|
HC HLA A, B, C, DR, DQ, DP HI-RES MOLECULAR
|
Facility
|
OP
|
$1,420.00
|
|
|
Service Code
|
CPT 81979
|
| Hospital Charge Code |
900913201
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$284.00 |
| Max. Negotiated Rate |
$1,278.00 |
| Rate for Payer: Adventist Health Commercial |
$284.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$862.37
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,207.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$781.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,065.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$687.56
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$833.97
|
| Rate for Payer: Blue Shield of California Commercial |
$861.94
|
| Rate for Payer: Blue Shield of California EPN |
$563.74
|
| Rate for Payer: Cash Price |
$639.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,136.00
|
| Rate for Payer: Cigna of CA HMO |
$908.80
|
| Rate for Payer: Cigna of CA PPO |
$1,050.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,207.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,207.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,207.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$568.00
|
| Rate for Payer: EPIC Health Plan Senior |
$568.00
|
| Rate for Payer: Galaxy Health WC |
$1,207.00
|
| Rate for Payer: Global Benefits Group Commercial |
$852.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,278.00
|
| Rate for Payer: InnovAge PACE Commercial |
$710.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$947.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$541.02
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$878.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$284.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$994.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$994.00
|
| Rate for Payer: Multiplan Commercial |
$1,065.00
|
| Rate for Payer: Networks By Design Commercial |
$923.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,207.00
|
| Rate for Payer: Riverside University Health System MISP |
$568.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$852.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$852.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$710.00
|
| Rate for Payer: United Healthcare All Other HMO |
$710.00
|
| Rate for Payer: United Healthcare HMO Rider |
$710.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$710.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,207.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,207.00
|
| Rate for Payer: Vantage Medical Group Senior |
$1,207.00
|
|
|
HC HLA A B C DR DQ DP MOLECULA
|
Facility
|
IP
|
$2,341.00
|
|
|
Service Code
|
CPT 81370
|
| Hospital Charge Code |
903902023
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$468.20 |
| Max. Negotiated Rate |
$2,106.90 |
| Rate for Payer: Adventist Health Commercial |
$468.20
|
| Rate for Payer: Cash Price |
$1,053.45
|
| Rate for Payer: Central Health Plan Commercial |
$1,872.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$936.40
|
| Rate for Payer: EPIC Health Plan Senior |
$936.40
|
| Rate for Payer: Galaxy Health WC |
$1,989.85
|
| Rate for Payer: Global Benefits Group Commercial |
$1,404.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,106.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,561.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$891.92
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,449.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$468.20
|
| Rate for Payer: Multiplan Commercial |
$1,755.75
|
| Rate for Payer: Networks By Design Commercial |
$1,521.65
|
| Rate for Payer: Prime Health Services Commercial |
$1,989.85
|
|
|
HC HLA A B C DR DQ DP MOLECULA
|
Facility
|
OP
|
$2,341.00
|
|
|
Service Code
|
CPT 81370
|
| Hospital Charge Code |
903902023
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$244.04 |
| Max. Negotiated Rate |
$2,106.90 |
| Rate for Payer: Adventist Health Commercial |
$468.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$402.12
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,421.69
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$603.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$442.33
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$402.12
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,202.43
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$244.04
|
| Rate for Payer: Blue Shield of California Commercial |
$1,420.99
|
| Rate for Payer: Blue Shield of California EPN |
$929.38
|
| Rate for Payer: Cash Price |
$1,053.45
|
| Rate for Payer: Cash Price |
$1,053.45
|
| Rate for Payer: Central Health Plan Commercial |
$1,872.80
|
| Rate for Payer: Cigna of CA HMO |
$1,498.24
|
| Rate for Payer: Cigna of CA PPO |
$1,732.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$603.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$442.33
|
| Rate for Payer: Dignity Health Medicare Advantage |
$402.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$542.86
|
| Rate for Payer: EPIC Health Plan Senior |
$402.12
|
| Rate for Payer: Galaxy Health WC |
$1,989.85
|
| Rate for Payer: Global Benefits Group Commercial |
$1,404.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,106.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$659.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$614.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$402.12
|
| Rate for Payer: InnovAge PACE Commercial |
$603.18
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,561.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$679.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$402.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$468.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$538.84
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$538.84
|
| Rate for Payer: Multiplan Commercial |
$1,755.75
|
| Rate for Payer: Networks By Design Commercial |
$1,521.65
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$402.12
|
| Rate for Payer: Prime Health Services Commercial |
$1,989.85
|
| Rate for Payer: Prime Health Services Medicare |
$426.25
|
| Rate for Payer: Riverside University Health System MISP |
$442.33
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,404.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,404.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$325.72
|
| Rate for Payer: United Healthcare All Other HMO |
$325.72
|
| Rate for Payer: United Healthcare HMO Rider |
$325.72
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$325.72
|
| Rate for Payer: Upland Medical Group Pediatric |
$402.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$603.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$442.33
|
| Rate for Payer: Vantage Medical Group Senior |
$402.12
|
|
|
HC HLA A B C DR DQ DP MOLECULAR
|
Facility
|
OP
|
$2,036.00
|
|
|
Service Code
|
CPT 81376
|
| Hospital Charge Code |
900913200
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$99.00 |
| Max. Negotiated Rate |
$1,832.40 |
| Rate for Payer: Adventist Health Commercial |
$407.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$122.22
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,236.46
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$183.33
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$134.44
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$122.22
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$550.16
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$111.66
|
| Rate for Payer: Blue Shield of California Commercial |
$1,235.85
|
| Rate for Payer: Blue Shield of California EPN |
$808.29
|
| Rate for Payer: Cash Price |
$916.20
|
| Rate for Payer: Cash Price |
$916.20
|
| Rate for Payer: Central Health Plan Commercial |
$1,628.80
|
| Rate for Payer: Cigna of CA HMO |
$1,303.04
|
| Rate for Payer: Cigna of CA PPO |
$1,506.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$183.33
|
| Rate for Payer: Dignity Health Medi-Cal |
$134.44
|
| Rate for Payer: Dignity Health Medicare Advantage |
$122.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$165.00
|
| Rate for Payer: EPIC Health Plan Senior |
$122.22
|
| Rate for Payer: Galaxy Health WC |
$1,730.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,221.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,832.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$200.44
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$186.86
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$122.22
|
| Rate for Payer: InnovAge PACE Commercial |
$183.33
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,358.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$206.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$122.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$407.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$163.77
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$163.77
|
| Rate for Payer: Multiplan Commercial |
$1,527.00
|
| Rate for Payer: Networks By Design Commercial |
$1,323.40
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$122.22
|
| Rate for Payer: Prime Health Services Commercial |
$1,730.60
|
| Rate for Payer: Prime Health Services Medicare |
$129.55
|
| Rate for Payer: Riverside University Health System MISP |
$134.44
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,221.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,221.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$99.00
|
| Rate for Payer: United Healthcare All Other HMO |
$99.00
|
| Rate for Payer: United Healthcare HMO Rider |
$99.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$99.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$122.22
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$183.33
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$134.44
|
| Rate for Payer: Vantage Medical Group Senior |
$122.22
|
|
|
HC HLA A B C DR DQ DP MOLECULAR
|
Facility
|
IP
|
$2,036.00
|
|
|
Service Code
|
CPT 81376
|
| Hospital Charge Code |
900913200
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$407.20 |
| Max. Negotiated Rate |
$1,832.40 |
| Rate for Payer: Adventist Health Commercial |
$407.20
|
| Rate for Payer: Cash Price |
$916.20
|
| Rate for Payer: Central Health Plan Commercial |
$1,628.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$814.40
|
| Rate for Payer: EPIC Health Plan Senior |
$814.40
|
| Rate for Payer: Galaxy Health WC |
$1,730.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,221.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,832.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,358.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$775.72
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,260.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$407.20
|
| Rate for Payer: Multiplan Commercial |
$1,527.00
|
| Rate for Payer: Networks By Design Commercial |
$1,323.40
|
| Rate for Payer: Prime Health Services Commercial |
$1,730.60
|
|
|
HC HLA A B C DR DQ DP MOLECULAR
|
Facility
|
IP
|
$2,036.00
|
|
|
Service Code
|
CPT 81376
|
| Hospital Charge Code |
903913200
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$407.20 |
| Max. Negotiated Rate |
$1,832.40 |
| Rate for Payer: Adventist Health Commercial |
$407.20
|
| Rate for Payer: Cash Price |
$916.20
|
| Rate for Payer: Central Health Plan Commercial |
$1,628.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$814.40
|
| Rate for Payer: EPIC Health Plan Senior |
$814.40
|
| Rate for Payer: Galaxy Health WC |
$1,730.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,221.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,832.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,358.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$775.72
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,260.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$407.20
|
| Rate for Payer: Multiplan Commercial |
$1,527.00
|
| Rate for Payer: Networks By Design Commercial |
$1,323.40
|
| Rate for Payer: Prime Health Services Commercial |
$1,730.60
|
|
|
HC HLA A B C DR DQ DP MOLECULAR
|
Facility
|
OP
|
$2,036.00
|
|
|
Service Code
|
CPT 81376
|
| Hospital Charge Code |
903913200
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$99.00 |
| Max. Negotiated Rate |
$1,832.40 |
| Rate for Payer: Adventist Health Commercial |
$407.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$122.22
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,236.46
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$183.33
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$134.44
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$122.22
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$550.16
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$111.66
|
| Rate for Payer: Blue Shield of California Commercial |
$1,235.85
|
| Rate for Payer: Blue Shield of California EPN |
$808.29
|
| Rate for Payer: Cash Price |
$916.20
|
| Rate for Payer: Cash Price |
$916.20
|
| Rate for Payer: Central Health Plan Commercial |
$1,628.80
|
| Rate for Payer: Cigna of CA HMO |
$1,303.04
|
| Rate for Payer: Cigna of CA PPO |
$1,506.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$183.33
|
| Rate for Payer: Dignity Health Medi-Cal |
$134.44
|
| Rate for Payer: Dignity Health Medicare Advantage |
$122.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$165.00
|
| Rate for Payer: EPIC Health Plan Senior |
$122.22
|
| Rate for Payer: Galaxy Health WC |
$1,730.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,221.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,832.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$200.44
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$186.86
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$122.22
|
| Rate for Payer: InnovAge PACE Commercial |
$183.33
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,358.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$206.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$122.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$407.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$163.77
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$163.77
|
| Rate for Payer: Multiplan Commercial |
$1,527.00
|
| Rate for Payer: Networks By Design Commercial |
$1,323.40
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$122.22
|
| Rate for Payer: Prime Health Services Commercial |
$1,730.60
|
| Rate for Payer: Prime Health Services Medicare |
$129.55
|
| Rate for Payer: Riverside University Health System MISP |
$134.44
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,221.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,221.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$99.00
|
| Rate for Payer: United Healthcare All Other HMO |
$99.00
|
| Rate for Payer: United Healthcare HMO Rider |
$99.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$99.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$122.22
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$183.33
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$134.44
|
| Rate for Payer: Vantage Medical Group Senior |
$122.22
|
|
|
HC HLA-A B C HI-RES MOLECULAR
|
Facility
|
OP
|
$4,007.00
|
|
|
Service Code
|
CPT 81379
|
| Hospital Charge Code |
903902022
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$271.66 |
| Max. Negotiated Rate |
$3,606.30 |
| Rate for Payer: Adventist Health Commercial |
$801.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$335.38
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,433.45
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$503.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$368.92
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$335.38
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,724.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$553.02
|
| Rate for Payer: Blue Shield of California Commercial |
$2,432.25
|
| Rate for Payer: Blue Shield of California EPN |
$1,590.78
|
| Rate for Payer: Cash Price |
$1,803.15
|
| Rate for Payer: Cash Price |
$1,803.15
|
| Rate for Payer: Central Health Plan Commercial |
$3,205.60
|
| Rate for Payer: Cigna of CA HMO |
$2,564.48
|
| Rate for Payer: Cigna of CA PPO |
$2,965.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$503.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$368.92
|
| Rate for Payer: Dignity Health Medicare Advantage |
$335.38
|
| Rate for Payer: EPIC Health Plan Commercial |
$452.76
|
| Rate for Payer: EPIC Health Plan Senior |
$335.38
|
| Rate for Payer: Galaxy Health WC |
$3,405.95
|
| Rate for Payer: Global Benefits Group Commercial |
$2,404.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,606.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$550.02
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$512.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$335.38
|
| Rate for Payer: InnovAge PACE Commercial |
$503.07
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,672.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$566.43
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$335.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$801.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$449.41
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$449.41
|
| Rate for Payer: Multiplan Commercial |
$3,005.25
|
| Rate for Payer: Networks By Design Commercial |
$2,604.55
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$335.38
|
| Rate for Payer: Prime Health Services Commercial |
$3,405.95
|
| Rate for Payer: Prime Health Services Medicare |
$355.50
|
| Rate for Payer: Riverside University Health System MISP |
$368.92
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,404.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,404.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$271.66
|
| Rate for Payer: United Healthcare All Other HMO |
$271.66
|
| Rate for Payer: United Healthcare HMO Rider |
$271.66
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$271.66
|
| Rate for Payer: Upland Medical Group Pediatric |
$335.38
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$503.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$368.92
|
| Rate for Payer: Vantage Medical Group Senior |
$335.38
|
|
|
HC HLA-A B C HI-RES MOLECULAR
|
Facility
|
IP
|
$4,007.00
|
|
|
Service Code
|
CPT 81379
|
| Hospital Charge Code |
903902022
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$801.40 |
| Max. Negotiated Rate |
$3,606.30 |
| Rate for Payer: Adventist Health Commercial |
$801.40
|
| Rate for Payer: Cash Price |
$1,803.15
|
| Rate for Payer: Central Health Plan Commercial |
$3,205.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,602.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,602.80
|
| Rate for Payer: Galaxy Health WC |
$3,405.95
|
| Rate for Payer: Global Benefits Group Commercial |
$2,404.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,606.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,672.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,526.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,480.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$801.40
|
| Rate for Payer: Multiplan Commercial |
$3,005.25
|
| Rate for Payer: Networks By Design Commercial |
$2,604.55
|
| Rate for Payer: Prime Health Services Commercial |
$3,405.95
|
|
|
HC HLA AB SCREEN I/II
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
CPT 86828
|
| Hospital Charge Code |
903901995
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$78.00 |
| Max. Negotiated Rate |
$351.00 |
| Rate for Payer: Adventist Health Commercial |
$78.00
|
| Rate for Payer: Cash Price |
$175.50
|
| Rate for Payer: Central Health Plan Commercial |
$312.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$156.00
|
| Rate for Payer: EPIC Health Plan Senior |
$156.00
|
| Rate for Payer: Galaxy Health WC |
$331.50
|
| Rate for Payer: Global Benefits Group Commercial |
$234.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$351.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$260.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$148.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$241.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$78.00
|
| Rate for Payer: Multiplan Commercial |
$292.50
|
| Rate for Payer: Networks By Design Commercial |
$253.50
|
| Rate for Payer: Prime Health Services Commercial |
$331.50
|
|
|
HC HLA AB SCREEN I/II
|
Facility
|
OP
|
$315.66
|
|
|
Service Code
|
CPT 86828
|
| Hospital Charge Code |
903901995
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$46.25 |
| Max. Negotiated Rate |
$284.09 |
| Rate for Payer: Adventist Health Commercial |
$63.13
|
| Rate for Payer: Adventist Health Medi-Cal |
$64.19
|
| Rate for Payer: Aetna of CA HMO/PPO |
$191.70
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$96.28
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$70.61
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$64.19
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$227.89
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$46.25
|
| Rate for Payer: Blue Shield of California Commercial |
$191.61
|
| Rate for Payer: Blue Shield of California EPN |
$125.32
|
| Rate for Payer: Cash Price |
$142.05
|
| Rate for Payer: Cash Price |
$142.05
|
| Rate for Payer: Central Health Plan Commercial |
$252.53
|
| Rate for Payer: Cigna of CA HMO |
$202.02
|
| Rate for Payer: Cigna of CA PPO |
$233.59
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$96.28
|
| Rate for Payer: Dignity Health Medi-Cal |
$70.61
|
| Rate for Payer: Dignity Health Medicare Advantage |
$64.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$86.66
|
| Rate for Payer: EPIC Health Plan Senior |
$64.19
|
| Rate for Payer: Galaxy Health WC |
$268.31
|
| Rate for Payer: Global Benefits Group Commercial |
$189.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$284.09
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$105.27
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$74.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$64.19
|
| Rate for Payer: InnovAge PACE Commercial |
$96.28
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$210.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$81.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$64.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$63.13
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$86.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$86.01
|
| Rate for Payer: Multiplan Commercial |
$236.75
|
| Rate for Payer: Networks By Design Commercial |
$205.18
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$64.19
|
| Rate for Payer: Prime Health Services Commercial |
$268.31
|
| Rate for Payer: Prime Health Services Medicare |
$68.04
|
| Rate for Payer: Riverside University Health System MISP |
$70.61
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$189.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$189.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$51.99
|
| Rate for Payer: United Healthcare All Other HMO |
$51.99
|
| Rate for Payer: United Healthcare HMO Rider |
$51.99
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$51.99
|
| Rate for Payer: Upland Medical Group Pediatric |
$64.19
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$96.28
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$70.61
|
| Rate for Payer: Vantage Medical Group Senior |
$64.19
|
|
|
HC HLA A-C MOLECULAR
|
Facility
|
IP
|
$1,466.00
|
|
|
Service Code
|
CPT 81372
|
| Hospital Charge Code |
903901902
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$293.20 |
| Max. Negotiated Rate |
$1,319.40 |
| Rate for Payer: Adventist Health Commercial |
$293.20
|
| Rate for Payer: Cash Price |
$659.70
|
| Rate for Payer: Central Health Plan Commercial |
$1,172.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$586.40
|
| Rate for Payer: EPIC Health Plan Senior |
$586.40
|
| Rate for Payer: Galaxy Health WC |
$1,246.10
|
| Rate for Payer: Global Benefits Group Commercial |
$879.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,319.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$977.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$558.55
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$907.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$293.20
|
| Rate for Payer: Multiplan Commercial |
$1,099.50
|
| Rate for Payer: Networks By Design Commercial |
$952.90
|
| Rate for Payer: Prime Health Services Commercial |
$1,246.10
|
|
|
HC HLA A-C MOLECULAR
|
Facility
|
OP
|
$743.00
|
|
|
Service Code
|
CPT 81372
|
| Hospital Charge Code |
903901902
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$148.60 |
| Max. Negotiated Rate |
$2,596.66 |
| Rate for Payer: Adventist Health Commercial |
$148.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$403.59
|
| Rate for Payer: Aetna of CA HMO/PPO |
$451.22
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$605.38
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$443.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$403.59
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,596.66
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$527.00
|
| Rate for Payer: Blue Shield of California Commercial |
$451.00
|
| Rate for Payer: Blue Shield of California EPN |
$294.97
|
| Rate for Payer: Cash Price |
$334.35
|
| Rate for Payer: Cash Price |
$334.35
|
| Rate for Payer: Central Health Plan Commercial |
$594.40
|
| Rate for Payer: Cigna of CA HMO |
$475.52
|
| Rate for Payer: Cigna of CA PPO |
$549.82
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$605.38
|
| Rate for Payer: Dignity Health Medi-Cal |
$443.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$403.59
|
| Rate for Payer: EPIC Health Plan Commercial |
$544.85
|
| Rate for Payer: EPIC Health Plan Senior |
$403.59
|
| Rate for Payer: Galaxy Health WC |
$631.55
|
| Rate for Payer: Global Benefits Group Commercial |
$445.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$668.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$661.89
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$413.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$403.59
|
| Rate for Payer: InnovAge PACE Commercial |
$605.38
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$495.58
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$456.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$403.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$148.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$540.81
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$540.81
|
| Rate for Payer: Multiplan Commercial |
$557.25
|
| Rate for Payer: Networks By Design Commercial |
$482.95
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$403.59
|
| Rate for Payer: Prime Health Services Commercial |
$631.55
|
| Rate for Payer: Prime Health Services Medicare |
$427.81
|
| Rate for Payer: Riverside University Health System MISP |
$443.95
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$445.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$445.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$326.91
|
| Rate for Payer: United Healthcare All Other HMO |
$326.91
|
| Rate for Payer: United Healthcare HMO Rider |
$326.91
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$326.91
|
| Rate for Payer: Upland Medical Group Pediatric |
$403.59
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$605.38
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$443.95
|
| Rate for Payer: Vantage Medical Group Senior |
$403.59
|
|
|
HC HLA A-C SEROLOGY
|
Facility
|
IP
|
$627.00
|
|
|
Service Code
|
CPT 86813
|
| Hospital Charge Code |
903901988
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$125.40 |
| Max. Negotiated Rate |
$564.30 |
| Rate for Payer: Adventist Health Commercial |
$125.40
|
| Rate for Payer: Cash Price |
$282.15
|
| Rate for Payer: Central Health Plan Commercial |
$501.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$250.80
|
| Rate for Payer: EPIC Health Plan Senior |
$250.80
|
| Rate for Payer: Galaxy Health WC |
$532.95
|
| Rate for Payer: Global Benefits Group Commercial |
$376.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$564.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$418.21
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$238.89
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$388.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$125.40
|
| Rate for Payer: Multiplan Commercial |
$470.25
|
| Rate for Payer: Networks By Design Commercial |
$407.55
|
| Rate for Payer: Prime Health Services Commercial |
$532.95
|
|
|
HC HLA A-C SEROLOGY
|
Facility
|
OP
|
$293.00
|
|
|
Service Code
|
CPT 86813
|
| Hospital Charge Code |
903901988
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$46.98 |
| Max. Negotiated Rate |
$421.84 |
| Rate for Payer: Adventist Health Commercial |
$58.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$58.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$177.94
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$87.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$63.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$58.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$421.84
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$85.61
|
| Rate for Payer: Blue Shield of California Commercial |
$177.85
|
| Rate for Payer: Blue Shield of California EPN |
$116.32
|
| Rate for Payer: Cash Price |
$131.85
|
| Rate for Payer: Cash Price |
$131.85
|
| Rate for Payer: Central Health Plan Commercial |
$234.40
|
| Rate for Payer: Cigna of CA HMO |
$187.52
|
| Rate for Payer: Cigna of CA PPO |
$216.82
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$87.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$63.80
|
| Rate for Payer: Dignity Health Medicare Advantage |
$58.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$78.30
|
| Rate for Payer: EPIC Health Plan Senior |
$58.00
|
| Rate for Payer: Galaxy Health WC |
$249.05
|
| Rate for Payer: Global Benefits Group Commercial |
$175.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$263.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$95.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$88.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$58.00
|
| Rate for Payer: InnovAge PACE Commercial |
$87.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$195.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$97.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$58.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$58.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$77.72
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$77.72
|
| Rate for Payer: Multiplan Commercial |
$219.75
|
| Rate for Payer: Networks By Design Commercial |
$190.45
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$58.00
|
| Rate for Payer: Prime Health Services Commercial |
$249.05
|
| Rate for Payer: Prime Health Services Medicare |
$61.48
|
| Rate for Payer: Riverside University Health System MISP |
$63.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$175.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$175.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$46.98
|
| Rate for Payer: United Healthcare All Other HMO |
$46.98
|
| Rate for Payer: United Healthcare HMO Rider |
$46.98
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$46.98
|
| Rate for Payer: Upland Medical Group Pediatric |
$58.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$87.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$63.80
|
| Rate for Payer: Vantage Medical Group Senior |
$58.00
|
|
|
HC HLA A MOLECULAR HI RESOLUTION
|
Facility
|
OP
|
$217.00
|
|
|
Service Code
|
CPT 81380
|
| Hospital Charge Code |
903901985
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$43.40 |
| Max. Negotiated Rate |
$780.40 |
| Rate for Payer: Adventist Health Commercial |
$43.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$177.25
|
| Rate for Payer: Aetna of CA HMO/PPO |
$131.78
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$265.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$194.97
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$177.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$780.40
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$158.38
|
| Rate for Payer: Blue Shield of California Commercial |
$131.72
|
| Rate for Payer: Blue Shield of California EPN |
$86.15
|
| Rate for Payer: Cash Price |
$97.65
|
| Rate for Payer: Cash Price |
$97.65
|
| Rate for Payer: Central Health Plan Commercial |
$173.60
|
| Rate for Payer: Cigna of CA HMO |
$138.88
|
| Rate for Payer: Cigna of CA PPO |
$160.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$265.88
|
| Rate for Payer: Dignity Health Medi-Cal |
$194.97
|
| Rate for Payer: Dignity Health Medicare Advantage |
$177.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$239.29
|
| Rate for Payer: EPIC Health Plan Senior |
$177.25
|
| Rate for Payer: Galaxy Health WC |
$184.45
|
| Rate for Payer: Global Benefits Group Commercial |
$130.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$195.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$290.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$270.99
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$177.25
|
| Rate for Payer: InnovAge PACE Commercial |
$265.88
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$144.74
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$299.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$177.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$43.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$237.51
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$237.51
|
| Rate for Payer: Multiplan Commercial |
$162.75
|
| Rate for Payer: Networks By Design Commercial |
$141.05
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$177.25
|
| Rate for Payer: Prime Health Services Commercial |
$184.45
|
| Rate for Payer: Prime Health Services Medicare |
$187.88
|
| Rate for Payer: Riverside University Health System MISP |
$194.97
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$130.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$130.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$143.58
|
| Rate for Payer: United Healthcare All Other HMO |
$143.58
|
| Rate for Payer: United Healthcare HMO Rider |
$143.58
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$143.58
|
| Rate for Payer: Upland Medical Group Pediatric |
$177.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$265.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$194.97
|
| Rate for Payer: Vantage Medical Group Senior |
$177.25
|
|
|
HC HLA A MOLECULAR HI RESOLUTION
|
Facility
|
IP
|
$984.00
|
|
|
Service Code
|
CPT 81380
|
| Hospital Charge Code |
903901985
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$196.80 |
| Max. Negotiated Rate |
$885.60 |
| Rate for Payer: Adventist Health Commercial |
$196.80
|
| Rate for Payer: Cash Price |
$442.80
|
| Rate for Payer: Central Health Plan Commercial |
$787.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$393.60
|
| Rate for Payer: EPIC Health Plan Senior |
$393.60
|
| Rate for Payer: Galaxy Health WC |
$836.40
|
| Rate for Payer: Global Benefits Group Commercial |
$590.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$885.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$656.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$374.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$609.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$196.80
|
| Rate for Payer: Multiplan Commercial |
$738.00
|
| Rate for Payer: Networks By Design Commercial |
$639.60
|
| Rate for Payer: Prime Health Services Commercial |
$836.40
|
|
|
HC HLA - B27
|
Facility
|
IP
|
$982.00
|
|
|
Service Code
|
CPT 81373
|
| Hospital Charge Code |
903901903
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$196.40 |
| Max. Negotiated Rate |
$883.80 |
| Rate for Payer: Adventist Health Commercial |
$196.40
|
| Rate for Payer: Cash Price |
$441.90
|
| Rate for Payer: Central Health Plan Commercial |
$785.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$392.80
|
| Rate for Payer: EPIC Health Plan Senior |
$392.80
|
| Rate for Payer: Galaxy Health WC |
$834.70
|
| Rate for Payer: Global Benefits Group Commercial |
$589.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$883.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$654.99
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$374.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$607.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$196.40
|
| Rate for Payer: Multiplan Commercial |
$736.50
|
| Rate for Payer: Networks By Design Commercial |
$638.30
|
| Rate for Payer: Prime Health Services Commercial |
$834.70
|
|
|
HC HLA - B27
|
Facility
|
OP
|
$326.00
|
|
|
Service Code
|
CPT 81373
|
| Hospital Charge Code |
903901903
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$65.20 |
| Max. Negotiated Rate |
$878.94 |
| Rate for Payer: Adventist Health Commercial |
$65.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$127.43
|
| Rate for Payer: Aetna of CA HMO/PPO |
$197.98
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$191.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$140.17
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$127.43
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$878.94
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$178.38
|
| Rate for Payer: Blue Shield of California Commercial |
$197.88
|
| Rate for Payer: Blue Shield of California EPN |
$129.42
|
| Rate for Payer: Cash Price |
$146.70
|
| Rate for Payer: Cash Price |
$146.70
|
| Rate for Payer: Central Health Plan Commercial |
$260.80
|
| Rate for Payer: Cigna of CA HMO |
$208.64
|
| Rate for Payer: Cigna of CA PPO |
$241.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$191.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$140.17
|
| Rate for Payer: Dignity Health Medicare Advantage |
$127.43
|
| Rate for Payer: EPIC Health Plan Commercial |
$172.03
|
| Rate for Payer: EPIC Health Plan Senior |
$127.43
|
| Rate for Payer: Galaxy Health WC |
$277.10
|
| Rate for Payer: Global Benefits Group Commercial |
$195.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$293.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$208.99
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$175.34
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$127.43
|
| Rate for Payer: InnovAge PACE Commercial |
$191.15
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$217.44
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$193.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$127.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$65.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$170.76
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$170.76
|
| Rate for Payer: Multiplan Commercial |
$244.50
|
| Rate for Payer: Networks By Design Commercial |
$211.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$127.43
|
| Rate for Payer: Prime Health Services Commercial |
$277.10
|
| Rate for Payer: Prime Health Services Medicare |
$135.08
|
| Rate for Payer: Riverside University Health System MISP |
$140.17
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$195.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$195.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$103.22
|
| Rate for Payer: United Healthcare All Other HMO |
$103.22
|
| Rate for Payer: United Healthcare HMO Rider |
$103.22
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$103.22
|
| Rate for Payer: Upland Medical Group Pediatric |
$127.43
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$191.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$140.17
|
| Rate for Payer: Vantage Medical Group Senior |
$127.43
|
|
|
HC HLA B MOLECULAR HI RESOLUTION
|
Facility
|
IP
|
$984.00
|
|
|
Service Code
|
CPT 81380
|
| Hospital Charge Code |
903901989
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$196.80 |
| Max. Negotiated Rate |
$885.60 |
| Rate for Payer: Adventist Health Commercial |
$196.80
|
| Rate for Payer: Cash Price |
$442.80
|
| Rate for Payer: Central Health Plan Commercial |
$787.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$393.60
|
| Rate for Payer: EPIC Health Plan Senior |
$393.60
|
| Rate for Payer: Galaxy Health WC |
$836.40
|
| Rate for Payer: Global Benefits Group Commercial |
$590.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$885.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$656.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$374.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$609.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$196.80
|
| Rate for Payer: Multiplan Commercial |
$738.00
|
| Rate for Payer: Networks By Design Commercial |
$639.60
|
| Rate for Payer: Prime Health Services Commercial |
$836.40
|
|
|
HC HLA B MOLECULAR HI RESOLUTION
|
Facility
|
OP
|
$217.00
|
|
|
Service Code
|
CPT 81380
|
| Hospital Charge Code |
903901989
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$43.40 |
| Max. Negotiated Rate |
$780.40 |
| Rate for Payer: Adventist Health Commercial |
$43.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$177.25
|
| Rate for Payer: Aetna of CA HMO/PPO |
$131.78
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$265.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$194.97
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$177.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$780.40
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$158.38
|
| Rate for Payer: Blue Shield of California Commercial |
$131.72
|
| Rate for Payer: Blue Shield of California EPN |
$86.15
|
| Rate for Payer: Cash Price |
$97.65
|
| Rate for Payer: Cash Price |
$97.65
|
| Rate for Payer: Central Health Plan Commercial |
$173.60
|
| Rate for Payer: Cigna of CA HMO |
$138.88
|
| Rate for Payer: Cigna of CA PPO |
$160.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$265.88
|
| Rate for Payer: Dignity Health Medi-Cal |
$194.97
|
| Rate for Payer: Dignity Health Medicare Advantage |
$177.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$239.29
|
| Rate for Payer: EPIC Health Plan Senior |
$177.25
|
| Rate for Payer: Galaxy Health WC |
$184.45
|
| Rate for Payer: Global Benefits Group Commercial |
$130.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$195.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$290.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$270.99
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$177.25
|
| Rate for Payer: InnovAge PACE Commercial |
$265.88
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$144.74
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$299.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$177.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$43.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$237.51
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$237.51
|
| Rate for Payer: Multiplan Commercial |
$162.75
|
| Rate for Payer: Networks By Design Commercial |
$141.05
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$177.25
|
| Rate for Payer: Prime Health Services Commercial |
$184.45
|
| Rate for Payer: Prime Health Services Medicare |
$187.88
|
| Rate for Payer: Riverside University Health System MISP |
$194.97
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$130.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$130.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$143.58
|
| Rate for Payer: United Healthcare All Other HMO |
$143.58
|
| Rate for Payer: United Healthcare HMO Rider |
$143.58
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$143.58
|
| Rate for Payer: Upland Medical Group Pediatric |
$177.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$265.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$194.97
|
| Rate for Payer: Vantage Medical Group Senior |
$177.25
|
|
|
HC HLA C1Q I
|
Facility
|
OP
|
$810.00
|
|
|
Service Code
|
CPT 86832
|
| Hospital Charge Code |
900913205
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$17.66 |
| Max. Negotiated Rate |
$729.00 |
| Rate for Payer: Adventist Health Commercial |
$162.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$323.75
|
| Rate for Payer: Aetna of CA HMO/PPO |
$491.91
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$485.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$356.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$323.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$588.02
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$119.34
|
| Rate for Payer: Blue Shield of California Commercial |
$491.67
|
| Rate for Payer: Blue Shield of California EPN |
$321.57
|
| Rate for Payer: Cash Price |
$364.50
|
| Rate for Payer: Cash Price |
$364.50
|
| Rate for Payer: Central Health Plan Commercial |
$648.00
|
| Rate for Payer: Cigna of CA HMO |
$518.40
|
| Rate for Payer: Cigna of CA PPO |
$599.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$485.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$356.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$323.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$437.06
|
| Rate for Payer: EPIC Health Plan Senior |
$323.75
|
| Rate for Payer: Galaxy Health WC |
$688.50
|
| Rate for Payer: Global Benefits Group Commercial |
$486.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$729.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$530.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$17.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$323.75
|
| Rate for Payer: InnovAge PACE Commercial |
$485.62
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$540.27
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$19.51
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$323.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$162.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$433.82
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$433.82
|
| Rate for Payer: Multiplan Commercial |
$607.50
|
| Rate for Payer: Networks By Design Commercial |
$526.50
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$323.75
|
| Rate for Payer: Prime Health Services Commercial |
$688.50
|
| Rate for Payer: Prime Health Services Medicare |
$343.18
|
| Rate for Payer: Riverside University Health System MISP |
$356.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$486.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$486.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$262.24
|
| Rate for Payer: United Healthcare All Other HMO |
$262.24
|
| Rate for Payer: United Healthcare HMO Rider |
$262.24
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$262.24
|
| Rate for Payer: Upland Medical Group Pediatric |
$323.75
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$485.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$356.12
|
| Rate for Payer: Vantage Medical Group Senior |
$323.75
|
|
|
HC HLA C1Q I
|
Facility
|
IP
|
$925.00
|
|
|
Service Code
|
CPT 86832
|
| Hospital Charge Code |
903913205
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$185.00 |
| Max. Negotiated Rate |
$832.50 |
| Rate for Payer: Adventist Health Commercial |
$185.00
|
| Rate for Payer: Cash Price |
$416.25
|
| Rate for Payer: Central Health Plan Commercial |
$740.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$370.00
|
| Rate for Payer: EPIC Health Plan Senior |
$370.00
|
| Rate for Payer: Galaxy Health WC |
$786.25
|
| Rate for Payer: Global Benefits Group Commercial |
$555.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$832.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$616.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$352.43
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$572.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$185.00
|
| Rate for Payer: Multiplan Commercial |
$693.75
|
| Rate for Payer: Networks By Design Commercial |
$601.25
|
| Rate for Payer: Prime Health Services Commercial |
$786.25
|
|
|
HC HLA C1Q I
|
Facility
|
OP
|
$810.00
|
|
|
Service Code
|
CPT 86832
|
| Hospital Charge Code |
903913205
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$17.66 |
| Max. Negotiated Rate |
$729.00 |
| Rate for Payer: Adventist Health Commercial |
$162.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$323.75
|
| Rate for Payer: Aetna of CA HMO/PPO |
$491.91
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$485.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$356.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$323.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$588.02
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$119.34
|
| Rate for Payer: Blue Shield of California Commercial |
$491.67
|
| Rate for Payer: Blue Shield of California EPN |
$321.57
|
| Rate for Payer: Cash Price |
$364.50
|
| Rate for Payer: Cash Price |
$364.50
|
| Rate for Payer: Central Health Plan Commercial |
$648.00
|
| Rate for Payer: Cigna of CA HMO |
$518.40
|
| Rate for Payer: Cigna of CA PPO |
$599.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$485.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$356.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$323.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$437.06
|
| Rate for Payer: EPIC Health Plan Senior |
$323.75
|
| Rate for Payer: Galaxy Health WC |
$688.50
|
| Rate for Payer: Global Benefits Group Commercial |
$486.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$729.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$530.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$17.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$323.75
|
| Rate for Payer: InnovAge PACE Commercial |
$485.62
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$540.27
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$19.51
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$323.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$162.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$433.82
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$433.82
|
| Rate for Payer: Multiplan Commercial |
$607.50
|
| Rate for Payer: Networks By Design Commercial |
$526.50
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$323.75
|
| Rate for Payer: Prime Health Services Commercial |
$688.50
|
| Rate for Payer: Prime Health Services Medicare |
$343.18
|
| Rate for Payer: Riverside University Health System MISP |
$356.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$486.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$486.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$262.24
|
| Rate for Payer: United Healthcare All Other HMO |
$262.24
|
| Rate for Payer: United Healthcare HMO Rider |
$262.24
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$262.24
|
| Rate for Payer: Upland Medical Group Pediatric |
$323.75
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$485.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$356.12
|
| Rate for Payer: Vantage Medical Group Senior |
$323.75
|
|
|
HC HLA C1Q I
|
Facility
|
IP
|
$925.00
|
|
|
Service Code
|
CPT 86832
|
| Hospital Charge Code |
900913205
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$185.00 |
| Max. Negotiated Rate |
$832.50 |
| Rate for Payer: Adventist Health Commercial |
$185.00
|
| Rate for Payer: Cash Price |
$416.25
|
| Rate for Payer: Central Health Plan Commercial |
$740.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$370.00
|
| Rate for Payer: EPIC Health Plan Senior |
$370.00
|
| Rate for Payer: Galaxy Health WC |
$786.25
|
| Rate for Payer: Global Benefits Group Commercial |
$555.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$832.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$616.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$352.43
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$572.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$185.00
|
| Rate for Payer: Multiplan Commercial |
$693.75
|
| Rate for Payer: Networks By Design Commercial |
$601.25
|
| Rate for Payer: Prime Health Services Commercial |
$786.25
|
|
