|
HC IMMUNOASSAY QUAN CA 15-3
|
Facility
|
IP
|
$95.00
|
|
|
Service Code
|
CPT 86300
|
| Hospital Charge Code |
900912123
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$19.00 |
| Max. Negotiated Rate |
$85.50 |
| Rate for Payer: Adventist Health Commercial |
$19.00
|
| Rate for Payer: Cash Price |
$52.25
|
| Rate for Payer: Central Health Plan Commercial |
$76.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$38.00
|
| Rate for Payer: EPIC Health Plan Senior |
$38.00
|
| Rate for Payer: Galaxy Health WC |
$80.75
|
| Rate for Payer: Global Benefits Group Commercial |
$57.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$85.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$63.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$36.20
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$58.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.00
|
| Rate for Payer: Multiplan Commercial |
$71.25
|
| Rate for Payer: Networks By Design Commercial |
$61.75
|
| Rate for Payer: Prime Health Services Commercial |
$80.75
|
|
|
HC IMMUNOASSAY QUAN CA 15-3
|
Facility
|
OP
|
$95.00
|
|
|
Service Code
|
CPT 86300
|
| Hospital Charge Code |
900912123
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$16.86 |
| Max. Negotiated Rate |
$151.29 |
| Rate for Payer: Adventist Health Commercial |
$19.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$20.81
|
| Rate for Payer: Aetna of CA HMO/PPO |
$57.69
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$31.21
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$22.89
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$20.81
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$151.29
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$30.70
|
| Rate for Payer: Blue Shield of California Commercial |
$57.66
|
| Rate for Payer: Blue Shield of California EPN |
$37.72
|
| Rate for Payer: Cash Price |
$52.25
|
| Rate for Payer: Cash Price |
$52.25
|
| Rate for Payer: Central Health Plan Commercial |
$76.00
|
| Rate for Payer: Cigna of CA HMO |
$60.80
|
| Rate for Payer: Cigna of CA PPO |
$70.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$31.21
|
| Rate for Payer: Dignity Health Medi-Cal |
$22.89
|
| Rate for Payer: Dignity Health Medicare Advantage |
$20.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$28.09
|
| Rate for Payer: EPIC Health Plan Senior |
$20.81
|
| Rate for Payer: Galaxy Health WC |
$80.75
|
| Rate for Payer: Global Benefits Group Commercial |
$57.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$85.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$34.13
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$31.82
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$20.81
|
| Rate for Payer: InnovAge PACE Commercial |
$31.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$63.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$35.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$20.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$27.89
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$27.89
|
| Rate for Payer: Multiplan Commercial |
$71.25
|
| Rate for Payer: Networks By Design Commercial |
$61.75
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$20.81
|
| Rate for Payer: Prime Health Services Commercial |
$80.75
|
| Rate for Payer: Prime Health Services Medicare |
$22.06
|
| Rate for Payer: Riverside University Health System MISP |
$22.89
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$57.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$57.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$16.86
|
| Rate for Payer: United Healthcare All Other HMO |
$16.86
|
| Rate for Payer: United Healthcare HMO Rider |
$16.86
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16.86
|
| Rate for Payer: Upland Medical Group Pediatric |
$20.81
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$31.21
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$22.89
|
| Rate for Payer: Vantage Medical Group Senior |
$20.81
|
|
|
HC IMMUNOASSAY QUAN CA 19-9
|
Facility
|
OP
|
$166.00
|
|
|
Service Code
|
CPT 86301
|
| Hospital Charge Code |
900912124
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$16.86 |
| Max. Negotiated Rate |
$151.29 |
| Rate for Payer: Adventist Health Commercial |
$33.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$20.81
|
| Rate for Payer: Aetna of CA HMO/PPO |
$100.81
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$31.21
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$22.89
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$20.81
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$151.29
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$30.70
|
| Rate for Payer: Blue Shield of California Commercial |
$100.76
|
| Rate for Payer: Blue Shield of California EPN |
$65.90
|
| Rate for Payer: Cash Price |
$91.30
|
| Rate for Payer: Cash Price |
$91.30
|
| Rate for Payer: Central Health Plan Commercial |
$132.80
|
| Rate for Payer: Cigna of CA HMO |
$106.24
|
| Rate for Payer: Cigna of CA PPO |
$122.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$31.21
|
| Rate for Payer: Dignity Health Medi-Cal |
$22.89
|
| Rate for Payer: Dignity Health Medicare Advantage |
$20.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$28.09
|
| Rate for Payer: EPIC Health Plan Senior |
$20.81
|
| Rate for Payer: Galaxy Health WC |
$141.10
|
| Rate for Payer: Global Benefits Group Commercial |
$99.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$149.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$34.13
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$31.82
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$20.81
|
| Rate for Payer: InnovAge PACE Commercial |
$31.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$110.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$35.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$20.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$33.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$27.89
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$27.89
|
| Rate for Payer: Multiplan Commercial |
$124.50
|
| Rate for Payer: Networks By Design Commercial |
$107.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$20.81
|
| Rate for Payer: Prime Health Services Commercial |
$141.10
|
| Rate for Payer: Prime Health Services Medicare |
$22.06
|
| Rate for Payer: Riverside University Health System MISP |
$22.89
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$99.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$99.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$16.86
|
| Rate for Payer: United Healthcare All Other HMO |
$16.86
|
| Rate for Payer: United Healthcare HMO Rider |
$16.86
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16.86
|
| Rate for Payer: Upland Medical Group Pediatric |
$20.81
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$31.21
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$22.89
|
| Rate for Payer: Vantage Medical Group Senior |
$20.81
|
|
|
HC IMMUNOASSAY QUAN CA 19-9
|
Facility
|
IP
|
$166.00
|
|
|
Service Code
|
CPT 86301
|
| Hospital Charge Code |
900912124
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$33.20 |
| Max. Negotiated Rate |
$149.40 |
| Rate for Payer: Adventist Health Commercial |
$33.20
|
| Rate for Payer: Cash Price |
$91.30
|
| Rate for Payer: Central Health Plan Commercial |
$132.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$66.40
|
| Rate for Payer: EPIC Health Plan Senior |
$66.40
|
| Rate for Payer: Galaxy Health WC |
$141.10
|
| Rate for Payer: Global Benefits Group Commercial |
$99.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$149.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$110.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$63.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$102.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$33.20
|
| Rate for Payer: Multiplan Commercial |
$124.50
|
| Rate for Payer: Networks By Design Commercial |
$107.90
|
| Rate for Payer: Prime Health Services Commercial |
$141.10
|
|
|
HC IMMUNOFLUORESCENCE STAIN EA AB
|
Facility
|
IP
|
$205.00
|
|
|
Service Code
|
CPT 88346
|
| Hospital Charge Code |
903800037
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$41.00 |
| Max. Negotiated Rate |
$184.50 |
| Rate for Payer: Adventist Health Commercial |
$41.00
|
| Rate for Payer: Cash Price |
$112.75
|
| Rate for Payer: Central Health Plan Commercial |
$164.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$82.00
|
| Rate for Payer: EPIC Health Plan Senior |
$82.00
|
| Rate for Payer: Galaxy Health WC |
$174.25
|
| Rate for Payer: Global Benefits Group Commercial |
$123.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$184.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$136.74
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$78.11
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$126.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$41.00
|
| Rate for Payer: Multiplan Commercial |
$153.75
|
| Rate for Payer: Networks By Design Commercial |
$133.25
|
| Rate for Payer: Prime Health Services Commercial |
$174.25
|
|
|
HC IMMUNOFLUORESCENCE STAIN EA AB
|
Facility
|
OP
|
$205.00
|
|
|
Service Code
|
CPT 88346
|
| Hospital Charge Code |
903800037
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$11.14 |
| Max. Negotiated Rate |
$357.08 |
| Rate for Payer: Adventist Health Commercial |
$41.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$217.73
|
| Rate for Payer: Aetna of CA HMO/PPO |
$124.50
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$326.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$239.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$217.73
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$54.90
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11.14
|
| Rate for Payer: Blue Shield of California Commercial |
$124.44
|
| Rate for Payer: Blue Shield of California EPN |
$81.39
|
| Rate for Payer: Cash Price |
$112.75
|
| Rate for Payer: Cash Price |
$112.75
|
| Rate for Payer: Central Health Plan Commercial |
$164.00
|
| Rate for Payer: Cigna of CA HMO |
$131.20
|
| Rate for Payer: Cigna of CA PPO |
$151.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$326.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$239.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$217.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$293.94
|
| Rate for Payer: EPIC Health Plan Senior |
$217.73
|
| Rate for Payer: Galaxy Health WC |
$174.25
|
| Rate for Payer: Global Benefits Group Commercial |
$123.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$184.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$357.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$96.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$217.73
|
| Rate for Payer: InnovAge PACE Commercial |
$326.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$136.74
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$106.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$217.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$41.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$291.76
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$291.76
|
| Rate for Payer: Multiplan Commercial |
$153.75
|
| Rate for Payer: Networks By Design Commercial |
$133.25
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$217.73
|
| Rate for Payer: Prime Health Services Commercial |
$174.25
|
| Rate for Payer: Prime Health Services Medicare |
$230.79
|
| Rate for Payer: Riverside University Health System MISP |
$239.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$123.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$123.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$240.94
|
| Rate for Payer: United Healthcare All Other HMO |
$240.94
|
| Rate for Payer: United Healthcare HMO Rider |
$240.94
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$240.94
|
| Rate for Payer: Upland Medical Group Pediatric |
$217.73
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$326.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$239.50
|
| Rate for Payer: Vantage Medical Group Senior |
$217.73
|
|
|
HC IMMUNOFLUORES STAIN EA ADDL
|
Facility
|
IP
|
$410.00
|
|
|
Service Code
|
CPT 88350
|
| Hospital Charge Code |
903800289
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$82.00 |
| Max. Negotiated Rate |
$369.00 |
| Rate for Payer: Adventist Health Commercial |
$82.00
|
| Rate for Payer: Cash Price |
$225.50
|
| Rate for Payer: Central Health Plan Commercial |
$328.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$164.00
|
| Rate for Payer: EPIC Health Plan Senior |
$164.00
|
| Rate for Payer: Galaxy Health WC |
$348.50
|
| Rate for Payer: Global Benefits Group Commercial |
$246.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$369.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$273.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$156.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$253.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$82.00
|
| Rate for Payer: Multiplan Commercial |
$307.50
|
| Rate for Payer: Networks By Design Commercial |
$266.50
|
| Rate for Payer: Prime Health Services Commercial |
$348.50
|
|
|
HC IMMUNOFLUORES STAIN EA ADDL
|
Facility
|
OP
|
$410.00
|
|
|
Service Code
|
CPT 88350
|
| Hospital Charge Code |
903800289
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$73.72 |
| Max. Negotiated Rate |
$403.72 |
| Rate for Payer: Adventist Health Commercial |
$82.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$248.99
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$348.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$225.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$307.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$403.72
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$81.94
|
| Rate for Payer: Blue Shield of California Commercial |
$248.87
|
| Rate for Payer: Blue Shield of California EPN |
$162.77
|
| Rate for Payer: Cash Price |
$225.50
|
| Rate for Payer: Cash Price |
$225.50
|
| Rate for Payer: Central Health Plan Commercial |
$328.00
|
| Rate for Payer: Cigna of CA HMO |
$262.40
|
| Rate for Payer: Cigna of CA PPO |
$303.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$348.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$348.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$348.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$164.00
|
| Rate for Payer: EPIC Health Plan Senior |
$164.00
|
| Rate for Payer: Galaxy Health WC |
$348.50
|
| Rate for Payer: Global Benefits Group Commercial |
$246.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$369.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$111.22
|
| Rate for Payer: InnovAge PACE Commercial |
$205.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$273.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$122.85
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$253.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$82.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$287.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$287.00
|
| Rate for Payer: Multiplan Commercial |
$307.50
|
| Rate for Payer: Networks By Design Commercial |
$266.50
|
| Rate for Payer: Prime Health Services Commercial |
$348.50
|
| Rate for Payer: Riverside University Health System MISP |
$164.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$246.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$246.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$73.72
|
| Rate for Payer: United Healthcare All Other HMO |
$73.72
|
| Rate for Payer: United Healthcare HMO Rider |
$73.72
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$73.72
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$348.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$348.50
|
| Rate for Payer: Vantage Medical Group Senior |
$348.50
|
|
|
HC IMMUNOGLOBULIN E
|
Facility
|
IP
|
$98.00
|
|
|
Service Code
|
CPT 82785
|
| Hospital Charge Code |
900912129
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$19.60 |
| Max. Negotiated Rate |
$88.20 |
| Rate for Payer: Adventist Health Commercial |
$19.60
|
| Rate for Payer: Cash Price |
$53.90
|
| Rate for Payer: Central Health Plan Commercial |
$78.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$39.20
|
| Rate for Payer: EPIC Health Plan Senior |
$39.20
|
| Rate for Payer: Galaxy Health WC |
$83.30
|
| Rate for Payer: Global Benefits Group Commercial |
$58.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$88.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$65.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$37.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$60.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.60
|
| Rate for Payer: Multiplan Commercial |
$73.50
|
| Rate for Payer: Networks By Design Commercial |
$63.70
|
| Rate for Payer: Prime Health Services Commercial |
$83.30
|
|
|
HC IMMUNOGLOBULIN E
|
Facility
|
OP
|
$98.00
|
|
|
Service Code
|
CPT 82785
|
| Hospital Charge Code |
900912129
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.33 |
| Max. Negotiated Rate |
$119.80 |
| Rate for Payer: Adventist Health Commercial |
$19.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$16.46
|
| Rate for Payer: Aetna of CA HMO/PPO |
$59.52
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$24.69
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$18.11
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$16.46
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$119.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$24.31
|
| Rate for Payer: Blue Shield of California Commercial |
$59.49
|
| Rate for Payer: Blue Shield of California EPN |
$38.91
|
| Rate for Payer: Cash Price |
$53.90
|
| Rate for Payer: Cash Price |
$53.90
|
| Rate for Payer: Central Health Plan Commercial |
$78.40
|
| Rate for Payer: Cigna of CA HMO |
$62.72
|
| Rate for Payer: Cigna of CA PPO |
$72.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$24.69
|
| Rate for Payer: Dignity Health Medi-Cal |
$18.11
|
| Rate for Payer: Dignity Health Medicare Advantage |
$16.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$22.22
|
| Rate for Payer: EPIC Health Plan Senior |
$16.46
|
| Rate for Payer: Galaxy Health WC |
$83.30
|
| Rate for Payer: Global Benefits Group Commercial |
$58.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$88.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$26.99
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$25.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$16.46
|
| Rate for Payer: InnovAge PACE Commercial |
$24.69
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$65.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$27.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$22.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$22.06
|
| Rate for Payer: Multiplan Commercial |
$73.50
|
| Rate for Payer: Networks By Design Commercial |
$63.70
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$16.46
|
| Rate for Payer: Prime Health Services Commercial |
$83.30
|
| Rate for Payer: Prime Health Services Medicare |
$17.45
|
| Rate for Payer: Riverside University Health System MISP |
$18.11
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$58.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$58.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$13.33
|
| Rate for Payer: United Healthcare All Other HMO |
$13.33
|
| Rate for Payer: United Healthcare HMO Rider |
$13.33
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$13.33
|
| Rate for Payer: Upland Medical Group Pediatric |
$16.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$24.69
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$18.11
|
| Rate for Payer: Vantage Medical Group Senior |
$16.46
|
|
|
HC IMMUNOGLOBULINS IGA
|
Facility
|
OP
|
$78.00
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
900910855
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.53 |
| Max. Negotiated Rate |
$70.20 |
| Rate for Payer: Adventist Health Commercial |
$15.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$9.30
|
| Rate for Payer: Aetna of CA HMO/PPO |
$47.37
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9.30
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$56.37
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11.44
|
| Rate for Payer: Blue Shield of California Commercial |
$47.35
|
| Rate for Payer: Blue Shield of California EPN |
$30.97
|
| Rate for Payer: Cash Price |
$42.90
|
| Rate for Payer: Cash Price |
$42.90
|
| Rate for Payer: Central Health Plan Commercial |
$62.40
|
| Rate for Payer: Cigna of CA HMO |
$49.92
|
| Rate for Payer: Cigna of CA PPO |
$57.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$10.23
|
| Rate for Payer: Dignity Health Medicare Advantage |
$9.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.55
|
| Rate for Payer: EPIC Health Plan Senior |
$9.30
|
| Rate for Payer: Galaxy Health WC |
$66.30
|
| Rate for Payer: Global Benefits Group Commercial |
$46.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$70.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$15.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$10.46
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$9.30
|
| Rate for Payer: InnovAge PACE Commercial |
$13.95
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$52.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.55
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$12.46
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$12.46
|
| Rate for Payer: Multiplan Commercial |
$58.50
|
| Rate for Payer: Networks By Design Commercial |
$50.70
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$9.30
|
| Rate for Payer: Prime Health Services Commercial |
$66.30
|
| Rate for Payer: Prime Health Services Medicare |
$9.86
|
| Rate for Payer: Riverside University Health System MISP |
$10.23
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$46.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$46.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.53
|
| Rate for Payer: United Healthcare All Other HMO |
$7.53
|
| Rate for Payer: United Healthcare HMO Rider |
$7.53
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.53
|
| Rate for Payer: Upland Medical Group Pediatric |
$9.30
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.23
|
| Rate for Payer: Vantage Medical Group Senior |
$9.30
|
|
|
HC IMMUNOGLOBULINS IGA
|
Facility
|
IP
|
$78.00
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
900910855
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.60 |
| Max. Negotiated Rate |
$70.20 |
| Rate for Payer: Adventist Health Commercial |
$15.60
|
| Rate for Payer: Cash Price |
$42.90
|
| Rate for Payer: Central Health Plan Commercial |
$62.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$31.20
|
| Rate for Payer: EPIC Health Plan Senior |
$31.20
|
| Rate for Payer: Galaxy Health WC |
$66.30
|
| Rate for Payer: Global Benefits Group Commercial |
$46.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$70.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$52.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$29.72
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$48.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.60
|
| Rate for Payer: Multiplan Commercial |
$58.50
|
| Rate for Payer: Networks By Design Commercial |
$50.70
|
| Rate for Payer: Prime Health Services Commercial |
$66.30
|
|
|
HC IMMUNOGLOBULINS IGG
|
Facility
|
OP
|
$78.00
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
900910857
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.53 |
| Max. Negotiated Rate |
$70.20 |
| Rate for Payer: Adventist Health Commercial |
$15.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$9.30
|
| Rate for Payer: Aetna of CA HMO/PPO |
$47.37
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9.30
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$56.37
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11.44
|
| Rate for Payer: Blue Shield of California Commercial |
$47.35
|
| Rate for Payer: Blue Shield of California EPN |
$30.97
|
| Rate for Payer: Cash Price |
$42.90
|
| Rate for Payer: Cash Price |
$42.90
|
| Rate for Payer: Central Health Plan Commercial |
$62.40
|
| Rate for Payer: Cigna of CA HMO |
$49.92
|
| Rate for Payer: Cigna of CA PPO |
$57.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$10.23
|
| Rate for Payer: Dignity Health Medicare Advantage |
$9.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.55
|
| Rate for Payer: EPIC Health Plan Senior |
$9.30
|
| Rate for Payer: Galaxy Health WC |
$66.30
|
| Rate for Payer: Global Benefits Group Commercial |
$46.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$70.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$15.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$10.46
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$9.30
|
| Rate for Payer: InnovAge PACE Commercial |
$13.95
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$52.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.55
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$12.46
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$12.46
|
| Rate for Payer: Multiplan Commercial |
$58.50
|
| Rate for Payer: Networks By Design Commercial |
$50.70
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$9.30
|
| Rate for Payer: Prime Health Services Commercial |
$66.30
|
| Rate for Payer: Prime Health Services Medicare |
$9.86
|
| Rate for Payer: Riverside University Health System MISP |
$10.23
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$46.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$46.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.53
|
| Rate for Payer: United Healthcare All Other HMO |
$7.53
|
| Rate for Payer: United Healthcare HMO Rider |
$7.53
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.53
|
| Rate for Payer: Upland Medical Group Pediatric |
$9.30
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.23
|
| Rate for Payer: Vantage Medical Group Senior |
$9.30
|
|
|
HC IMMUNOGLOBULINS IGG
|
Facility
|
IP
|
$78.00
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
900910857
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.60 |
| Max. Negotiated Rate |
$70.20 |
| Rate for Payer: Adventist Health Commercial |
$15.60
|
| Rate for Payer: Cash Price |
$42.90
|
| Rate for Payer: Central Health Plan Commercial |
$62.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$31.20
|
| Rate for Payer: EPIC Health Plan Senior |
$31.20
|
| Rate for Payer: Galaxy Health WC |
$66.30
|
| Rate for Payer: Global Benefits Group Commercial |
$46.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$70.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$52.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$29.72
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$48.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.60
|
| Rate for Payer: Multiplan Commercial |
$58.50
|
| Rate for Payer: Networks By Design Commercial |
$50.70
|
| Rate for Payer: Prime Health Services Commercial |
$66.30
|
|
|
HC IMMUNOGLOBULINS IGM
|
Facility
|
IP
|
$78.00
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
900910856
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.60 |
| Max. Negotiated Rate |
$70.20 |
| Rate for Payer: Adventist Health Commercial |
$15.60
|
| Rate for Payer: Cash Price |
$42.90
|
| Rate for Payer: Central Health Plan Commercial |
$62.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$31.20
|
| Rate for Payer: EPIC Health Plan Senior |
$31.20
|
| Rate for Payer: Galaxy Health WC |
$66.30
|
| Rate for Payer: Global Benefits Group Commercial |
$46.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$70.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$52.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$29.72
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$48.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.60
|
| Rate for Payer: Multiplan Commercial |
$58.50
|
| Rate for Payer: Networks By Design Commercial |
$50.70
|
| Rate for Payer: Prime Health Services Commercial |
$66.30
|
|
|
HC IMMUNOGLOBULINS IGM
|
Facility
|
OP
|
$78.00
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
900910856
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.53 |
| Max. Negotiated Rate |
$70.20 |
| Rate for Payer: Adventist Health Commercial |
$15.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$9.30
|
| Rate for Payer: Aetna of CA HMO/PPO |
$47.37
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9.30
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$56.37
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11.44
|
| Rate for Payer: Blue Shield of California Commercial |
$47.35
|
| Rate for Payer: Blue Shield of California EPN |
$30.97
|
| Rate for Payer: Cash Price |
$42.90
|
| Rate for Payer: Cash Price |
$42.90
|
| Rate for Payer: Central Health Plan Commercial |
$62.40
|
| Rate for Payer: Cigna of CA HMO |
$49.92
|
| Rate for Payer: Cigna of CA PPO |
$57.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$10.23
|
| Rate for Payer: Dignity Health Medicare Advantage |
$9.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.55
|
| Rate for Payer: EPIC Health Plan Senior |
$9.30
|
| Rate for Payer: Galaxy Health WC |
$66.30
|
| Rate for Payer: Global Benefits Group Commercial |
$46.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$70.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$15.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$10.46
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$9.30
|
| Rate for Payer: InnovAge PACE Commercial |
$13.95
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$52.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.55
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$12.46
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$12.46
|
| Rate for Payer: Multiplan Commercial |
$58.50
|
| Rate for Payer: Networks By Design Commercial |
$50.70
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$9.30
|
| Rate for Payer: Prime Health Services Commercial |
$66.30
|
| Rate for Payer: Prime Health Services Medicare |
$9.86
|
| Rate for Payer: Riverside University Health System MISP |
$10.23
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$46.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$46.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.53
|
| Rate for Payer: United Healthcare All Other HMO |
$7.53
|
| Rate for Payer: United Healthcare HMO Rider |
$7.53
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.53
|
| Rate for Payer: Upland Medical Group Pediatric |
$9.30
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.23
|
| Rate for Payer: Vantage Medical Group Senior |
$9.30
|
|
|
HC IMMUNOHISTO ANTIBOD ADD SLID
|
Facility
|
IP
|
$724.00
|
|
|
Service Code
|
CPT 88344
|
| Hospital Charge Code |
903800241
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$144.80 |
| Max. Negotiated Rate |
$651.60 |
| Rate for Payer: Adventist Health Commercial |
$144.80
|
| Rate for Payer: Cash Price |
$398.20
|
| Rate for Payer: Central Health Plan Commercial |
$579.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$289.60
|
| Rate for Payer: EPIC Health Plan Senior |
$289.60
|
| Rate for Payer: Galaxy Health WC |
$615.40
|
| Rate for Payer: Global Benefits Group Commercial |
$434.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$651.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$482.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$275.84
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$448.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$144.80
|
| Rate for Payer: Multiplan Commercial |
$543.00
|
| Rate for Payer: Networks By Design Commercial |
$470.60
|
| Rate for Payer: Prime Health Services Commercial |
$615.40
|
|
|
HC IMMUNOHISTO ANTIBOD ADD SLID
|
Facility
|
OP
|
$724.00
|
|
|
Service Code
|
CPT 88344
|
| Hospital Charge Code |
903800241
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$110.32 |
| Max. Negotiated Rate |
$749.58 |
| Rate for Payer: Adventist Health Commercial |
$144.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$457.06
|
| Rate for Payer: Aetna of CA HMO/PPO |
$439.69
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$685.59
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$502.77
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$457.06
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$543.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$110.32
|
| Rate for Payer: Blue Shield of California Commercial |
$439.47
|
| Rate for Payer: Blue Shield of California EPN |
$287.43
|
| Rate for Payer: Cash Price |
$398.20
|
| Rate for Payer: Cash Price |
$398.20
|
| Rate for Payer: Central Health Plan Commercial |
$579.20
|
| Rate for Payer: Cigna of CA HMO |
$463.36
|
| Rate for Payer: Cigna of CA PPO |
$535.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$685.59
|
| Rate for Payer: Dignity Health Medi-Cal |
$502.77
|
| Rate for Payer: Dignity Health Medicare Advantage |
$457.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$617.03
|
| Rate for Payer: EPIC Health Plan Senior |
$457.06
|
| Rate for Payer: Galaxy Health WC |
$615.40
|
| Rate for Payer: Global Benefits Group Commercial |
$434.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$651.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$749.58
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$180.46
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$457.06
|
| Rate for Payer: InnovAge PACE Commercial |
$685.59
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$482.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$199.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$457.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$144.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$612.46
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$612.46
|
| Rate for Payer: Multiplan Commercial |
$543.00
|
| Rate for Payer: Networks By Design Commercial |
$470.60
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$457.06
|
| Rate for Payer: Prime Health Services Commercial |
$615.40
|
| Rate for Payer: Prime Health Services Medicare |
$484.48
|
| Rate for Payer: Riverside University Health System MISP |
$502.77
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$434.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$434.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$240.94
|
| Rate for Payer: United Healthcare All Other HMO |
$240.94
|
| Rate for Payer: United Healthcare HMO Rider |
$240.94
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$240.94
|
| Rate for Payer: Upland Medical Group Pediatric |
$457.06
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$685.59
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$502.77
|
| Rate for Payer: Vantage Medical Group Senior |
$457.06
|
|
|
HC IMMUNOHISTOCHEM OR IMMUNOCYTOCHEM EA ABY STAIN
|
Facility
|
OP
|
$174.00
|
|
|
Service Code
|
CPT 88342
|
| Hospital Charge Code |
903800031
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$14.08 |
| Max. Negotiated Rate |
$357.08 |
| Rate for Payer: Adventist Health Commercial |
$34.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$217.73
|
| Rate for Payer: Aetna of CA HMO/PPO |
$105.67
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$326.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$239.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$217.73
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$69.35
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14.08
|
| Rate for Payer: Blue Shield of California Commercial |
$105.62
|
| Rate for Payer: Blue Shield of California EPN |
$69.08
|
| Rate for Payer: Cash Price |
$95.70
|
| Rate for Payer: Cash Price |
$95.70
|
| Rate for Payer: Central Health Plan Commercial |
$139.20
|
| Rate for Payer: Cigna of CA HMO |
$111.36
|
| Rate for Payer: Cigna of CA PPO |
$128.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$326.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$239.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$217.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$293.94
|
| Rate for Payer: EPIC Health Plan Senior |
$217.73
|
| Rate for Payer: Galaxy Health WC |
$147.90
|
| Rate for Payer: Global Benefits Group Commercial |
$104.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$156.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$357.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$92.52
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$217.73
|
| Rate for Payer: InnovAge PACE Commercial |
$326.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$116.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$102.20
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$217.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$34.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$291.76
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$291.76
|
| Rate for Payer: Multiplan Commercial |
$130.50
|
| Rate for Payer: Networks By Design Commercial |
$113.10
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$217.73
|
| Rate for Payer: Prime Health Services Commercial |
$147.90
|
| Rate for Payer: Prime Health Services Medicare |
$230.79
|
| Rate for Payer: Riverside University Health System MISP |
$239.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$104.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$104.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$123.38
|
| Rate for Payer: United Healthcare All Other HMO |
$123.38
|
| Rate for Payer: United Healthcare HMO Rider |
$123.38
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$123.38
|
| Rate for Payer: Upland Medical Group Pediatric |
$217.73
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$326.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$239.50
|
| Rate for Payer: Vantage Medical Group Senior |
$217.73
|
|
|
HC IMMUNOHISTOCHEM OR IMMUNOCYTOCHEM EA ABY STAIN
|
Facility
|
IP
|
$174.00
|
|
|
Service Code
|
CPT 88342
|
| Hospital Charge Code |
903800031
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$34.80 |
| Max. Negotiated Rate |
$156.60 |
| Rate for Payer: Adventist Health Commercial |
$34.80
|
| Rate for Payer: Cash Price |
$95.70
|
| Rate for Payer: Central Health Plan Commercial |
$139.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$69.60
|
| Rate for Payer: EPIC Health Plan Senior |
$69.60
|
| Rate for Payer: Galaxy Health WC |
$147.90
|
| Rate for Payer: Global Benefits Group Commercial |
$104.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$156.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$116.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$66.29
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$107.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$34.80
|
| Rate for Payer: Multiplan Commercial |
$130.50
|
| Rate for Payer: Networks By Design Commercial |
$113.10
|
| Rate for Payer: Prime Health Services Commercial |
$147.90
|
|
|
HC IMMUNOHISTOCHEM OR IMMUNOCYTOCHEM EA ADDITIONAL ABY STAIN
|
Facility
|
OP
|
$479.00
|
|
|
Service Code
|
CPT 88341
|
| Hospital Charge Code |
903800252
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$49.90 |
| Max. Negotiated Rate |
$431.10 |
| Rate for Payer: Adventist Health Commercial |
$95.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$290.90
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$407.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$263.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$359.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$323.10
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$65.57
|
| Rate for Payer: Blue Shield of California Commercial |
$290.75
|
| Rate for Payer: Blue Shield of California EPN |
$190.16
|
| Rate for Payer: Cash Price |
$263.45
|
| Rate for Payer: Cash Price |
$263.45
|
| Rate for Payer: Central Health Plan Commercial |
$383.20
|
| Rate for Payer: Cigna of CA HMO |
$306.56
|
| Rate for Payer: Cigna of CA PPO |
$354.46
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$407.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$407.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$407.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$191.60
|
| Rate for Payer: EPIC Health Plan Senior |
$191.60
|
| Rate for Payer: Galaxy Health WC |
$407.15
|
| Rate for Payer: Global Benefits Group Commercial |
$287.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$431.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$104.27
|
| Rate for Payer: InnovAge PACE Commercial |
$239.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$319.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$115.18
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$296.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$95.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$335.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$335.30
|
| Rate for Payer: Multiplan Commercial |
$359.25
|
| Rate for Payer: Networks By Design Commercial |
$311.35
|
| Rate for Payer: Prime Health Services Commercial |
$407.15
|
| Rate for Payer: Riverside University Health System MISP |
$191.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$287.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$287.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$49.90
|
| Rate for Payer: United Healthcare All Other HMO |
$49.90
|
| Rate for Payer: United Healthcare HMO Rider |
$49.90
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$49.90
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$407.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$407.15
|
| Rate for Payer: Vantage Medical Group Senior |
$407.15
|
|
|
HC IMMUNOHISTOCHEM OR IMMUNOCYTOCHEM EA ADDITIONAL ABY STAIN
|
Facility
|
IP
|
$479.00
|
|
|
Service Code
|
CPT 88341
|
| Hospital Charge Code |
903800252
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$95.80 |
| Max. Negotiated Rate |
$431.10 |
| Rate for Payer: Adventist Health Commercial |
$95.80
|
| Rate for Payer: Cash Price |
$263.45
|
| Rate for Payer: Central Health Plan Commercial |
$383.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$191.60
|
| Rate for Payer: EPIC Health Plan Senior |
$191.60
|
| Rate for Payer: Galaxy Health WC |
$407.15
|
| Rate for Payer: Global Benefits Group Commercial |
$287.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$431.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$319.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$182.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$296.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$95.80
|
| Rate for Payer: Multiplan Commercial |
$359.25
|
| Rate for Payer: Networks By Design Commercial |
$311.35
|
| Rate for Payer: Prime Health Services Commercial |
$407.15
|
|
|
HC IMMUNOHISTOCHEM STAIN ER/PR
|
Facility
|
IP
|
$192.00
|
|
|
Service Code
|
CPT 88360
|
| Hospital Charge Code |
903800179
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$38.40 |
| Max. Negotiated Rate |
$172.80 |
| Rate for Payer: Adventist Health Commercial |
$38.40
|
| Rate for Payer: Cash Price |
$105.60
|
| Rate for Payer: Central Health Plan Commercial |
$153.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$76.80
|
| Rate for Payer: EPIC Health Plan Senior |
$76.80
|
| Rate for Payer: Galaxy Health WC |
$163.20
|
| Rate for Payer: Global Benefits Group Commercial |
$115.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$172.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$128.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$73.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$118.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$38.40
|
| Rate for Payer: Multiplan Commercial |
$144.00
|
| Rate for Payer: Networks By Design Commercial |
$124.80
|
| Rate for Payer: Prime Health Services Commercial |
$163.20
|
|
|
HC IMMUNOHISTOCHEM STAIN ER/PR
|
Facility
|
OP
|
$192.00
|
|
|
Service Code
|
CPT 88360
|
| Hospital Charge Code |
903800179
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$38.40 |
| Max. Negotiated Rate |
$357.08 |
| Rate for Payer: Adventist Health Commercial |
$38.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$217.73
|
| Rate for Payer: Aetna of CA HMO/PPO |
$116.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$326.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$239.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$217.73
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$271.04
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$55.01
|
| Rate for Payer: Blue Shield of California Commercial |
$116.54
|
| Rate for Payer: Blue Shield of California EPN |
$76.22
|
| Rate for Payer: Cash Price |
$105.60
|
| Rate for Payer: Cash Price |
$105.60
|
| Rate for Payer: Central Health Plan Commercial |
$153.60
|
| Rate for Payer: Cigna of CA HMO |
$122.88
|
| Rate for Payer: Cigna of CA PPO |
$142.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$326.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$239.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$217.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$293.94
|
| Rate for Payer: EPIC Health Plan Senior |
$217.73
|
| Rate for Payer: Galaxy Health WC |
$163.20
|
| Rate for Payer: Global Benefits Group Commercial |
$115.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$172.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$357.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$97.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$217.73
|
| Rate for Payer: InnovAge PACE Commercial |
$326.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$128.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$107.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$217.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$38.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$291.76
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$291.76
|
| Rate for Payer: Multiplan Commercial |
$144.00
|
| Rate for Payer: Networks By Design Commercial |
$124.80
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$217.73
|
| Rate for Payer: Prime Health Services Commercial |
$163.20
|
| Rate for Payer: Prime Health Services Medicare |
$230.79
|
| Rate for Payer: Riverside University Health System MISP |
$239.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$115.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$115.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$123.38
|
| Rate for Payer: United Healthcare All Other HMO |
$123.38
|
| Rate for Payer: United Healthcare HMO Rider |
$123.38
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$123.38
|
| Rate for Payer: Upland Medical Group Pediatric |
$217.73
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$326.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$239.50
|
| Rate for Payer: Vantage Medical Group Senior |
$217.73
|
|
|
HC IMMUNOTYPING ELECTROPHORESIS
|
Facility
|
IP
|
$196.00
|
|
|
Service Code
|
CPT 86334
|
| Hospital Charge Code |
900913611
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$39.20 |
| Max. Negotiated Rate |
$176.40 |
| Rate for Payer: Adventist Health Commercial |
$39.20
|
| Rate for Payer: Cash Price |
$107.80
|
| Rate for Payer: Central Health Plan Commercial |
$156.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$78.40
|
| Rate for Payer: EPIC Health Plan Senior |
$78.40
|
| Rate for Payer: Galaxy Health WC |
$166.60
|
| Rate for Payer: Global Benefits Group Commercial |
$117.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$176.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$130.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$74.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$121.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$39.20
|
| Rate for Payer: Multiplan Commercial |
$147.00
|
| Rate for Payer: Networks By Design Commercial |
$127.40
|
| Rate for Payer: Prime Health Services Commercial |
$166.60
|
|
