|
HC HLA-DP MOLECULAR
|
Facility
OP
|
$246.00
|
|
|
Service Code
|
CPT 81382
|
| Hospital Charge Code |
903902017
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$49.20 |
| Max. Negotiated Rate |
$747.35 |
| Rate for Payer: Adventist Health Medi-Cal |
$123.68
|
| Rate for Payer: Aetna of CA HMO/PPO |
$353.23
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$185.52
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$136.05
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$123.68
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$612.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$747.35
|
| Rate for Payer: BCBS Transplant Transplant |
$147.60
|
| Rate for Payer: Blue Shield of California Commercial |
$152.03
|
| Rate for Payer: Blue Shield of California EPN |
$119.56
|
| Rate for Payer: Caremore Medicare Advantage |
$123.68
|
| Rate for Payer: Cash Price |
$110.70
|
| Rate for Payer: Cash Price |
$110.70
|
| Rate for Payer: Central Health Plan Commercial |
$196.80
|
| Rate for Payer: Cigna of CA HMO |
$157.44
|
| Rate for Payer: Cigna of CA PPO |
$182.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$185.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$166.97
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$123.68
|
| Rate for Payer: EPIC Health Plan Transplant |
$123.68
|
| Rate for Payer: Galaxy Health WC |
$209.10
|
| Rate for Payer: Global Benefits Group Commercial |
$147.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$221.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$184.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$202.84
|
| Rate for Payer: IEHP medi-cal |
$204.07
|
| Rate for Payer: IEHP Medicare Advantage |
$123.68
|
| Rate for Payer: Innovage PACE Commercial |
$185.52
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$164.08
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$123.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$49.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$165.73
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$165.73
|
| Rate for Payer: Multiplan Commercial |
$184.50
|
| Rate for Payer: Networks By Design Commercial |
$159.90
|
| Rate for Payer: Prime Health Services Commercial |
$209.10
|
| Rate for Payer: Prime Health Services Medicare |
$131.10
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$147.60
|
| Rate for Payer: Riverside University Health MISP |
$136.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$147.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$147.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$100.18
|
| Rate for Payer: United Healthcare All Other HMO |
$100.18
|
| Rate for Payer: United Healthcare HMO Rider |
$100.18
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$100.18
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$185.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$136.05
|
| Rate for Payer: Vantage Medical Group Senior |
$123.68
|
|
|
HC HLA-DP MOLECULAR HI RESOLUTION
|
Facility
OP
|
$319.00
|
|
|
Service Code
|
CPT 86817
|
| Hospital Charge Code |
903902018
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$63.80 |
| Max. Negotiated Rate |
$485.03 |
| Rate for Payer: Adventist Health Medi-Cal |
$106.14
|
| Rate for Payer: Aetna of CA HMO/PPO |
$472.57
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$159.21
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$116.75
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$106.14
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$397.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$485.03
|
| Rate for Payer: BCBS Transplant Transplant |
$191.40
|
| Rate for Payer: Blue Shield of California Commercial |
$197.14
|
| Rate for Payer: Blue Shield of California EPN |
$155.03
|
| Rate for Payer: Caremore Medicare Advantage |
$106.14
|
| Rate for Payer: Cash Price |
$143.55
|
| Rate for Payer: Cash Price |
$143.55
|
| Rate for Payer: Central Health Plan Commercial |
$255.20
|
| Rate for Payer: Cigna of CA HMO |
$204.16
|
| Rate for Payer: Cigna of CA PPO |
$236.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$159.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$143.29
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$106.14
|
| Rate for Payer: EPIC Health Plan Transplant |
$106.14
|
| Rate for Payer: Galaxy Health WC |
$271.15
|
| Rate for Payer: Global Benefits Group Commercial |
$191.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$287.10
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$239.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$174.07
|
| Rate for Payer: IEHP medi-cal |
$175.13
|
| Rate for Payer: IEHP Medicare Advantage |
$106.14
|
| Rate for Payer: Innovage PACE Commercial |
$159.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$212.77
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$106.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$63.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$142.23
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$142.23
|
| Rate for Payer: Multiplan Commercial |
$239.25
|
| Rate for Payer: Networks By Design Commercial |
$207.35
|
| Rate for Payer: Prime Health Services Commercial |
$271.15
|
| Rate for Payer: Prime Health Services Medicare |
$112.51
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$191.40
|
| Rate for Payer: Riverside University Health MISP |
$116.75
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$191.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$191.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$85.98
|
| Rate for Payer: United Healthcare All Other HMO |
$85.98
|
| Rate for Payer: United Healthcare HMO Rider |
$85.98
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$85.98
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$159.21
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$116.75
|
| Rate for Payer: Vantage Medical Group Senior |
$106.14
|
|
|
HC HLA-DP MOLECULAR HI RESOLUTION
|
Facility
IP
|
$676.00
|
|
|
Service Code
|
CPT 86817
|
| Hospital Charge Code |
903902018
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$135.20 |
| Max. Negotiated Rate |
$608.40 |
| Rate for Payer: Cash Price |
$304.20
|
| Rate for Payer: Central Health Plan Commercial |
$540.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$270.40
|
| Rate for Payer: Galaxy Health WC |
$574.60
|
| Rate for Payer: Global Benefits Group Commercial |
$405.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$608.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$450.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$135.20
|
| Rate for Payer: Multiplan Commercial |
$507.00
|
| Rate for Payer: Networks By Design Commercial |
$439.40
|
| Rate for Payer: Prime Health Services Commercial |
$574.60
|
|
|
HC HLA DQ MOLECULAR
|
Facility
OP
|
$222.00
|
|
|
Service Code
|
CPT 81376
|
| Hospital Charge Code |
903901992
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$44.40 |
| Max. Negotiated Rate |
$671.06 |
| Rate for Payer: Adventist Health Medi-Cal |
$122.22
|
| Rate for Payer: Aetna of CA HMO/PPO |
$348.75
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$183.33
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$134.44
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$122.22
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$550.16
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$671.06
|
| Rate for Payer: BCBS Transplant Transplant |
$133.20
|
| Rate for Payer: Blue Shield of California Commercial |
$137.20
|
| Rate for Payer: Blue Shield of California EPN |
$107.89
|
| Rate for Payer: Caremore Medicare Advantage |
$122.22
|
| Rate for Payer: Cash Price |
$99.90
|
| Rate for Payer: Cash Price |
$99.90
|
| Rate for Payer: Central Health Plan Commercial |
$177.60
|
| Rate for Payer: Cigna of CA HMO |
$142.08
|
| Rate for Payer: Cigna of CA PPO |
$164.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$183.33
|
| Rate for Payer: EPIC Health Plan Commercial |
$165.00
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$122.22
|
| Rate for Payer: EPIC Health Plan Transplant |
$122.22
|
| Rate for Payer: Galaxy Health WC |
$188.70
|
| Rate for Payer: Global Benefits Group Commercial |
$133.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$199.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$166.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$200.44
|
| Rate for Payer: IEHP medi-cal |
$201.66
|
| Rate for Payer: IEHP Medicare Advantage |
$122.22
|
| Rate for Payer: Innovage PACE Commercial |
$183.33
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$148.07
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$122.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$44.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$163.77
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$163.77
|
| Rate for Payer: Multiplan Commercial |
$166.50
|
| Rate for Payer: Networks By Design Commercial |
$144.30
|
| Rate for Payer: Prime Health Services Commercial |
$188.70
|
| Rate for Payer: Prime Health Services Medicare |
$129.55
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$133.20
|
| Rate for Payer: Riverside University Health MISP |
$134.44
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$133.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$133.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$99.00
|
| Rate for Payer: United Healthcare All Other HMO |
$99.00
|
| Rate for Payer: United Healthcare HMO Rider |
$99.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$99.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$183.33
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$134.44
|
| Rate for Payer: Vantage Medical Group Senior |
$122.22
|
|
|
HC HLA DQ MOLECULAR
|
Facility
IP
|
$1,259.00
|
|
|
Service Code
|
CPT 81376
|
| Hospital Charge Code |
903901992
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$251.80 |
| Max. Negotiated Rate |
$1,133.10 |
| Rate for Payer: Cash Price |
$566.55
|
| Rate for Payer: Central Health Plan Commercial |
$1,007.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$503.60
|
| Rate for Payer: Galaxy Health WC |
$1,070.15
|
| Rate for Payer: Global Benefits Group Commercial |
$755.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,133.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$839.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$251.80
|
| Rate for Payer: Multiplan Commercial |
$944.25
|
| Rate for Payer: Networks By Design Commercial |
$818.35
|
| Rate for Payer: Prime Health Services Commercial |
$1,070.15
|
|
|
HC HLA DQ MOLECULAR HI RESOLUTION
|
Facility
IP
|
$1,569.00
|
|
|
Service Code
|
CPT 81382
|
| Hospital Charge Code |
903901994
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$313.80 |
| Max. Negotiated Rate |
$1,412.10 |
| Rate for Payer: Cash Price |
$706.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,255.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$627.60
|
| Rate for Payer: Galaxy Health WC |
$1,333.65
|
| Rate for Payer: Global Benefits Group Commercial |
$941.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,412.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,046.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$313.80
|
| Rate for Payer: Multiplan Commercial |
$1,176.75
|
| Rate for Payer: Networks By Design Commercial |
$1,019.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,333.65
|
|
|
HC HLA DQ MOLECULAR HI RESOLUTION
|
Facility
OP
|
$222.00
|
|
|
Service Code
|
CPT 81382
|
| Hospital Charge Code |
903901994
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$44.40 |
| Max. Negotiated Rate |
$747.35 |
| Rate for Payer: Adventist Health Medi-Cal |
$123.68
|
| Rate for Payer: Aetna of CA HMO/PPO |
$353.23
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$185.52
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$136.05
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$123.68
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$612.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$747.35
|
| Rate for Payer: BCBS Transplant Transplant |
$133.20
|
| Rate for Payer: Blue Shield of California Commercial |
$137.20
|
| Rate for Payer: Blue Shield of California EPN |
$107.89
|
| Rate for Payer: Caremore Medicare Advantage |
$123.68
|
| Rate for Payer: Cash Price |
$99.90
|
| Rate for Payer: Cash Price |
$99.90
|
| Rate for Payer: Central Health Plan Commercial |
$177.60
|
| Rate for Payer: Cigna of CA HMO |
$142.08
|
| Rate for Payer: Cigna of CA PPO |
$164.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$185.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$166.97
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$123.68
|
| Rate for Payer: EPIC Health Plan Transplant |
$123.68
|
| Rate for Payer: Galaxy Health WC |
$188.70
|
| Rate for Payer: Global Benefits Group Commercial |
$133.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$199.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$166.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$202.84
|
| Rate for Payer: IEHP medi-cal |
$204.07
|
| Rate for Payer: IEHP Medicare Advantage |
$123.68
|
| Rate for Payer: Innovage PACE Commercial |
$185.52
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$148.07
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$123.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$44.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$165.73
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$165.73
|
| Rate for Payer: Multiplan Commercial |
$166.50
|
| Rate for Payer: Networks By Design Commercial |
$144.30
|
| Rate for Payer: Prime Health Services Commercial |
$188.70
|
| Rate for Payer: Prime Health Services Medicare |
$131.10
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$133.20
|
| Rate for Payer: Riverside University Health MISP |
$136.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$133.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$133.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$100.18
|
| Rate for Payer: United Healthcare All Other HMO |
$100.18
|
| Rate for Payer: United Healthcare HMO Rider |
$100.18
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$100.18
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$185.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$136.05
|
| Rate for Payer: Vantage Medical Group Senior |
$123.68
|
|
|
HC HLA-DR/DQ MOLECULAR
|
Facility
OP
|
$470.00
|
|
|
Service Code
|
CPT 81375
|
| Hospital Charge Code |
903901901
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$94.00 |
| Max. Negotiated Rate |
$17,880.30 |
| Rate for Payer: Adventist Health Medi-Cal |
$220.74
|
| Rate for Payer: Aetna of CA HMO/PPO |
$658.97
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$331.11
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$242.81
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$220.74
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$962.74
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,174.31
|
| Rate for Payer: BCBS Transplant Transplant |
$282.00
|
| Rate for Payer: Blue Shield of California Commercial |
$290.46
|
| Rate for Payer: Blue Shield of California EPN |
$228.42
|
| Rate for Payer: Caremore Medicare Advantage |
$220.74
|
| Rate for Payer: Cash Price |
$211.50
|
| Rate for Payer: Cash Price |
$211.50
|
| Rate for Payer: Central Health Plan Commercial |
$376.00
|
| Rate for Payer: Cigna of CA HMO |
$300.80
|
| Rate for Payer: Cigna of CA PPO |
$347.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$331.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$298.00
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$220.74
|
| Rate for Payer: EPIC Health Plan Transplant |
$220.74
|
| Rate for Payer: Galaxy Health WC |
$399.50
|
| Rate for Payer: Global Benefits Group Commercial |
$282.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$423.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$352.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$362.01
|
| Rate for Payer: IEHP medi-cal |
$364.22
|
| Rate for Payer: IEHP Medicare Advantage |
$220.74
|
| Rate for Payer: Innovage PACE Commercial |
$331.11
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$313.49
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$220.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$94.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$295.79
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$295.79
|
| Rate for Payer: Multiplan Commercial |
$352.50
|
| Rate for Payer: Networks By Design Commercial |
$305.50
|
| Rate for Payer: Prime Health Services Commercial |
$399.50
|
| Rate for Payer: Prime Health Services Medicare |
$233.98
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$282.00
|
| Rate for Payer: Riverside University Health MISP |
$242.81
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$282.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$282.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$178.80
|
| Rate for Payer: United Healthcare All Other HMO |
$178.80
|
| Rate for Payer: United Healthcare HMO Rider |
$178.80
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$17,880.30
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$331.11
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$242.81
|
| Rate for Payer: Vantage Medical Group Senior |
$220.74
|
|
|
HC HLA-DR/DQ MOLECULAR
|
Facility
IP
|
$470.00
|
|
|
Service Code
|
CPT 81375
|
| Hospital Charge Code |
903901901
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$94.00 |
| Max. Negotiated Rate |
$423.00 |
| Rate for Payer: Cash Price |
$211.50
|
| Rate for Payer: Central Health Plan Commercial |
$376.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$188.00
|
| Rate for Payer: Galaxy Health WC |
$399.50
|
| Rate for Payer: Global Benefits Group Commercial |
$282.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$423.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$313.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$94.00
|
| Rate for Payer: Multiplan Commercial |
$352.50
|
| Rate for Payer: Networks By Design Commercial |
$305.50
|
| Rate for Payer: Prime Health Services Commercial |
$399.50
|
|
|
HC HLA-DR/DQ SEROLOGY
|
Facility
OP
|
$560.00
|
|
|
Service Code
|
CPT 86817
|
| Hospital Charge Code |
903901986
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$85.98 |
| Max. Negotiated Rate |
$504.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$106.14
|
| Rate for Payer: Aetna of CA HMO/PPO |
$472.57
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$159.21
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$116.75
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$106.14
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$397.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$485.03
|
| Rate for Payer: BCBS Transplant Transplant |
$336.00
|
| Rate for Payer: Blue Shield of California Commercial |
$346.08
|
| Rate for Payer: Blue Shield of California EPN |
$272.16
|
| Rate for Payer: Caremore Medicare Advantage |
$106.14
|
| Rate for Payer: Cash Price |
$252.00
|
| Rate for Payer: Cash Price |
$252.00
|
| Rate for Payer: Central Health Plan Commercial |
$448.00
|
| Rate for Payer: Cigna of CA HMO |
$358.40
|
| Rate for Payer: Cigna of CA PPO |
$414.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$159.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$143.29
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$106.14
|
| Rate for Payer: EPIC Health Plan Transplant |
$106.14
|
| Rate for Payer: Galaxy Health WC |
$476.00
|
| Rate for Payer: Global Benefits Group Commercial |
$336.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$504.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$420.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$174.07
|
| Rate for Payer: IEHP medi-cal |
$175.13
|
| Rate for Payer: IEHP Medicare Advantage |
$106.14
|
| Rate for Payer: Innovage PACE Commercial |
$159.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$373.52
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$106.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$112.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$142.23
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$142.23
|
| Rate for Payer: Multiplan Commercial |
$420.00
|
| Rate for Payer: Networks By Design Commercial |
$364.00
|
| Rate for Payer: Prime Health Services Commercial |
$476.00
|
| Rate for Payer: Prime Health Services Medicare |
$112.51
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$336.00
|
| Rate for Payer: Riverside University Health MISP |
$116.75
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$336.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$336.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$85.98
|
| Rate for Payer: United Healthcare All Other HMO |
$85.98
|
| Rate for Payer: United Healthcare HMO Rider |
$85.98
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$85.98
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$159.21
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$116.75
|
| Rate for Payer: Vantage Medical Group Senior |
$106.14
|
|
|
HC HLA-DR/DQ SEROLOGY
|
Facility
IP
|
$560.00
|
|
|
Service Code
|
CPT 86817
|
| Hospital Charge Code |
903901986
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$112.00 |
| Max. Negotiated Rate |
$504.00 |
| Rate for Payer: Cash Price |
$252.00
|
| Rate for Payer: Central Health Plan Commercial |
$448.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$224.00
|
| Rate for Payer: Galaxy Health WC |
$476.00
|
| Rate for Payer: Global Benefits Group Commercial |
$336.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$504.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$373.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$112.00
|
| Rate for Payer: Multiplan Commercial |
$420.00
|
| Rate for Payer: Networks By Design Commercial |
$364.00
|
| Rate for Payer: Prime Health Services Commercial |
$476.00
|
|
|
HC HLA DR MOLECULAR
|
Facility
OP
|
$222.00
|
|
|
Service Code
|
CPT 81376
|
| Hospital Charge Code |
903901991
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$44.40 |
| Max. Negotiated Rate |
$671.06 |
| Rate for Payer: Adventist Health Medi-Cal |
$122.22
|
| Rate for Payer: Aetna of CA HMO/PPO |
$348.75
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$183.33
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$134.44
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$122.22
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$550.16
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$671.06
|
| Rate for Payer: BCBS Transplant Transplant |
$133.20
|
| Rate for Payer: Blue Shield of California Commercial |
$137.20
|
| Rate for Payer: Blue Shield of California EPN |
$107.89
|
| Rate for Payer: Caremore Medicare Advantage |
$122.22
|
| Rate for Payer: Cash Price |
$99.90
|
| Rate for Payer: Cash Price |
$99.90
|
| Rate for Payer: Central Health Plan Commercial |
$177.60
|
| Rate for Payer: Cigna of CA HMO |
$142.08
|
| Rate for Payer: Cigna of CA PPO |
$164.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$183.33
|
| Rate for Payer: EPIC Health Plan Commercial |
$165.00
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$122.22
|
| Rate for Payer: EPIC Health Plan Transplant |
$122.22
|
| Rate for Payer: Galaxy Health WC |
$188.70
|
| Rate for Payer: Global Benefits Group Commercial |
$133.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$199.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$166.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$200.44
|
| Rate for Payer: IEHP medi-cal |
$201.66
|
| Rate for Payer: IEHP Medicare Advantage |
$122.22
|
| Rate for Payer: Innovage PACE Commercial |
$183.33
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$148.07
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$122.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$44.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$163.77
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$163.77
|
| Rate for Payer: Multiplan Commercial |
$166.50
|
| Rate for Payer: Networks By Design Commercial |
$144.30
|
| Rate for Payer: Prime Health Services Commercial |
$188.70
|
| Rate for Payer: Prime Health Services Medicare |
$129.55
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$133.20
|
| Rate for Payer: Riverside University Health MISP |
$134.44
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$133.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$133.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$99.00
|
| Rate for Payer: United Healthcare All Other HMO |
$99.00
|
| Rate for Payer: United Healthcare HMO Rider |
$99.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$99.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$183.33
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$134.44
|
| Rate for Payer: Vantage Medical Group Senior |
$122.22
|
|
|
HC HLA DR MOLECULAR
|
Facility
IP
|
$1,259.00
|
|
|
Service Code
|
CPT 81376
|
| Hospital Charge Code |
903901991
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$251.80 |
| Max. Negotiated Rate |
$1,133.10 |
| Rate for Payer: Cash Price |
$566.55
|
| Rate for Payer: Central Health Plan Commercial |
$1,007.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$503.60
|
| Rate for Payer: Galaxy Health WC |
$1,070.15
|
| Rate for Payer: Global Benefits Group Commercial |
$755.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,133.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$839.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$251.80
|
| Rate for Payer: Multiplan Commercial |
$944.25
|
| Rate for Payer: Networks By Design Commercial |
$818.35
|
| Rate for Payer: Prime Health Services Commercial |
$1,070.15
|
|
|
HC HLA DR MOLECULAR HI RESOLUTION
|
Facility
IP
|
$1,569.00
|
|
|
Service Code
|
CPT 81382
|
| Hospital Charge Code |
903901993
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$313.80 |
| Max. Negotiated Rate |
$1,412.10 |
| Rate for Payer: Cash Price |
$706.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,255.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$627.60
|
| Rate for Payer: Galaxy Health WC |
$1,333.65
|
| Rate for Payer: Global Benefits Group Commercial |
$941.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,412.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,046.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$313.80
|
| Rate for Payer: Multiplan Commercial |
$1,176.75
|
| Rate for Payer: Networks By Design Commercial |
$1,019.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,333.65
|
|
|
HC HLA DR MOLECULAR HI RESOLUTION
|
Facility
OP
|
$222.00
|
|
|
Service Code
|
CPT 81382
|
| Hospital Charge Code |
903901993
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$44.40 |
| Max. Negotiated Rate |
$747.35 |
| Rate for Payer: Adventist Health Medi-Cal |
$123.68
|
| Rate for Payer: Aetna of CA HMO/PPO |
$353.23
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$185.52
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$136.05
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$123.68
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$612.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$747.35
|
| Rate for Payer: BCBS Transplant Transplant |
$133.20
|
| Rate for Payer: Blue Shield of California Commercial |
$137.20
|
| Rate for Payer: Blue Shield of California EPN |
$107.89
|
| Rate for Payer: Caremore Medicare Advantage |
$123.68
|
| Rate for Payer: Cash Price |
$99.90
|
| Rate for Payer: Cash Price |
$99.90
|
| Rate for Payer: Central Health Plan Commercial |
$177.60
|
| Rate for Payer: Cigna of CA HMO |
$142.08
|
| Rate for Payer: Cigna of CA PPO |
$164.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$185.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$166.97
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$123.68
|
| Rate for Payer: EPIC Health Plan Transplant |
$123.68
|
| Rate for Payer: Galaxy Health WC |
$188.70
|
| Rate for Payer: Global Benefits Group Commercial |
$133.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$199.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$166.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$202.84
|
| Rate for Payer: IEHP medi-cal |
$204.07
|
| Rate for Payer: IEHP Medicare Advantage |
$123.68
|
| Rate for Payer: Innovage PACE Commercial |
$185.52
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$148.07
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$123.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$44.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$165.73
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$165.73
|
| Rate for Payer: Multiplan Commercial |
$166.50
|
| Rate for Payer: Networks By Design Commercial |
$144.30
|
| Rate for Payer: Prime Health Services Commercial |
$188.70
|
| Rate for Payer: Prime Health Services Medicare |
$131.10
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$133.20
|
| Rate for Payer: Riverside University Health MISP |
$136.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$133.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$133.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$100.18
|
| Rate for Payer: United Healthcare All Other HMO |
$100.18
|
| Rate for Payer: United Healthcare HMO Rider |
$100.18
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$100.18
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$185.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$136.05
|
| Rate for Payer: Vantage Medical Group Senior |
$123.68
|
|
|
HC HLA SERUM PROCESSING
|
Facility
IP
|
$68.00
|
|
|
Service Code
|
CPT 86849
|
| Hospital Charge Code |
903901964
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.60 |
| Max. Negotiated Rate |
$61.20 |
| Rate for Payer: Cash Price |
$30.60
|
| Rate for Payer: Central Health Plan Commercial |
$54.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$27.20
|
| Rate for Payer: Galaxy Health WC |
$57.80
|
| Rate for Payer: Global Benefits Group Commercial |
$40.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$61.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$45.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.60
|
| Rate for Payer: Multiplan Commercial |
$51.00
|
| Rate for Payer: Networks By Design Commercial |
$44.20
|
| Rate for Payer: Prime Health Services Commercial |
$57.80
|
|
|
HC HLA SERUM PROCESSING
|
Facility
OP
|
$20.00
|
|
|
Service Code
|
CPT 86849
|
| Hospital Charge Code |
903901964
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.00 |
| Max. Negotiated Rate |
$18.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$12.15
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$17.00
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$11.00
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$11.00
|
| Rate for Payer: BCBS Transplant Transplant |
$12.00
|
| Rate for Payer: Blue Shield of California Commercial |
$12.36
|
| Rate for Payer: Blue Shield of California EPN |
$9.72
|
| Rate for Payer: Cash Price |
$9.00
|
| Rate for Payer: Central Health Plan Commercial |
$16.00
|
| Rate for Payer: Cigna of CA HMO |
$12.80
|
| Rate for Payer: Cigna of CA PPO |
$14.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$17.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$8.00
|
| Rate for Payer: Galaxy Health WC |
$17.00
|
| Rate for Payer: Global Benefits Group Commercial |
$12.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$18.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$15.00
|
| Rate for Payer: IEHP medi-cal |
$7.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$13.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.00
|
| Rate for Payer: Multiplan Commercial |
$15.00
|
| Rate for Payer: Networks By Design Commercial |
$13.00
|
| Rate for Payer: Prime Health Services Commercial |
$17.00
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$12.00
|
| Rate for Payer: Riverside University Health MISP |
$8.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$12.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$12.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.00
|
| Rate for Payer: United Healthcare All Other HMO |
$10.00
|
| Rate for Payer: United Healthcare HMO Rider |
$10.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$17.00
|
| Rate for Payer: Vantage Medical Group Senior |
$17.00
|
|
|
HC HLA X MATCH AUTO
|
Facility
IP
|
$616.00
|
|
|
Service Code
|
CPT 86825
|
| Hospital Charge Code |
903901926
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$123.20 |
| Max. Negotiated Rate |
$554.40 |
| Rate for Payer: Cash Price |
$277.20
|
| Rate for Payer: Central Health Plan Commercial |
$492.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$246.40
|
| Rate for Payer: Galaxy Health WC |
$523.60
|
| Rate for Payer: Global Benefits Group Commercial |
$369.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$554.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$410.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$123.20
|
| Rate for Payer: Multiplan Commercial |
$462.00
|
| Rate for Payer: Networks By Design Commercial |
$400.40
|
| Rate for Payer: Prime Health Services Commercial |
$523.60
|
|
|
HC HLA X MATCH AUTO
|
Facility
OP
|
$228.00
|
|
|
Service Code
|
CPT 86825
|
| Hospital Charge Code |
903901926
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$45.60 |
| Max. Negotiated Rate |
$629.48 |
| Rate for Payer: Adventist Health Medi-Cal |
$109.49
|
| Rate for Payer: Aetna of CA HMO/PPO |
$589.52
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$164.24
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$120.44
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$109.49
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$516.07
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$629.48
|
| Rate for Payer: BCBS Transplant Transplant |
$136.80
|
| Rate for Payer: Blue Shield of California Commercial |
$140.90
|
| Rate for Payer: Blue Shield of California EPN |
$110.81
|
| Rate for Payer: Caremore Medicare Advantage |
$109.49
|
| Rate for Payer: Cash Price |
$102.60
|
| Rate for Payer: Cash Price |
$102.60
|
| Rate for Payer: Central Health Plan Commercial |
$182.40
|
| Rate for Payer: Cigna of CA HMO |
$145.92
|
| Rate for Payer: Cigna of CA PPO |
$168.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$164.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$147.81
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$109.49
|
| Rate for Payer: EPIC Health Plan Transplant |
$109.49
|
| Rate for Payer: Galaxy Health WC |
$193.80
|
| Rate for Payer: Global Benefits Group Commercial |
$136.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$205.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$171.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$179.56
|
| Rate for Payer: IEHP medi-cal |
$180.66
|
| Rate for Payer: IEHP Medicare Advantage |
$109.49
|
| Rate for Payer: Innovage PACE Commercial |
$164.24
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$152.08
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$109.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$45.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$146.72
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$146.72
|
| Rate for Payer: Multiplan Commercial |
$171.00
|
| Rate for Payer: Networks By Design Commercial |
$148.20
|
| Rate for Payer: Prime Health Services Commercial |
$193.80
|
| Rate for Payer: Prime Health Services Medicare |
$116.06
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$136.80
|
| Rate for Payer: Riverside University Health MISP |
$120.44
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$136.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$136.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$88.69
|
| Rate for Payer: United Healthcare All Other HMO |
$88.69
|
| Rate for Payer: United Healthcare HMO Rider |
$88.69
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$88.69
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$164.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$120.44
|
| Rate for Payer: Vantage Medical Group Senior |
$109.49
|
|
|
HC HLA X MATCH B FLOW
|
Facility
OP
|
$269.00
|
|
|
Service Code
|
CPT 86356
|
| Hospital Charge Code |
903901936
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$21.69 |
| Max. Negotiated Rate |
$242.10 |
| Rate for Payer: Adventist Health Medi-Cal |
$26.78
|
| Rate for Payer: Aetna of CA HMO/PPO |
$196.47
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$40.17
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$29.46
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$26.78
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$194.78
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$237.59
|
| Rate for Payer: BCBS Transplant Transplant |
$161.40
|
| Rate for Payer: Blue Shield of California Commercial |
$166.24
|
| Rate for Payer: Blue Shield of California EPN |
$130.73
|
| Rate for Payer: Caremore Medicare Advantage |
$26.78
|
| Rate for Payer: Cash Price |
$121.05
|
| Rate for Payer: Cash Price |
$121.05
|
| Rate for Payer: Central Health Plan Commercial |
$215.20
|
| Rate for Payer: Cigna of CA HMO |
$172.16
|
| Rate for Payer: Cigna of CA PPO |
$199.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$40.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$36.15
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$26.78
|
| Rate for Payer: EPIC Health Plan Transplant |
$26.78
|
| Rate for Payer: Galaxy Health WC |
$228.65
|
| Rate for Payer: Global Benefits Group Commercial |
$161.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$242.10
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$201.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$43.92
|
| Rate for Payer: IEHP medi-cal |
$44.19
|
| Rate for Payer: IEHP Medicare Advantage |
$26.78
|
| Rate for Payer: Innovage PACE Commercial |
$40.17
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$179.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$26.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$53.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$35.89
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$35.89
|
| Rate for Payer: Multiplan Commercial |
$201.75
|
| Rate for Payer: Networks By Design Commercial |
$174.85
|
| Rate for Payer: Prime Health Services Commercial |
$228.65
|
| Rate for Payer: Prime Health Services Medicare |
$28.39
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$161.40
|
| Rate for Payer: Riverside University Health MISP |
$29.46
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$161.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$161.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$21.69
|
| Rate for Payer: United Healthcare All Other HMO |
$21.69
|
| Rate for Payer: United Healthcare HMO Rider |
$21.69
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$21.69
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$40.17
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$29.46
|
| Rate for Payer: Vantage Medical Group Senior |
$26.78
|
|
|
HC HLA X MATCH B FLOW
|
Facility
IP
|
$845.00
|
|
|
Service Code
|
CPT 86356
|
| Hospital Charge Code |
903901936
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$169.00 |
| Max. Negotiated Rate |
$760.50 |
| Rate for Payer: Cash Price |
$380.25
|
| Rate for Payer: Central Health Plan Commercial |
$676.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$338.00
|
| Rate for Payer: Galaxy Health WC |
$718.25
|
| Rate for Payer: Global Benefits Group Commercial |
$507.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$760.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$563.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$169.00
|
| Rate for Payer: Multiplan Commercial |
$633.75
|
| Rate for Payer: Networks By Design Commercial |
$549.25
|
| Rate for Payer: Prime Health Services Commercial |
$718.25
|
|
|
HC HLA X MATCH B SEROLOGY
|
Facility
OP
|
$199.00
|
|
|
Service Code
|
CPT 86805
|
| Hospital Charge Code |
903901925
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$39.80 |
| Max. Negotiated Rate |
$319.37 |
| Rate for Payer: Adventist Health Medi-Cal |
$189.51
|
| Rate for Payer: Aetna of CA HMO/PPO |
$317.71
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$284.26
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$208.46
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$189.51
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$261.83
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$319.37
|
| Rate for Payer: BCBS Transplant Transplant |
$119.40
|
| Rate for Payer: Blue Shield of California Commercial |
$122.98
|
| Rate for Payer: Blue Shield of California EPN |
$96.71
|
| Rate for Payer: Caremore Medicare Advantage |
$189.51
|
| Rate for Payer: Cash Price |
$89.55
|
| Rate for Payer: Cash Price |
$89.55
|
| Rate for Payer: Central Health Plan Commercial |
$159.20
|
| Rate for Payer: Cigna of CA HMO |
$127.36
|
| Rate for Payer: Cigna of CA PPO |
$147.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$284.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$255.84
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$189.51
|
| Rate for Payer: EPIC Health Plan Transplant |
$189.51
|
| Rate for Payer: Galaxy Health WC |
$169.15
|
| Rate for Payer: Global Benefits Group Commercial |
$119.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$179.10
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$149.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$310.80
|
| Rate for Payer: IEHP medi-cal |
$312.69
|
| Rate for Payer: IEHP Medicare Advantage |
$189.51
|
| Rate for Payer: Innovage PACE Commercial |
$284.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$132.73
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$189.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$39.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$253.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$253.94
|
| Rate for Payer: Multiplan Commercial |
$149.25
|
| Rate for Payer: Networks By Design Commercial |
$129.35
|
| Rate for Payer: Prime Health Services Commercial |
$169.15
|
| Rate for Payer: Prime Health Services Medicare |
$200.88
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$119.40
|
| Rate for Payer: Riverside University Health MISP |
$208.46
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$119.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$119.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$153.50
|
| Rate for Payer: United Healthcare All Other HMO |
$153.50
|
| Rate for Payer: United Healthcare HMO Rider |
$153.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$153.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$284.26
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$208.46
|
| Rate for Payer: Vantage Medical Group Senior |
$189.51
|
|
|
HC HLA X MATCH B SEROLOGY
|
Facility
IP
|
$583.00
|
|
|
Service Code
|
CPT 86805
|
| Hospital Charge Code |
903901925
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$116.60 |
| Max. Negotiated Rate |
$524.70 |
| Rate for Payer: Cash Price |
$262.35
|
| Rate for Payer: Central Health Plan Commercial |
$466.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$233.20
|
| Rate for Payer: Galaxy Health WC |
$495.55
|
| Rate for Payer: Global Benefits Group Commercial |
$349.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$524.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$388.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$116.60
|
| Rate for Payer: Multiplan Commercial |
$437.25
|
| Rate for Payer: Networks By Design Commercial |
$378.95
|
| Rate for Payer: Prime Health Services Commercial |
$495.55
|
|
|
HC HLA X MATCH T FLOW
|
Facility
IP
|
$845.00
|
|
|
Service Code
|
CPT 86825
|
| Hospital Charge Code |
903901914
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$169.00 |
| Max. Negotiated Rate |
$760.50 |
| Rate for Payer: Cash Price |
$380.25
|
| Rate for Payer: Central Health Plan Commercial |
$676.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$338.00
|
| Rate for Payer: Galaxy Health WC |
$718.25
|
| Rate for Payer: Global Benefits Group Commercial |
$507.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$760.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$563.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$169.00
|
| Rate for Payer: Multiplan Commercial |
$633.75
|
| Rate for Payer: Networks By Design Commercial |
$549.25
|
| Rate for Payer: Prime Health Services Commercial |
$718.25
|
|
|
HC HLA X MATCH T FLOW
|
Facility
OP
|
$274.00
|
|
|
Service Code
|
CPT 86825
|
| Hospital Charge Code |
903901914
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$54.80 |
| Max. Negotiated Rate |
$629.48 |
| Rate for Payer: Adventist Health Medi-Cal |
$109.49
|
| Rate for Payer: Aetna of CA HMO/PPO |
$589.52
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$164.24
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$120.44
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$109.49
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$516.07
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$629.48
|
| Rate for Payer: BCBS Transplant Transplant |
$164.40
|
| Rate for Payer: Blue Shield of California Commercial |
$169.33
|
| Rate for Payer: Blue Shield of California EPN |
$133.16
|
| Rate for Payer: Caremore Medicare Advantage |
$109.49
|
| Rate for Payer: Cash Price |
$123.30
|
| Rate for Payer: Cash Price |
$123.30
|
| Rate for Payer: Central Health Plan Commercial |
$219.20
|
| Rate for Payer: Cigna of CA HMO |
$175.36
|
| Rate for Payer: Cigna of CA PPO |
$202.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$164.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$147.81
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$109.49
|
| Rate for Payer: EPIC Health Plan Transplant |
$109.49
|
| Rate for Payer: Galaxy Health WC |
$232.90
|
| Rate for Payer: Global Benefits Group Commercial |
$164.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$246.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$205.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$179.56
|
| Rate for Payer: IEHP medi-cal |
$180.66
|
| Rate for Payer: IEHP Medicare Advantage |
$109.49
|
| Rate for Payer: Innovage PACE Commercial |
$164.24
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$182.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$109.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$54.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$146.72
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$146.72
|
| Rate for Payer: Multiplan Commercial |
$205.50
|
| Rate for Payer: Networks By Design Commercial |
$178.10
|
| Rate for Payer: Prime Health Services Commercial |
$232.90
|
| Rate for Payer: Prime Health Services Medicare |
$116.06
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$164.40
|
| Rate for Payer: Riverside University Health MISP |
$120.44
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$164.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$164.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$88.69
|
| Rate for Payer: United Healthcare All Other HMO |
$88.69
|
| Rate for Payer: United Healthcare HMO Rider |
$88.69
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$88.69
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$164.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$120.44
|
| Rate for Payer: Vantage Medical Group Senior |
$109.49
|
|
