|
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 |
$2,203.85
|
| 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-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 |
$2,203.85
|
| Rate for Payer: Cash Price |
$2,203.85
|
| 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 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 |
$173.61
|
| Rate for Payer: Cash Price |
$173.61
|
| 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 AB SCREEN I/II
|
Facility
|
IP
|
$315.66
|
|
|
Service Code
|
CPT 86828
|
| Hospital Charge Code |
903901995
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$63.13 |
| Max. Negotiated Rate |
$284.09 |
| Rate for Payer: Adventist Health Commercial |
$63.13
|
| Rate for Payer: Cash Price |
$173.61
|
| Rate for Payer: Central Health Plan Commercial |
$252.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$126.26
|
| Rate for Payer: EPIC Health Plan Senior |
$126.26
|
| 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: Kaiser Permanente of CA Commercial/Self Funded |
$210.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$120.27
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$195.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$63.13
|
| Rate for Payer: Multiplan Commercial |
$236.75
|
| Rate for Payer: Networks By Design Commercial |
$205.18
|
| Rate for Payer: Prime Health Services Commercial |
$268.31
|
|
|
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 |
$408.65
|
| Rate for Payer: Cash Price |
$408.65
|
| 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 MOLECULAR
|
Facility
|
IP
|
$743.00
|
|
|
Service Code
|
CPT 81372
|
| Hospital Charge Code |
903901902
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$148.60 |
| Max. Negotiated Rate |
$668.70 |
| Rate for Payer: Adventist Health Commercial |
$148.60
|
| Rate for Payer: Cash Price |
$408.65
|
| Rate for Payer: Central Health Plan Commercial |
$594.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$297.20
|
| Rate for Payer: EPIC Health Plan Senior |
$297.20
|
| 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: Kaiser Permanente of CA Commercial/Self Funded |
$495.58
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$283.08
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$459.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$148.60
|
| Rate for Payer: Multiplan Commercial |
$557.25
|
| Rate for Payer: Networks By Design Commercial |
$482.95
|
| Rate for Payer: Prime Health Services Commercial |
$631.55
|
|
|
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 |
$161.15
|
| Rate for Payer: Cash Price |
$161.15
|
| 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-C SEROLOGY
|
Facility
|
IP
|
$293.00
|
|
|
Service Code
|
CPT 86813
|
| Hospital Charge Code |
903901988
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$58.60 |
| Max. Negotiated Rate |
$263.70 |
| Rate for Payer: Adventist Health Commercial |
$58.60
|
| Rate for Payer: Cash Price |
$161.15
|
| Rate for Payer: Central Health Plan Commercial |
$234.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$117.20
|
| Rate for Payer: EPIC Health Plan Senior |
$117.20
|
| 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: Kaiser Permanente of CA Commercial/Self Funded |
$195.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$111.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$181.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$58.60
|
| Rate for Payer: Multiplan Commercial |
$219.75
|
| Rate for Payer: Networks By Design Commercial |
$190.45
|
| Rate for Payer: Prime Health Services Commercial |
$249.05
|
|
|
HC HLA A MOLECULAR HI RESOLUTION
|
Facility
|
IP
|
$217.00
|
|
|
Service Code
|
CPT 81380
|
| Hospital Charge Code |
903901985
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$43.40 |
| Max. Negotiated Rate |
$195.30 |
| Rate for Payer: Adventist Health Commercial |
$43.40
|
| Rate for Payer: Cash Price |
$119.35
|
| Rate for Payer: Central Health Plan Commercial |
$173.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$86.80
|
| Rate for Payer: EPIC Health Plan Senior |
$86.80
|
| 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: Kaiser Permanente of CA Commercial/Self Funded |
$144.74
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$82.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$134.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$43.40
|
| Rate for Payer: Multiplan Commercial |
$162.75
|
| Rate for Payer: Networks By Design Commercial |
$141.05
|
| Rate for Payer: Prime Health Services Commercial |
$184.45
|
|
|
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 |
$119.35
|
| Rate for Payer: Cash Price |
$119.35
|
| 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 - 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 |
$179.30
|
| Rate for Payer: Cash Price |
$179.30
|
| 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 - B27
|
Facility
|
IP
|
$326.00
|
|
|
Service Code
|
CPT 81373
|
| Hospital Charge Code |
903901903
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$65.20 |
| Max. Negotiated Rate |
$293.40 |
| Rate for Payer: Adventist Health Commercial |
$65.20
|
| Rate for Payer: Cash Price |
$179.30
|
| Rate for Payer: Central Health Plan Commercial |
$260.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$130.40
|
| Rate for Payer: EPIC Health Plan Senior |
$130.40
|
| 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: Kaiser Permanente of CA Commercial/Self Funded |
$217.44
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$124.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$201.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$65.20
|
| Rate for Payer: Multiplan Commercial |
$244.50
|
| Rate for Payer: Networks By Design Commercial |
$211.90
|
| Rate for Payer: Prime Health Services Commercial |
$277.10
|
|
|
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 |
$119.35
|
| Rate for Payer: Cash Price |
$119.35
|
| 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 B MOLECULAR HI RESOLUTION
|
Facility
|
IP
|
$217.00
|
|
|
Service Code
|
CPT 81380
|
| Hospital Charge Code |
903901989
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$43.40 |
| Max. Negotiated Rate |
$195.30 |
| Rate for Payer: Adventist Health Commercial |
$43.40
|
| Rate for Payer: Cash Price |
$119.35
|
| Rate for Payer: Central Health Plan Commercial |
$173.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$86.80
|
| Rate for Payer: EPIC Health Plan Senior |
$86.80
|
| 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: Kaiser Permanente of CA Commercial/Self Funded |
$144.74
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$82.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$134.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$43.40
|
| Rate for Payer: Multiplan Commercial |
$162.75
|
| Rate for Payer: Networks By Design Commercial |
$141.05
|
| Rate for Payer: Prime Health Services Commercial |
$184.45
|
|
|
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 |
$445.50
|
| Rate for Payer: Cash Price |
$445.50
|
| 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
|
$810.00
|
|
|
Service Code
|
CPT 86832
|
| Hospital Charge Code |
900913205
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$162.00 |
| Max. Negotiated Rate |
$729.00 |
| Rate for Payer: Adventist Health Commercial |
$162.00
|
| Rate for Payer: Cash Price |
$445.50
|
| Rate for Payer: Central Health Plan Commercial |
$648.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$324.00
|
| Rate for Payer: EPIC Health Plan Senior |
$324.00
|
| 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: Kaiser Permanente of CA Commercial/Self Funded |
$540.27
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$308.61
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$501.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$162.00
|
| Rate for Payer: Multiplan Commercial |
$607.50
|
| Rate for Payer: Networks By Design Commercial |
$526.50
|
| Rate for Payer: Prime Health Services Commercial |
$688.50
|
|
|
HC HLA C1Q I
|
Facility
|
IP
|
$810.00
|
|
|
Service Code
|
CPT 86832
|
| Hospital Charge Code |
903913205
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$162.00 |
| Max. Negotiated Rate |
$729.00 |
| Rate for Payer: Adventist Health Commercial |
$162.00
|
| Rate for Payer: Cash Price |
$445.50
|
| Rate for Payer: Central Health Plan Commercial |
$648.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$324.00
|
| Rate for Payer: EPIC Health Plan Senior |
$324.00
|
| 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: Kaiser Permanente of CA Commercial/Self Funded |
$540.27
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$308.61
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$501.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$162.00
|
| Rate for Payer: Multiplan Commercial |
$607.50
|
| Rate for Payer: Networks By Design Commercial |
$526.50
|
| Rate for Payer: Prime Health Services Commercial |
$688.50
|
|
|
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 |
$445.50
|
| Rate for Payer: Cash Price |
$445.50
|
| 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 II
|
Facility
|
IP
|
$786.00
|
|
|
Service Code
|
CPT 86833
|
| Hospital Charge Code |
903913206
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$157.20 |
| Max. Negotiated Rate |
$707.40 |
| Rate for Payer: Adventist Health Commercial |
$157.20
|
| Rate for Payer: Cash Price |
$432.30
|
| Rate for Payer: Central Health Plan Commercial |
$628.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$314.40
|
| Rate for Payer: EPIC Health Plan Senior |
$314.40
|
| Rate for Payer: Galaxy Health WC |
$668.10
|
| Rate for Payer: Global Benefits Group Commercial |
$471.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$707.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$524.26
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$299.47
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$486.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$157.20
|
| Rate for Payer: Multiplan Commercial |
$589.50
|
| Rate for Payer: Networks By Design Commercial |
$510.90
|
| Rate for Payer: Prime Health Services Commercial |
$668.10
|
|
|
HC HLA C1Q II
|
Facility
|
OP
|
$786.00
|
|
|
Service Code
|
CPT 86833
|
| Hospital Charge Code |
900913206
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$17.66 |
| Max. Negotiated Rate |
$707.40 |
| Rate for Payer: Adventist Health Commercial |
$157.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$325.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$477.34
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$488.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$358.38
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$325.80
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$534.53
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$108.49
|
| Rate for Payer: Blue Shield of California Commercial |
$477.10
|
| Rate for Payer: Blue Shield of California EPN |
$312.04
|
| Rate for Payer: Cash Price |
$432.30
|
| Rate for Payer: Cash Price |
$432.30
|
| Rate for Payer: Central Health Plan Commercial |
$628.80
|
| Rate for Payer: Cigna of CA HMO |
$503.04
|
| Rate for Payer: Cigna of CA PPO |
$581.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$488.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$358.38
|
| Rate for Payer: Dignity Health Medicare Advantage |
$325.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$439.83
|
| Rate for Payer: EPIC Health Plan Senior |
$325.80
|
| Rate for Payer: Galaxy Health WC |
$668.10
|
| Rate for Payer: Global Benefits Group Commercial |
$471.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$707.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$534.31
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$17.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$325.80
|
| Rate for Payer: InnovAge PACE Commercial |
$488.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$524.26
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$19.51
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$325.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$157.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$436.57
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$436.57
|
| Rate for Payer: Multiplan Commercial |
$589.50
|
| Rate for Payer: Networks By Design Commercial |
$510.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$325.80
|
| Rate for Payer: Prime Health Services Commercial |
$668.10
|
| Rate for Payer: Prime Health Services Medicare |
$345.35
|
| Rate for Payer: Riverside University Health System MISP |
$358.38
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$471.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$471.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$263.90
|
| Rate for Payer: United Healthcare All Other HMO |
$263.90
|
| Rate for Payer: United Healthcare HMO Rider |
$263.90
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$263.90
|
| Rate for Payer: Upland Medical Group Pediatric |
$325.80
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$488.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$358.38
|
| Rate for Payer: Vantage Medical Group Senior |
$325.80
|
|
|
HC HLA C1Q II
|
Facility
|
OP
|
$786.00
|
|
|
Service Code
|
CPT 86833
|
| Hospital Charge Code |
903913206
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$17.66 |
| Max. Negotiated Rate |
$707.40 |
| Rate for Payer: Adventist Health Commercial |
$157.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$325.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$477.34
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$488.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$358.38
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$325.80
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$534.53
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$108.49
|
| Rate for Payer: Blue Shield of California Commercial |
$477.10
|
| Rate for Payer: Blue Shield of California EPN |
$312.04
|
| Rate for Payer: Cash Price |
$432.30
|
| Rate for Payer: Cash Price |
$432.30
|
| Rate for Payer: Central Health Plan Commercial |
$628.80
|
| Rate for Payer: Cigna of CA HMO |
$503.04
|
| Rate for Payer: Cigna of CA PPO |
$581.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$488.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$358.38
|
| Rate for Payer: Dignity Health Medicare Advantage |
$325.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$439.83
|
| Rate for Payer: EPIC Health Plan Senior |
$325.80
|
| Rate for Payer: Galaxy Health WC |
$668.10
|
| Rate for Payer: Global Benefits Group Commercial |
$471.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$707.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$534.31
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$17.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$325.80
|
| Rate for Payer: InnovAge PACE Commercial |
$488.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$524.26
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$19.51
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$325.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$157.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$436.57
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$436.57
|
| Rate for Payer: Multiplan Commercial |
$589.50
|
| Rate for Payer: Networks By Design Commercial |
$510.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$325.80
|
| Rate for Payer: Prime Health Services Commercial |
$668.10
|
| Rate for Payer: Prime Health Services Medicare |
$345.35
|
| Rate for Payer: Riverside University Health System MISP |
$358.38
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$471.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$471.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$263.90
|
| Rate for Payer: United Healthcare All Other HMO |
$263.90
|
| Rate for Payer: United Healthcare HMO Rider |
$263.90
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$263.90
|
| Rate for Payer: Upland Medical Group Pediatric |
$325.80
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$488.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$358.38
|
| Rate for Payer: Vantage Medical Group Senior |
$325.80
|
|
|
HC HLA C1Q II
|
Facility
|
IP
|
$786.00
|
|
|
Service Code
|
CPT 86833
|
| Hospital Charge Code |
900913206
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$157.20 |
| Max. Negotiated Rate |
$707.40 |
| Rate for Payer: Adventist Health Commercial |
$157.20
|
| Rate for Payer: Cash Price |
$432.30
|
| Rate for Payer: Central Health Plan Commercial |
$628.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$314.40
|
| Rate for Payer: EPIC Health Plan Senior |
$314.40
|
| Rate for Payer: Galaxy Health WC |
$668.10
|
| Rate for Payer: Global Benefits Group Commercial |
$471.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$707.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$524.26
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$299.47
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$486.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$157.20
|
| Rate for Payer: Multiplan Commercial |
$589.50
|
| Rate for Payer: Networks By Design Commercial |
$510.90
|
| Rate for Payer: Prime Health Services Commercial |
$668.10
|
|
|
HC HLA CELL STORAGE
|
Facility
|
IP
|
$108.00
|
|
|
Service Code
|
CPT 86849
|
| Hospital Charge Code |
903901971
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$21.60 |
| Max. Negotiated Rate |
$97.20 |
| Rate for Payer: Adventist Health Commercial |
$21.60
|
| Rate for Payer: Cash Price |
$59.40
|
| Rate for Payer: Central Health Plan Commercial |
$86.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$43.20
|
| Rate for Payer: EPIC Health Plan Senior |
$43.20
|
| Rate for Payer: Galaxy Health WC |
$91.80
|
| Rate for Payer: Global Benefits Group Commercial |
$64.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$97.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$72.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$41.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$66.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$21.60
|
| Rate for Payer: Multiplan Commercial |
$81.00
|
| Rate for Payer: Networks By Design Commercial |
$70.20
|
| Rate for Payer: Prime Health Services Commercial |
$91.80
|
|
|
HC HLA CELL STORAGE
|
Facility
|
OP
|
$108.00
|
|
|
Service Code
|
CPT 86849
|
| Hospital Charge Code |
903901971
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$21.60 |
| Max. Negotiated Rate |
$97.20 |
| Rate for Payer: Adventist Health Commercial |
$21.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$65.59
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$91.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$59.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$81.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$52.29
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$63.43
|
| Rate for Payer: Blue Shield of California Commercial |
$65.56
|
| Rate for Payer: Blue Shield of California EPN |
$42.88
|
| Rate for Payer: Cash Price |
$59.40
|
| Rate for Payer: Central Health Plan Commercial |
$86.40
|
| Rate for Payer: Cigna of CA HMO |
$69.12
|
| Rate for Payer: Cigna of CA PPO |
$79.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$91.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$91.80
|
| Rate for Payer: Dignity Health Medicare Advantage |
$91.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$43.20
|
| Rate for Payer: EPIC Health Plan Senior |
$43.20
|
| Rate for Payer: Galaxy Health WC |
$91.80
|
| Rate for Payer: Global Benefits Group Commercial |
$64.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$97.20
|
| Rate for Payer: InnovAge PACE Commercial |
$54.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$72.04
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$66.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$21.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$75.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$75.60
|
| Rate for Payer: Multiplan Commercial |
$81.00
|
| Rate for Payer: Networks By Design Commercial |
$70.20
|
| Rate for Payer: Prime Health Services Commercial |
$91.80
|
| Rate for Payer: Riverside University Health System MISP |
$43.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$64.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$64.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$54.00
|
| Rate for Payer: United Healthcare All Other HMO |
$54.00
|
| Rate for Payer: United Healthcare HMO Rider |
$54.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$54.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$91.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$91.80
|
| Rate for Payer: Vantage Medical Group Senior |
$91.80
|
|
|
HC HLA C MOLECULAR HI RESOLUTION
|
Facility
|
IP
|
$217.00
|
|
|
Service Code
|
CPT 81380
|
| Hospital Charge Code |
903901990
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$43.40 |
| Max. Negotiated Rate |
$195.30 |
| Rate for Payer: Adventist Health Commercial |
$43.40
|
| Rate for Payer: Cash Price |
$119.35
|
| Rate for Payer: Central Health Plan Commercial |
$173.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$86.80
|
| Rate for Payer: EPIC Health Plan Senior |
$86.80
|
| 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: Kaiser Permanente of CA Commercial/Self Funded |
$144.74
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$82.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$134.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$43.40
|
| Rate for Payer: Multiplan Commercial |
$162.75
|
| Rate for Payer: Networks By Design Commercial |
$141.05
|
| Rate for Payer: Prime Health Services Commercial |
$184.45
|
|
