial |
$508.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$677.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$387.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$628.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$203.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$711.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$711.20
|
| Rate for Payer: Multiplan Commercial |
$762.00
|
| Rate for Payer: Networks By Design Commercial |
$508.00
|
| Rate for Payer: Prime Health Services Commercial |
$863.60
|
| Rate for Payer: Riverside University Health System MISP |
$406.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$609.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$609.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$381.30
|
| Rate for Payer: United Healthcare All Other HMO |
$371.14
|
| Rate for Payer: United Healthcare HMO Rider |
$363.12
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$332.74
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$863.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$863.60
|
| Rate for Payer: Vantage Medical Group Senior |
$863.60
|
|
|
HC HEMOSTATIC FLOSEAL 5ML KIT
|
Facility
|
IP
|
$1,016.00
|
|
| Hospital Charge Code |
901698863
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$203.20 |
| Max. Negotiated Rate |
$914.40 |
| Rate for Payer: Adventist Health Commercial |
$203.20
|
| Rate for Payer: Blue Shield of California Commercial |
$785.37
|
| Rate for Payer: Blue Shield of California EPN |
$512.06
|
| Rate for Payer: Cash Price |
$558.80
|
| Rate for Payer: Central Health Plan Commercial |
$812.80
|
| Rate for Payer: Cigna of CA HMO |
$711.20
|
| Rate for Payer: Cigna of CA PPO |
$711.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$406.40
|
| Rate for Payer: EPIC Health Plan Senior |
$406.40
|
| Rate for Payer: Galaxy Health WC |
$863.60
|
| Rate for Payer: Global Benefits Group Commercial |
$609.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$914.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$677.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$387.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$628.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$203.20
|
| Rate for Payer: Multiplan Commercial |
$762.00
|
| Rate for Payer: Networks By Design Commercial |
$508.00
|
| Rate for Payer: Prime Health Services Commercial |
$863.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$381.30
|
| Rate for Payer: United Healthcare All Other HMO |
$371.14
|
| Rate for Payer: United Healthcare HMO Rider |
$363.12
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$332.74
|
|
|
HC HEMOSTATIC VALVE
|
Facility
|
OP
|
$60.50
|
|
| Hospital Charge Code |
909081232
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$12.10 |
| Max. Negotiated Rate |
$54.45 |
| Rate for Payer: Adventist Health Commercial |
$12.10
|
| Rate for Payer: Aetna of CA HMO/PPO |
$36.74
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$51.42
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$33.27
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$45.38
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$29.29
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$35.53
|
| Rate for Payer: Blue Shield of California Commercial |
$36.97
|
| Rate for Payer: Blue Shield of California EPN |
$24.14
|
| Rate for Payer: Cash Price |
$33.28
|
| Rate for Payer: Central Health Plan Commercial |
$48.40
|
| Rate for Payer: Cigna of CA HMO |
$38.72
|
| Rate for Payer: Cigna of CA PPO |
$44.77
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$51.42
|
| Rate for Payer: Dignity Health Medi-Cal |
$51.42
|
| Rate for Payer: Dignity Health Medicare Advantage |
$51.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$24.20
|
| Rate for Payer: EPIC Health Plan Senior |
$24.20
|
| Rate for Payer: Galaxy Health WC |
$51.42
|
| Rate for Payer: Global Benefits Group Commercial |
$36.30
|
| Rate for Payer: Health Management Network EPO/PPO |
$54.45
|
| Rate for Payer: InnovAge PACE Commercial |
$30.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$40.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$23.05
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$37.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.10
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$42.35
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$42.35
|
| Rate for Payer: Multiplan Commercial |
$45.38
|
| Rate for Payer: Networks By Design Commercial |
$39.33
|
| Rate for Payer: Prime Health Services Commercial |
$51.42
|
| Rate for Payer: Riverside University Health System MISP |
$24.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$36.30
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$36.30
|
| Rate for Payer: United Healthcare All Other Commercial |
$30.25
|
| Rate for Payer: United Healthcare All Other HMO |
$30.25
|
| Rate for Payer: United Healthcare HMO Rider |
$30.25
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$30.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$51.42
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$51.42
|
| Rate for Payer: Vantage Medical Group Senior |
$51.42
|
|
|
HC HEMOSTATIC VALVE
|
Facility
|
IP
|
$60.50
|
|
| Hospital Charge Code |
909081232
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$12.10 |
| Max. Negotiated Rate |
$54.45 |
| Rate for Payer: Adventist Health Commercial |
$12.10
|
| Rate for Payer: Cash Price |
$33.28
|
| Rate for Payer: Central Health Plan Commercial |
$48.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$24.20
|
| Rate for Payer: EPIC Health Plan Senior |
$24.20
|
| Rate for Payer: Galaxy Health WC |
$51.42
|
| Rate for Payer: Global Benefits Group Commercial |
$36.30
|
| Rate for Payer: Health Management Network EPO/PPO |
$54.45
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$40.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$23.05
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$37.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.10
|
| Rate for Payer: Multiplan Commercial |
$45.38
|
| Rate for Payer: Networks By Design Commercial |
$39.33
|
| Rate for Payer: Prime Health Services Commercial |
$51.42
|
|
|
HC HEP A PED/ADOL ADMIN 3 DOSE SCHED
|
Facility
|
OP
|
$41.00
|
|
| Hospital Charge Code |
908603034
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$8.20 |
| Max. Negotiated Rate |
$36.90 |
| Rate for Payer: Adventist Health Commercial |
$8.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$24.90
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$34.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$22.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$30.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$19.85
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$24.08
|
| Rate for Payer: Blue Shield of California Commercial |
$25.05
|
| Rate for Payer: Blue Shield of California EPN |
$16.36
|
| Rate for Payer: Cash Price |
$22.55
|
| Rate for Payer: Central Health Plan Commercial |
$32.80
|
| Rate for Payer: Cigna of CA HMO |
$26.24
|
| Rate for Payer: Cigna of CA PPO |
$30.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$34.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$34.85
|
| Rate for Payer: Dignity Health Medicare Advantage |
$34.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.40
|
| Rate for Payer: EPIC Health Plan Senior |
$16.40
|
| Rate for Payer: Galaxy Health WC |
$34.85
|
| Rate for Payer: Global Benefits Group Commercial |
$24.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$36.90
|
| Rate for Payer: InnovAge PACE Commercial |
$20.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$27.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$15.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$28.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$28.70
|
| Rate for Payer: Multiplan Commercial |
$30.75
|
| Rate for Payer: Networks By Design Commercial |
$26.65
|
| Rate for Payer: Prime Health Services Commercial |
$34.85
|
| Rate for Payer: Riverside University Health System MISP |
$16.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$24.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$24.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$20.50
|
| Rate for Payer: United Healthcare All Other HMO |
$20.50
|
| Rate for Payer: United Healthcare HMO Rider |
$20.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$20.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$34.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$34.85
|
| Rate for Payer: Vantage Medical Group Senior |
$34.85
|
|
|
HC HEP A PED/ADOL ADMIN 3 DOSE SCHED
|
Facility
|
IP
|
$41.00
|
|
| Hospital Charge Code |
908603034
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$8.20 |
| Max. Negotiated Rate |
$36.90 |
| Rate for Payer: Adventist Health Commercial |
$8.20
|
| Rate for Payer: Cash Price |
$22.55
|
| Rate for Payer: Central Health Plan Commercial |
$32.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.40
|
| Rate for Payer: EPIC Health Plan Senior |
$16.40
|
| Rate for Payer: Galaxy Health WC |
$34.85
|
| Rate for Payer: Global Benefits Group Commercial |
$24.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$36.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$27.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$15.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.20
|
| Rate for Payer: Multiplan Commercial |
$30.75
|
| Rate for Payer: Networks By Design Commercial |
$26.65
|
| Rate for Payer: Prime Health Services Commercial |
$34.85
|
|
|
HC HEP A PED/ADOL ADMINISTRATION
|
Facility
|
IP
|
$24.00
|
|
| Hospital Charge Code |
902890227
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$4.80 |
| Max. Negotiated Rate |
$21.60 |
| Rate for Payer: Adventist Health Commercial |
$4.80
|
| Rate for Payer: Cash Price |
$13.20
|
| Rate for Payer: Central Health Plan Commercial |
$19.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.60
|
| Rate for Payer: EPIC Health Plan Senior |
$9.60
|
| Rate for Payer: Galaxy Health WC |
$20.40
|
| Rate for Payer: Global Benefits Group Commercial |
$14.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$21.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.80
|
| Rate for Payer: Multiplan Commercial |
$18.00
|
| Rate for Payer: Networks By Design Commercial |
$15.60
|
| Rate for Payer: Prime Health Services Commercial |
$20.40
|
|
|
HC HEP A PED/ADOL ADMINISTRATION
|
Facility
|
OP
|
$24.00
|
|
| Hospital Charge Code |
902890227
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$4.80 |
| Max. Negotiated Rate |
$1,833.00 |
| Rate for Payer: Adventist Health Commercial |
$9.84
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$14.58
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$18.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14.10
|
| Rate for Payer: Cash Price |
$13.20
|
| Rate for Payer: Cash Price |
$13.20
|
| Rate for Payer: Cash Price |
$13.20
|
| Rate for Payer: Central Health Plan Commercial |
$19.20
|
| Rate for Payer: Cigna of CA HMO |
$15.36
|
| Rate for Payer: Cigna of CA PPO |
$17.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$20.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$20.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.60
|
| Rate for Payer: EPIC Health Plan Senior |
$9.60
|
| Rate for Payer: Galaxy Health WC |
$20.40
|
| Rate for Payer: Global Benefits Group Commercial |
$14.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$21.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: InnovAge PACE Commercial |
$12.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16.80
|
| Rate for Payer: Multiplan Commercial |
$18.00
|
| Rate for Payer: Networks By Design Commercial |
$15.60
|
| Rate for Payer: Prime Health Services Commercial |
$20.40
|
| Rate for Payer: Riverside University Health System MISP |
$9.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$14.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$14.40
|
| 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: Vantage Medical Group Commercial/Exchange |
$20.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$20.40
|
| Rate for Payer: Vantage Medical Group Senior |
$20.40
|
|
|
HC HEPARIN ASSAY, HPT (POC)
|
Facility
|
OP
|
$98.00
|
|
|
Service Code
|
CPT 85520
|
| Hospital Charge Code |
900912039
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$10.60 |
| Max. Negotiated Rate |
$88.20 |
| Rate for Payer: Adventist Health Commercial |
$19.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$13.09
|
| Rate for Payer: Aetna of CA HMO/PPO |
$59.52
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19.64
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13.09
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$80.91
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$16.42
|
| Rate for Payer: Blue Shield of California Commercial |
$59.49
|
| Rate for Payer: Blue Shield of California EPN |
$38.91
|
| Rate for Payer: Cash Price |
$53.90
|
| Rate for Payer: Cash Price |
$53.90
|
| Rate for Payer: Central Health Plan Commercial |
$78.40
|
| Rate for Payer: Cigna of CA HMO |
$62.72
|
| Rate for Payer: Cigna of CA PPO |
$72.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.64
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$13.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$17.67
|
| Rate for Payer: EPIC Health Plan Senior |
$13.09
|
| 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: Heritage Provider Network Commercial/Senior |
$21.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$19.73
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13.09
|
| Rate for Payer: InnovAge PACE Commercial |
$19.64
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$65.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$21.79
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17.54
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17.54
|
| Rate for Payer: Multiplan Commercial |
$73.50
|
| Rate for Payer: Networks By Design Commercial |
$63.70
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$13.09
|
| Rate for Payer: Prime Health Services Commercial |
$83.30
|
| Rate for Payer: Prime Health Services Medicare |
$13.88
|
| Rate for Payer: Riverside University Health System MISP |
$14.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$58.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$58.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.60
|
| Rate for Payer: United Healthcare All Other HMO |
$10.60
|
| Rate for Payer: United Healthcare HMO Rider |
$10.60
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.60
|
| Rate for Payer: Upland Medical Group Pediatric |
$13.09
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.64
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.40
|
| Rate for Payer: Vantage Medical Group Senior |
$13.09
|
|
|
HC HEPARIN ASSAY, HPT (POC)
|
Facility
|
IP
|
$98.00
|
|
|
Service Code
|
CPT 85520
|
| Hospital Charge Code |
900912039
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$19.60 |
| Max. Negotiated Rate |
$88.20 |
| Rate for Payer: Adventist Health Commercial |
$19.60
|
| Rate for Payer: Cash Price |
$53.90
|
| 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 HEPARIN DOSE RESPONSE, HDR (POC)
|
Facility
|
OP
|
$37.00
|
|
|
Service Code
|
CPT 85999
|
| Hospital Charge Code |
900912040
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$7.40 |
| Max. Negotiated Rate |
$33.30 |
| Rate for Payer: Adventist Health Commercial |
$7.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$22.47
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$31.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$20.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$27.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$17.92
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$21.73
|
| 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 |
$20.35
|
| 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 |
$31.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$31.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$31.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.80
|
| Rate for Payer: EPIC Health Plan Senior |
$14.80
|
| 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: InnovAge PACE Commercial |
$18.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$24.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$25.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$25.90
|
| Rate for Payer: Multiplan Commercial |
$27.75
|
| Rate for Payer: Networks By Design Commercial |
$24.05
|
| Rate for Payer: Prime Health Services Commercial |
$31.45
|
| Rate for Payer: Riverside University Health System MISP |
$14.80
|
| 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 |
$18.50
|
| Rate for Payer: United Healthcare All Other HMO |
$18.50
|
| Rate for Payer: United Healthcare HMO Rider |
$18.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$18.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$31.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$31.45
|
| Rate for Payer: Vantage Medical Group Senior |
$31.45
|
|
|
HC HEPARIN DOSE RESPONSE, HDR (POC)
|
Facility
|
IP
|
$37.00
|
|
|
Service Code
|
CPT 85999
|
| Hospital Charge Code |
900912040
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$7.40 |
| Max. Negotiated Rate |
$33.30 |
| Rate for Payer: Adventist Health Commercial |
$7.40
|
| Rate for Payer: Cash Price |
$20.35
|
| Rate for Payer: Central Health Plan Commercial |
$29.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.80
|
| Rate for Payer: EPIC Health Plan Senior |
$14.80
|
| 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: Kaiser Permanente of CA Commercial/Self Funded |
$24.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.40
|
| Rate for Payer: Multiplan Commercial |
$27.75
|
| Rate for Payer: Networks By Design Commercial |
$24.05
|
| Rate for Payer: Prime Health Services Commercial |
$31.45
|
|
|
HC HEPARIN NEUTRALIZED PT/PTT
|
Facility
|
OP
|
$34.00
|
|
|
Service Code
|
CPT 85525
|
| Hospital Charge Code |
900910094
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$6.80 |
| Max. Negotiated Rate |
$62.49 |
| Rate for Payer: Adventist Health Commercial |
$6.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$11.84
|
| Rate for Payer: Aetna of CA HMO/PPO |
$20.65
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$17.76
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13.02
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11.84
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$62.49
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12.68
|
| Rate for Payer: Blue Shield of California Commercial |
$20.64
|
| Rate for Payer: Blue Shield of California EPN |
$13.50
|
| Rate for Payer: Cash Price |
$18.70
|
| Rate for Payer: Cash Price |
$18.70
|
| Rate for Payer: Central Health Plan Commercial |
$27.20
|
| Rate for Payer: Cigna of CA HMO |
$21.76
|
| Rate for Payer: Cigna of CA PPO |
$25.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$17.76
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.02
|
| Rate for Payer: Dignity Health Medicare Advantage |
$11.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.98
|
| Rate for Payer: EPIC Health Plan Senior |
$11.84
|
| Rate for Payer: Galaxy Health WC |
$28.90
|
| Rate for Payer: Global Benefits Group Commercial |
$20.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$30.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$19.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$17.37
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$11.84
|
| Rate for Payer: InnovAge PACE Commercial |
$17.76
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$22.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$19.19
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$11.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$15.87
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$15.87
|
| Rate for Payer: Multiplan Commercial |
$25.50
|
| Rate for Payer: Networks By Design Commercial |
$22.10
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$11.84
|
| Rate for Payer: Prime Health Services Commercial |
$28.90
|
| Rate for Payer: Prime Health Services Medicare |
$12.55
|
| Rate for Payer: Riverside University Health System MISP |
$13.02
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$20.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$20.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.59
|
| Rate for Payer: United Healthcare All Other HMO |
$9.59
|
| Rate for Payer: United Healthcare HMO Rider |
$9.59
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.59
|
| Rate for Payer: Upland Medical Group Pediatric |
$11.84
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$17.76
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.02
|
| Rate for Payer: Vantage Medical Group Senior |
$11.84
|
|
|
HC HEPARIN NEUTRALIZED PT/PTT
|
Facility
|
IP
|
$34.00
|
|
|
Service Code
|
CPT 85525
|
| Hospital Charge Code |
900910094
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$6.80 |
| Max. Negotiated Rate |
$30.60 |
| Rate for Payer: Adventist Health Commercial |
$6.80
|
| Rate for Payer: Cash Price |
$18.70
|
| Rate for Payer: Central Health Plan Commercial |
$27.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.60
|
| Rate for Payer: EPIC Health Plan Senior |
$13.60
|
| Rate for Payer: Galaxy Health WC |
$28.90
|
| Rate for Payer: Global Benefits Group Commercial |
$20.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$30.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$22.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12.95
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.80
|
| Rate for Payer: Multiplan Commercial |
$25.50
|
| Rate for Payer: Networks By Design Commercial |
$22.10
|
| Rate for Payer: Prime Health Services Commercial |
$28.90
|
|
|
HC HEPATIC FUNCTION PANEL
|
Facility
|
IP
|
$64.81
|
|
|
Service Code
|
CPT 80076
|
| Hospital Charge Code |
900912166
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.96 |
| Max. Negotiated Rate |
$58.33 |
| Rate for Payer: Adventist Health Commercial |
$12.96
|
| Rate for Payer: Cash Price |
$35.65
|
| Rate for Payer: Central Health Plan Commercial |
$51.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$25.92
|
| Rate for Payer: EPIC Health Plan Senior |
$25.92
|
| Rate for Payer: Galaxy Health WC |
$55.09
|
| Rate for Payer: Global Benefits Group Commercial |
$38.89
|
| Rate for Payer: Health Management Network EPO/PPO |
$58.33
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$43.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$24.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$40.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.96
|
| Rate for Payer: Multiplan Commercial |
$48.61
|
| Rate for Payer: Networks By Design Commercial |
$42.13
|
| Rate for Payer: Prime Health Services Commercial |
$55.09
|
|
|
HC HEPATIC FUNCTION PANEL
|
Facility
|
OP
|
$64.81
|
|
|
Service Code
|
CPT 80076
|
| Hospital Charge Code |
900912166
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.62 |
| Max. Negotiated Rate |
$59.46 |
| Rate for Payer: Adventist Health Commercial |
$12.96
|
| Rate for Payer: Adventist Health Medi-Cal |
$8.17
|
| Rate for Payer: Aetna of CA HMO/PPO |
$39.36
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.26
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.99
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.17
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$59.46
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12.07
|
| Rate for Payer: Blue Shield of California Commercial |
$39.34
|
| Rate for Payer: Blue Shield of California EPN |
$25.73
|
| Rate for Payer: Cash Price |
$35.65
|
| Rate for Payer: Cash Price |
$35.65
|
| Rate for Payer: Central Health Plan Commercial |
$51.85
|
| Rate for Payer: Cigna of CA HMO |
$41.48
|
| Rate for Payer: Cigna of CA PPO |
$47.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.26
|
| Rate for Payer: Dignity Health Medi-Cal |
$8.99
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.03
|
| Rate for Payer: EPIC Health Plan Senior |
$8.17
|
| Rate for Payer: Galaxy Health WC |
$55.09
|
| Rate for Payer: Global Benefits Group Commercial |
$38.89
|
| Rate for Payer: Health Management Network EPO/PPO |
$58.33
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$13.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$10.97
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.17
|
| Rate for Payer: InnovAge PACE Commercial |
$12.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$43.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.96
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.95
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10.95
|
| Rate for Payer: Multiplan Commercial |
$48.61
|
| Rate for Payer: Networks By Design Commercial |
$42.13
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$8.17
|
| Rate for Payer: Prime Health Services Commercial |
$55.09
|
| Rate for Payer: Prime Health Services Medicare |
$8.66
|
| Rate for Payer: Riverside University Health System MISP |
$8.99
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$38.89
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$38.89
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.62
|
| Rate for Payer: United Healthcare All Other HMO |
$6.62
|
| Rate for Payer: United Healthcare HMO Rider |
$6.62
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.62
|
| Rate for Payer: Upland Medical Group Pediatric |
$8.17
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.26
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.99
|
| Rate for Payer: Vantage Medical Group Senior |
$8.17
|
|
|
HC HEPATIC W/HEMODYNAMI
|
Facility
|
IP
|
$13,097.00
|
|
|
Service Code
|
CPT 75889
|
| Hospital Charge Code |
909081643
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,619.40 |
| Max. Negotiated Rate |
$11,787.30 |
| Rate for Payer: Adventist Health Commercial |
$2,619.40
|
| Rate for Payer: Cash Price |
$7,203.35
|
| Rate for Payer: Central Health Plan Commercial |
$10,477.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,238.80
|
| Rate for Payer: EPIC Health Plan Senior |
$5,238.80
|
| Rate for Payer: Galaxy Health WC |
$11,132.45
|
| Rate for Payer: Global Benefits Group Commercial |
$7,858.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,787.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,735.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,989.96
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8,107.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,619.40
|
| Rate for Payer: Multiplan Commercial |
$9,822.75
|
| Rate for Payer: Networks By Design Commercial |
$8,513.05
|
| Rate for Payer: Prime Health Services Commercial |
$11,132.45
|
|
