|
HC HOLDER TRACH TUBE ADULT
|
Facility
IP
|
$26.57
|
|
| Hospital Charge Code |
901601474
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.31 |
| Max. Negotiated Rate |
$23.91 |
| Rate for Payer: Cash Price |
$11.96
|
| Rate for Payer: Central Health Plan Commercial |
$21.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.63
|
| Rate for Payer: Galaxy Health WC |
$22.58
|
| Rate for Payer: Global Benefits Group Commercial |
$15.94
|
| Rate for Payer: Health Management Network EPO/PPO |
$23.91
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.31
|
| Rate for Payer: Multiplan Commercial |
$19.93
|
| Rate for Payer: Networks By Design Commercial |
$17.27
|
| Rate for Payer: Prime Health Services Commercial |
$22.58
|
|
|
HC HOLDER TRACH TUBE ADULT
|
Facility
OP
|
$26.57
|
|
| Hospital Charge Code |
901601474
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.31 |
| Max. Negotiated Rate |
$23.91 |
| Rate for Payer: Aetna of CA HMO/PPO |
$16.14
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$22.58
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$14.61
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$14.61
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$12.87
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15.70
|
| Rate for Payer: BCBS Transplant Transplant |
$15.94
|
| Rate for Payer: Blue Shield of California Commercial |
$16.71
|
| Rate for Payer: Blue Shield of California EPN |
$12.99
|
| Rate for Payer: Cash Price |
$11.96
|
| Rate for Payer: Central Health Plan Commercial |
$21.26
|
| Rate for Payer: Cigna of CA HMO |
$17.00
|
| Rate for Payer: Cigna of CA PPO |
$19.66
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$22.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.63
|
| Rate for Payer: EPIC Health Plan Transplant |
$10.63
|
| Rate for Payer: Galaxy Health WC |
$22.58
|
| Rate for Payer: Global Benefits Group Commercial |
$15.94
|
| Rate for Payer: Health Management Network EPO/PPO |
$23.91
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$19.93
|
| Rate for Payer: IEHP medi-cal |
$9.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.31
|
| Rate for Payer: Multiplan Commercial |
$19.93
|
| Rate for Payer: Networks By Design Commercial |
$17.27
|
| Rate for Payer: Prime Health Services Commercial |
$22.58
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$15.94
|
| Rate for Payer: Riverside University Health MISP |
$10.63
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15.94
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$15.94
|
| Rate for Payer: United Healthcare All Other Commercial |
$13.28
|
| Rate for Payer: United Healthcare All Other HMO |
$13.28
|
| Rate for Payer: United Healthcare HMO Rider |
$13.28
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$13.28
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$22.58
|
| Rate for Payer: Vantage Medical Group Senior |
$22.58
|
|
|
HC HOLDER TRACH TUBE INFANT 3/4"
|
Facility
OP
|
$22.14
|
|
|
Service Code
|
CPT A7526
|
| Hospital Charge Code |
901607711
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.43 |
| Max. Negotiated Rate |
$19.93 |
| Rate for Payer: Aetna of CA HMO/PPO |
$8.84
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$18.82
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$12.18
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$12.18
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$10.72
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13.08
|
| Rate for Payer: BCBS Transplant Transplant |
$13.28
|
| Rate for Payer: Blue Shield of California Commercial |
$13.93
|
| Rate for Payer: Blue Shield of California EPN |
$10.83
|
| Rate for Payer: Cash Price |
$9.96
|
| Rate for Payer: Cash Price |
$9.96
|
| Rate for Payer: Central Health Plan Commercial |
$17.71
|
| Rate for Payer: Cigna of CA HMO |
$14.17
|
| Rate for Payer: Cigna of CA PPO |
$16.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$18.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.86
|
| Rate for Payer: EPIC Health Plan Transplant |
$8.86
|
| Rate for Payer: Galaxy Health WC |
$18.82
|
| Rate for Payer: Global Benefits Group Commercial |
$13.28
|
| Rate for Payer: Health Management Network EPO/PPO |
$19.93
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$16.60
|
| Rate for Payer: IEHP medi-cal |
$7.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$14.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.43
|
| Rate for Payer: Multiplan Commercial |
$16.60
|
| Rate for Payer: Networks By Design Commercial |
$14.39
|
| Rate for Payer: Prime Health Services Commercial |
$18.82
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$13.28
|
| Rate for Payer: Riverside University Health MISP |
$8.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$13.28
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$13.28
|
| Rate for Payer: United Healthcare All Other Commercial |
$11.07
|
| Rate for Payer: United Healthcare All Other HMO |
$11.07
|
| Rate for Payer: United Healthcare HMO Rider |
$11.07
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$18.82
|
| Rate for Payer: Vantage Medical Group Senior |
$18.82
|
|
|
HC HOLDER TRACH TUBE INFANT 3/4"
|
Facility
IP
|
$22.14
|
|
|
Service Code
|
CPT A7526
|
| Hospital Charge Code |
901607711
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.43 |
| Max. Negotiated Rate |
$19.93 |
| Rate for Payer: Cash Price |
$9.96
|
| Rate for Payer: Central Health Plan Commercial |
$17.71
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.86
|
| Rate for Payer: Galaxy Health WC |
$18.82
|
| Rate for Payer: Global Benefits Group Commercial |
$13.28
|
| Rate for Payer: Health Management Network EPO/PPO |
$19.93
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$14.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.43
|
| Rate for Payer: Multiplan Commercial |
$16.60
|
| Rate for Payer: Networks By Design Commercial |
$14.39
|
| Rate for Payer: Prime Health Services Commercial |
$18.82
|
|
|
HC HO METACARPL FX PREFAB
|
Facility
IP
|
$189.00
|
|
|
Service Code
|
CPT L3917
|
| Hospital Charge Code |
905353917
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$37.80 |
| Max. Negotiated Rate |
$170.10 |
| Rate for Payer: Blue Shield of California EPN |
$100.93
|
| Rate for Payer: Cash Price |
$85.05
|
| Rate for Payer: Central Health Plan Commercial |
$151.20
|
| Rate for Payer: Cigna of CA HMO |
$132.30
|
| Rate for Payer: Cigna of CA PPO |
$132.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$75.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$75.60
|
| Rate for Payer: Galaxy Health WC |
$160.65
|
| Rate for Payer: Global Benefits Group Commercial |
$113.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$170.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$126.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$37.80
|
| Rate for Payer: Multiplan Commercial |
$141.75
|
| Rate for Payer: Networks By Design Commercial |
$94.50
|
| Rate for Payer: Prime Health Services Commercial |
$160.65
|
|
|
HC HO METACARPL FX PREFAB
|
Facility
OP
|
$189.00
|
|
|
Service Code
|
CPT L3917
|
| Hospital Charge Code |
905353917
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$66.15 |
| Max. Negotiated Rate |
$381.27 |
| Rate for Payer: Aetna of CA HMO/PPO |
$381.27
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$160.65
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$103.95
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$103.95
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$91.51
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$111.66
|
| Rate for Payer: BCBS Transplant Transplant |
$113.40
|
| Rate for Payer: Blue Shield of California Commercial |
$141.75
|
| Rate for Payer: Blue Shield of California EPN |
$102.82
|
| Rate for Payer: Cash Price |
$85.05
|
| Rate for Payer: Cash Price |
$85.05
|
| Rate for Payer: Central Health Plan Commercial |
$151.20
|
| Rate for Payer: Cigna of CA HMO |
$132.30
|
| Rate for Payer: Cigna of CA PPO |
$132.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$160.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$75.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$75.60
|
| Rate for Payer: Galaxy Health WC |
$160.65
|
| Rate for Payer: Global Benefits Group Commercial |
$113.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$170.10
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$141.75
|
| Rate for Payer: IEHP medi-cal |
$66.15
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$126.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$77.49
|
| Rate for Payer: Multiplan Commercial |
$141.75
|
| Rate for Payer: Networks By Design Commercial |
$94.50
|
| Rate for Payer: Prime Health Services Commercial |
$160.65
|
| Rate for Payer: Riverside University Health MISP |
$75.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$113.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$113.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$94.50
|
| Rate for Payer: United Healthcare All Other HMO |
$94.50
|
| Rate for Payer: United Healthcare HMO Rider |
$94.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$94.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$160.65
|
| Rate for Payer: Vantage Medical Group Senior |
$160.65
|
|
|
HC HOMOVANILLIC ACID (HVA)
|
Facility
IP
|
$204.00
|
|
|
Service Code
|
CPT 83150
|
| Hospital Charge Code |
900910532
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$40.80 |
| Max. Negotiated Rate |
$183.60 |
| Rate for Payer: Cash Price |
$91.80
|
| Rate for Payer: Central Health Plan Commercial |
$163.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$81.60
|
| Rate for Payer: Galaxy Health WC |
$173.40
|
| Rate for Payer: Global Benefits Group Commercial |
$122.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$183.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$136.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$40.80
|
| Rate for Payer: Multiplan Commercial |
$153.00
|
| Rate for Payer: Networks By Design Commercial |
$132.60
|
| Rate for Payer: Prime Health Services Commercial |
$173.40
|
|
|
HC HOMOVANILLIC ACID (HVA)
|
Facility
OP
|
$74.00
|
|
|
Service Code
|
CPT 83150
|
| Hospital Charge Code |
900910532
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.80 |
| Max. Negotiated Rate |
$145.71 |
| Rate for Payer: Adventist Health Medi-Cal |
$22.41
|
| Rate for Payer: Aetna of CA HMO/PPO |
$141.98
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$33.62
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$24.65
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$22.41
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$119.45
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$145.71
|
| Rate for Payer: BCBS Transplant Transplant |
$44.40
|
| Rate for Payer: Blue Shield of California Commercial |
$45.73
|
| Rate for Payer: Blue Shield of California EPN |
$35.96
|
| Rate for Payer: Caremore Medicare Advantage |
$22.41
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Central Health Plan Commercial |
$59.20
|
| Rate for Payer: Cigna of CA HMO |
$47.36
|
| Rate for Payer: Cigna of CA PPO |
$54.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$33.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$30.25
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$22.41
|
| Rate for Payer: EPIC Health Plan Transplant |
$22.41
|
| Rate for Payer: Galaxy Health WC |
$62.90
|
| Rate for Payer: Global Benefits Group Commercial |
$44.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$66.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$55.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$36.75
|
| Rate for Payer: IEHP medi-cal |
$36.98
|
| Rate for Payer: IEHP Medicare Advantage |
$22.41
|
| Rate for Payer: Innovage PACE Commercial |
$33.62
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$49.36
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$30.03
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$30.03
|
| Rate for Payer: Multiplan Commercial |
$55.50
|
| Rate for Payer: Networks By Design Commercial |
$48.10
|
| Rate for Payer: Prime Health Services Commercial |
$62.90
|
| Rate for Payer: Prime Health Services Medicare |
$23.75
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$44.40
|
| Rate for Payer: Riverside University Health MISP |
$24.65
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$44.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$44.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$18.15
|
| Rate for Payer: United Healthcare All Other HMO |
$18.15
|
| Rate for Payer: United Healthcare HMO Rider |
$18.15
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$18.15
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$33.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$24.65
|
| Rate for Payer: Vantage Medical Group Senior |
$22.41
|
|
|
HC HOMOVANILLIC ACID URINE 24 HOURS
|
Facility
IP
|
$204.00
|
|
|
Service Code
|
CPT 83150
|
| Hospital Charge Code |
900912207
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$40.80 |
| Max. Negotiated Rate |
$183.60 |
| Rate for Payer: Cash Price |
$91.80
|
| Rate for Payer: Central Health Plan Commercial |
$163.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$81.60
|
| Rate for Payer: Galaxy Health WC |
$173.40
|
| Rate for Payer: Global Benefits Group Commercial |
$122.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$183.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$136.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$40.80
|
| Rate for Payer: Multiplan Commercial |
$153.00
|
| Rate for Payer: Networks By Design Commercial |
$132.60
|
| Rate for Payer: Prime Health Services Commercial |
$173.40
|
|
|
HC HOMOVANILLIC ACID URINE 24 HOURS
|
Facility
OP
|
$74.00
|
|
|
Service Code
|
CPT 83150
|
| Hospital Charge Code |
900912207
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.80 |
| Max. Negotiated Rate |
$145.71 |
| Rate for Payer: Adventist Health Medi-Cal |
$22.41
|
| Rate for Payer: Aetna of CA HMO/PPO |
$141.98
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$33.62
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$24.65
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$22.41
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$119.45
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$145.71
|
| Rate for Payer: BCBS Transplant Transplant |
$44.40
|
| Rate for Payer: Blue Shield of California Commercial |
$45.73
|
| Rate for Payer: Blue Shield of California EPN |
$35.96
|
| Rate for Payer: Caremore Medicare Advantage |
$22.41
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Central Health Plan Commercial |
$59.20
|
| Rate for Payer: Cigna of CA HMO |
$47.36
|
| Rate for Payer: Cigna of CA PPO |
$54.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$33.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$30.25
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$22.41
|
| Rate for Payer: EPIC Health Plan Transplant |
$22.41
|
| Rate for Payer: Galaxy Health WC |
$62.90
|
| Rate for Payer: Global Benefits Group Commercial |
$44.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$66.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$55.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$36.75
|
| Rate for Payer: IEHP medi-cal |
$36.98
|
| Rate for Payer: IEHP Medicare Advantage |
$22.41
|
| Rate for Payer: Innovage PACE Commercial |
$33.62
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$49.36
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$30.03
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$30.03
|
| Rate for Payer: Multiplan Commercial |
$55.50
|
| Rate for Payer: Networks By Design Commercial |
$48.10
|
| Rate for Payer: Prime Health Services Commercial |
$62.90
|
| Rate for Payer: Prime Health Services Medicare |
$23.75
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$44.40
|
| Rate for Payer: Riverside University Health MISP |
$24.65
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$44.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$44.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$18.15
|
| Rate for Payer: United Healthcare All Other HMO |
$18.15
|
| Rate for Payer: United Healthcare HMO Rider |
$18.15
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$18.15
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$33.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$24.65
|
| Rate for Payer: Vantage Medical Group Senior |
$22.41
|
|
|
HC HOMOVANILLIC ACID URINE RANDOM
|
Facility
OP
|
$74.00
|
|
|
Service Code
|
CPT 83150
|
| Hospital Charge Code |
900912206
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.80 |
| Max. Negotiated Rate |
$145.71 |
| Rate for Payer: Adventist Health Medi-Cal |
$22.41
|
| Rate for Payer: Aetna of CA HMO/PPO |
$141.98
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$33.62
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$24.65
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$22.41
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$119.45
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$145.71
|
| Rate for Payer: BCBS Transplant Transplant |
$44.40
|
| Rate for Payer: Blue Shield of California Commercial |
$45.73
|
| Rate for Payer: Blue Shield of California EPN |
$35.96
|
| Rate for Payer: Caremore Medicare Advantage |
$22.41
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Central Health Plan Commercial |
$59.20
|
| Rate for Payer: Cigna of CA HMO |
$47.36
|
| Rate for Payer: Cigna of CA PPO |
$54.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$33.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$30.25
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$22.41
|
| Rate for Payer: EPIC Health Plan Transplant |
$22.41
|
| Rate for Payer: Galaxy Health WC |
$62.90
|
| Rate for Payer: Global Benefits Group Commercial |
$44.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$66.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$55.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$36.75
|
| Rate for Payer: IEHP medi-cal |
$36.98
|
| Rate for Payer: IEHP Medicare Advantage |
$22.41
|
| Rate for Payer: Innovage PACE Commercial |
$33.62
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$49.36
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$30.03
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$30.03
|
| Rate for Payer: Multiplan Commercial |
$55.50
|
| Rate for Payer: Networks By Design Commercial |
$48.10
|
| Rate for Payer: Prime Health Services Commercial |
$62.90
|
| Rate for Payer: Prime Health Services Medicare |
$23.75
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$44.40
|
| Rate for Payer: Riverside University Health MISP |
$24.65
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$44.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$44.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$18.15
|
| Rate for Payer: United Healthcare All Other HMO |
$18.15
|
| Rate for Payer: United Healthcare HMO Rider |
$18.15
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$18.15
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$33.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$24.65
|
| Rate for Payer: Vantage Medical Group Senior |
$22.41
|
|
|
HC HOMOVANILLIC ACID URINE RANDOM
|
Facility
IP
|
$204.00
|
|
|
Service Code
|
CPT 83150
|
| Hospital Charge Code |
900912206
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$40.80 |
| Max. Negotiated Rate |
$183.60 |
| Rate for Payer: Cash Price |
$91.80
|
| Rate for Payer: Central Health Plan Commercial |
$163.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$81.60
|
| Rate for Payer: Galaxy Health WC |
$173.40
|
| Rate for Payer: Global Benefits Group Commercial |
$122.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$183.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$136.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$40.80
|
| Rate for Payer: Multiplan Commercial |
$153.00
|
| Rate for Payer: Networks By Design Commercial |
$132.60
|
| Rate for Payer: Prime Health Services Commercial |
$173.40
|
|
|
HC HOSPITAL BLOOD BANK STORAGE FEE
|
Facility
IP
|
$86.00
|
|
|
Service Code
|
CPT 86999
|
| Hospital Charge Code |
900905000
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$17.20 |
| Max. Negotiated Rate |
$77.40 |
| Rate for Payer: Cash Price |
$38.70
|
| Rate for Payer: Central Health Plan Commercial |
$68.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$34.40
|
| Rate for Payer: Galaxy Health WC |
$73.10
|
| Rate for Payer: Global Benefits Group Commercial |
$51.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$77.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$57.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$17.20
|
| Rate for Payer: Multiplan Commercial |
$64.50
|
| Rate for Payer: Networks By Design Commercial |
$55.90
|
| Rate for Payer: Prime Health Services Commercial |
$73.10
|
|
|
HC HOSPITAL BLOOD BANK STORAGE FEE
|
Facility
OP
|
$86.00
|
|
|
Service Code
|
CPT 86999
|
| Hospital Charge Code |
900905000
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$17.20 |
| Max. Negotiated Rate |
$631.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$37.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$52.23
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$55.80
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$40.92
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$37.20
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$41.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$50.81
|
| Rate for Payer: BCBS Transplant Transplant |
$51.60
|
| Rate for Payer: Blue Shield of California Commercial |
$54.09
|
| Rate for Payer: Blue Shield of California EPN |
$42.05
|
| Rate for Payer: Caremore Medicare Advantage |
$37.20
|
| Rate for Payer: Cash Price |
$38.70
|
| Rate for Payer: Cash Price |
$38.70
|
| Rate for Payer: Cash Price |
$38.70
|
| Rate for Payer: Central Health Plan Commercial |
$68.80
|
| Rate for Payer: Cigna of CA HMO |
$55.04
|
| Rate for Payer: Cigna of CA PPO |
$63.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$55.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$50.22
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$37.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$37.20
|
| Rate for Payer: Galaxy Health WC |
$73.10
|
| Rate for Payer: Global Benefits Group Commercial |
$51.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$77.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$64.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$61.01
|
| Rate for Payer: IEHP medi-cal |
$61.38
|
| Rate for Payer: IEHP Medicare Advantage |
$37.20
|
| Rate for Payer: Innovage PACE Commercial |
$55.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$57.36
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$37.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$17.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$49.85
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$49.85
|
| Rate for Payer: Multiplan Commercial |
$64.50
|
| Rate for Payer: Networks By Design Commercial |
$55.90
|
| Rate for Payer: Prime Health Services Commercial |
$73.10
|
| Rate for Payer: Prime Health Services Medicare |
$39.43
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$51.60
|
| Rate for Payer: Riverside University Health MISP |
$40.92
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$51.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$51.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$43.00
|
| Rate for Payer: United Healthcare All Other HMO |
$631.00
|
| Rate for Payer: United Healthcare HMO Rider |
$630.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$575.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$55.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$40.92
|
| Rate for Payer: Vantage Medical Group Senior |
$37.20
|
|
|
HC HO W/O JOINTS CF
|
Facility
IP
|
$405.00
|
|
|
Service Code
|
CPT L3919
|
| Hospital Charge Code |
905353919
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$81.00 |
| Max. Negotiated Rate |
$364.50 |
| Rate for Payer: Blue Shield of California EPN |
$216.27
|
| Rate for Payer: Cash Price |
$182.25
|
| Rate for Payer: Central Health Plan Commercial |
$324.00
|
| Rate for Payer: Cigna of CA HMO |
$283.50
|
| Rate for Payer: Cigna of CA PPO |
$283.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$162.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$162.00
|
| Rate for Payer: Galaxy Health WC |
$344.25
|
| Rate for Payer: Global Benefits Group Commercial |
$243.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$364.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$270.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$81.00
|
| Rate for Payer: Multiplan Commercial |
$303.75
|
| Rate for Payer: Networks By Design Commercial |
$202.50
|
| Rate for Payer: Prime Health Services Commercial |
$344.25
|
|
|
HC HO W/O JOINTS CF
|
Facility
OP
|
$405.00
|
|
|
Service Code
|
CPT L3919
|
| Hospital Charge Code |
905353919
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$141.75 |
| Max. Negotiated Rate |
$977.66 |
| Rate for Payer: Aetna of CA HMO/PPO |
$977.66
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$344.25
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$222.75
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$222.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$196.10
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$239.27
|
| Rate for Payer: BCBS Transplant Transplant |
$243.00
|
| Rate for Payer: Blue Shield of California Commercial |
$303.75
|
| Rate for Payer: Blue Shield of California EPN |
$220.32
|
| Rate for Payer: Cash Price |
$182.25
|
| Rate for Payer: Cash Price |
$182.25
|
| Rate for Payer: Central Health Plan Commercial |
$324.00
|
| Rate for Payer: Cigna of CA HMO |
$283.50
|
| Rate for Payer: Cigna of CA PPO |
$283.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$344.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$162.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$162.00
|
| Rate for Payer: Galaxy Health WC |
$344.25
|
| Rate for Payer: Global Benefits Group Commercial |
$243.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$364.50
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$303.75
|
| Rate for Payer: IEHP medi-cal |
$141.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$270.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$166.05
|
| Rate for Payer: Multiplan Commercial |
$303.75
|
| Rate for Payer: Networks By Design Commercial |
$202.50
|
| Rate for Payer: Prime Health Services Commercial |
$344.25
|
| Rate for Payer: Riverside University Health MISP |
$162.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$243.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$243.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$202.50
|
| Rate for Payer: United Healthcare All Other HMO |
$202.50
|
| Rate for Payer: United Healthcare HMO Rider |
$202.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$202.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$344.25
|
| Rate for Payer: Vantage Medical Group Senior |
$344.25
|
|
|
HC HP ADDITION TEST SOCKET
|
Facility
OP
|
$745.00
|
|
|
Service Code
|
CPT L5628
|
| Hospital Charge Code |
905355628
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$260.75 |
| Max. Negotiated Rate |
$2,135.53 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,135.53
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$633.25
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$409.75
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$409.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$360.73
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$440.15
|
| Rate for Payer: BCBS Transplant Transplant |
$447.00
|
| Rate for Payer: Blue Shield of California Commercial |
$558.75
|
| Rate for Payer: Blue Shield of California EPN |
$405.28
|
| Rate for Payer: Cash Price |
$335.25
|
| Rate for Payer: Cash Price |
$335.25
|
| Rate for Payer: Central Health Plan Commercial |
$596.00
|
| Rate for Payer: Cigna of CA HMO |
$521.50
|
| Rate for Payer: Cigna of CA PPO |
$521.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$633.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$298.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$298.00
|
| Rate for Payer: Galaxy Health WC |
$633.25
|
| Rate for Payer: Global Benefits Group Commercial |
$447.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$670.50
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$558.75
|
| Rate for Payer: IEHP medi-cal |
$260.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$496.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$305.45
|
| Rate for Payer: Multiplan Commercial |
$558.75
|
| Rate for Payer: Networks By Design Commercial |
$372.50
|
| Rate for Payer: Prime Health Services Commercial |
$633.25
|
| Rate for Payer: Riverside University Health MISP |
$298.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$447.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$447.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$372.50
|
| Rate for Payer: United Healthcare All Other HMO |
$372.50
|
| Rate for Payer: United Healthcare HMO Rider |
$372.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$372.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$633.25
|
| Rate for Payer: Vantage Medical Group Senior |
$633.25
|
|
|
HC HP ADDITION TEST SOCKET
|
Facility
IP
|
$745.00
|
|
|
Service Code
|
CPT L5628
|
| Hospital Charge Code |
905355628
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$149.00 |
| Max. Negotiated Rate |
$670.50 |
| Rate for Payer: Blue Shield of California EPN |
$397.83
|
| Rate for Payer: Cash Price |
$335.25
|
| Rate for Payer: Central Health Plan Commercial |
$596.00
|
| Rate for Payer: Cigna of CA HMO |
$521.50
|
| Rate for Payer: Cigna of CA PPO |
$521.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$298.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$298.00
|
| Rate for Payer: Galaxy Health WC |
$633.25
|
| Rate for Payer: Global Benefits Group Commercial |
$447.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$670.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$496.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$149.00
|
| Rate for Payer: Multiplan Commercial |
$558.75
|
| Rate for Payer: Networks By Design Commercial |
$372.50
|
| Rate for Payer: Prime Health Services Commercial |
$633.25
|
|
|
HC HP CANADIAN TYPE W SACH
|
Facility
IP
|
$15,701.00
|
|
|
Service Code
|
CPT L5280
|
| Hospital Charge Code |
905355280
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$3,140.20 |
| Max. Negotiated Rate |
$14,130.90 |
| Rate for Payer: Blue Shield of California EPN |
$8,384.33
|
| Rate for Payer: Cash Price |
$7,065.45
|
| Rate for Payer: Central Health Plan Commercial |
$12,560.80
|
| Rate for Payer: Cigna of CA HMO |
$10,990.70
|
| Rate for Payer: Cigna of CA PPO |
$10,990.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,280.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$6,280.40
|
| Rate for Payer: Galaxy Health WC |
$13,345.85
|
| Rate for Payer: Global Benefits Group Commercial |
$9,420.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$14,130.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10,472.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,140.20
|
| Rate for Payer: Multiplan Commercial |
$11,775.75
|
| Rate for Payer: Networks By Design Commercial |
$7,850.50
|
| Rate for Payer: Prime Health Services Commercial |
$13,345.85
|
|
|
HC HP CANADIAN TYPE W SACH
|
Facility
OP
|
$15,701.00
|
|
|
Service Code
|
CPT L5280
|
| Hospital Charge Code |
905355280
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$5,495.35 |
| Max. Negotiated Rate |
$22,520.66 |
| Rate for Payer: Aetna of CA HMO/PPO |
$22,520.66
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$13,345.85
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$8,635.55
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$8,635.55
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$7,602.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,276.15
|
| Rate for Payer: BCBS Transplant Transplant |
$9,420.60
|
| Rate for Payer: Blue Shield of California Commercial |
$11,775.75
|
| Rate for Payer: Blue Shield of California EPN |
$8,541.34
|
| Rate for Payer: Cash Price |
$7,065.45
|
| Rate for Payer: Cash Price |
$7,065.45
|
| Rate for Payer: Central Health Plan Commercial |
$12,560.80
|
| Rate for Payer: Cigna of CA HMO |
$10,990.70
|
| Rate for Payer: Cigna of CA PPO |
$10,990.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13,345.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,280.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$6,280.40
|
| Rate for Payer: Galaxy Health WC |
$13,345.85
|
| Rate for Payer: Global Benefits Group Commercial |
$9,420.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$14,130.90
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$11,775.75
|
| Rate for Payer: IEHP medi-cal |
$5,495.35
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10,472.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,437.41
|
| Rate for Payer: Multiplan Commercial |
$11,775.75
|
| Rate for Payer: Networks By Design Commercial |
$7,850.50
|
| Rate for Payer: Prime Health Services Commercial |
$13,345.85
|
| Rate for Payer: Riverside University Health MISP |
$6,280.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9,420.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9,420.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$7,850.50
|
| Rate for Payer: United Healthcare All Other HMO |
$7,850.50
|
| Rate for Payer: United Healthcare HMO Rider |
$7,850.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7,850.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13,345.85
|
| Rate for Payer: Vantage Medical Group Senior |
$13,345.85
|
|
|
HC HP PROS MID SKT ENDO,NO-COVER
|
Facility
OP
|
$10,808.00
|
|
|
Service Code
|
CPT L5341
|
| Hospital Charge Code |
905355341
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$3,782.80 |
| Max. Negotiated Rate |
$22,353.89 |
| Rate for Payer: Aetna of CA HMO/PPO |
$22,353.89
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$9,186.80
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$5,944.40
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$5,944.40
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,233.23
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,385.37
|
| Rate for Payer: BCBS Transplant Transplant |
$6,484.80
|
| Rate for Payer: Blue Shield of California Commercial |
$8,106.00
|
| Rate for Payer: Blue Shield of California EPN |
$5,879.55
|
| Rate for Payer: Cash Price |
$4,863.60
|
| Rate for Payer: Cash Price |
$4,863.60
|
| Rate for Payer: Central Health Plan Commercial |
$8,646.40
|
| Rate for Payer: Cigna of CA HMO |
$7,565.60
|
| Rate for Payer: Cigna of CA PPO |
$7,565.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9,186.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,323.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,323.20
|
| Rate for Payer: Galaxy Health WC |
$9,186.80
|
| Rate for Payer: Global Benefits Group Commercial |
$6,484.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,727.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$8,106.00
|
| Rate for Payer: IEHP medi-cal |
$3,782.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,208.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,431.28
|
| Rate for Payer: Multiplan Commercial |
$8,106.00
|
| Rate for Payer: Networks By Design Commercial |
$5,404.00
|
| Rate for Payer: Prime Health Services Commercial |
$9,186.80
|
| Rate for Payer: Riverside University Health MISP |
$4,323.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,484.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6,484.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,404.00
|
| Rate for Payer: United Healthcare All Other HMO |
$5,404.00
|
| Rate for Payer: United Healthcare HMO Rider |
$5,404.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,404.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9,186.80
|
| Rate for Payer: Vantage Medical Group Senior |
$9,186.80
|
|
|
HC HP PROS MID SKT ENDO,NO-COVER
|
Facility
IP
|
$10,808.00
|
|
|
Service Code
|
CPT L5341
|
| Hospital Charge Code |
905355341
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$2,161.60 |
| Max. Negotiated Rate |
$9,727.20 |
| Rate for Payer: Blue Shield of California EPN |
$5,771.47
|
| Rate for Payer: Cash Price |
$4,863.60
|
| Rate for Payer: Central Health Plan Commercial |
$8,646.40
|
| Rate for Payer: Cigna of CA HMO |
$7,565.60
|
| Rate for Payer: Cigna of CA PPO |
$7,565.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,323.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,323.20
|
| Rate for Payer: Galaxy Health WC |
$9,186.80
|
| Rate for Payer: Global Benefits Group Commercial |
$6,484.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,727.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,208.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,161.60
|
| Rate for Payer: Multiplan Commercial |
$8,106.00
|
| Rate for Payer: Networks By Design Commercial |
$5,404.00
|
| Rate for Payer: Prime Health Services Commercial |
$9,186.80
|
|
|
HC HPV BY NUCLEIC ACID
|
Facility
IP
|
$77.00
|
|
|
Service Code
|
CPT 87624
|
| Hospital Charge Code |
900913641
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.40 |
| Max. Negotiated Rate |
$69.30 |
| Rate for Payer: Cash Price |
$34.65
|
| Rate for Payer: Central Health Plan Commercial |
$61.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$30.80
|
| Rate for Payer: Galaxy Health WC |
$65.45
|
| Rate for Payer: Global Benefits Group Commercial |
$46.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$69.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$51.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.40
|
| Rate for Payer: Multiplan Commercial |
$57.75
|
| Rate for Payer: Networks By Design Commercial |
$50.05
|
| Rate for Payer: Prime Health Services Commercial |
$65.45
|
|
|
HC HPV BY NUCLEIC ACID
|
Facility
OP
|
$56.00
|
|
|
Service Code
|
CPT 87624
|
| Hospital Charge Code |
900913641
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.20 |
| Max. Negotiated Rate |
$249.11 |
| Rate for Payer: Adventist Health Medi-Cal |
$35.09
|
| Rate for Payer: Aetna of CA HMO/PPO |
$249.11
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$52.64
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$38.60
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$35.09
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$191.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$233.58
|
| Rate for Payer: BCBS Transplant Transplant |
$33.60
|
| Rate for Payer: Blue Shield of California Commercial |
$34.61
|
| Rate for Payer: Blue Shield of California EPN |
$27.22
|
| Rate for Payer: Caremore Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$25.20
|
| Rate for Payer: Cash Price |
$25.20
|
| Rate for Payer: Central Health Plan Commercial |
$44.80
|
| Rate for Payer: Cigna of CA HMO |
$35.84
|
| Rate for Payer: Cigna of CA PPO |
$41.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$52.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$47.37
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$35.09
|
| Rate for Payer: EPIC Health Plan Transplant |
$35.09
|
| Rate for Payer: Galaxy Health WC |
$47.60
|
| Rate for Payer: Global Benefits Group Commercial |
$33.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$50.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$42.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$57.55
|
| Rate for Payer: IEHP medi-cal |
$57.90
|
| Rate for Payer: IEHP Medicare Advantage |
$35.09
|
| Rate for Payer: Innovage PACE Commercial |
$52.64
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$37.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$35.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$47.02
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$47.02
|
| Rate for Payer: Multiplan Commercial |
$42.00
|
| Rate for Payer: Networks By Design Commercial |
$36.40
|
| Rate for Payer: Prime Health Services Commercial |
$47.60
|
| Rate for Payer: Prime Health Services Medicare |
$37.20
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$33.60
|
| Rate for Payer: Riverside University Health MISP |
$38.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$33.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$33.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$28.42
|
| Rate for Payer: United Healthcare All Other HMO |
$28.42
|
| Rate for Payer: United Healthcare HMO Rider |
$28.42
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$28.42
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$52.64
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$38.60
|
| Rate for Payer: Vantage Medical Group Senior |
$35.09
|
|
|
HC H. PYLORI AB, IGG
|
Facility
OP
|
$56.00
|
|
|
Service Code
|
CPT 86677
|
| Hospital Charge Code |
900913556
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.20 |
| Max. Negotiated Rate |
$132.14 |
| Rate for Payer: Adventist Health Medi-Cal |
$16.85
|
| Rate for Payer: Aetna of CA HMO/PPO |
$106.52
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$25.28
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$18.54
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$16.85
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$108.34
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$132.14
|
| Rate for Payer: BCBS Transplant Transplant |
$33.60
|
| Rate for Payer: Blue Shield of California Commercial |
$34.61
|
| Rate for Payer: Blue Shield of California EPN |
$27.22
|
| Rate for Payer: Caremore Medicare Advantage |
$16.85
|
| Rate for Payer: Cash Price |
$25.20
|
| Rate for Payer: Cash Price |
$25.20
|
| Rate for Payer: Central Health Plan Commercial |
$44.80
|
| Rate for Payer: Cigna of CA HMO |
$35.84
|
| Rate for Payer: Cigna of CA PPO |
$41.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$25.28
|
| Rate for Payer: EPIC Health Plan Commercial |
$22.75
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$16.85
|
| Rate for Payer: EPIC Health Plan Transplant |
$16.85
|
| Rate for Payer: Galaxy Health WC |
$47.60
|
| Rate for Payer: Global Benefits Group Commercial |
$33.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$50.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$42.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$27.63
|
| Rate for Payer: IEHP medi-cal |
$27.80
|
| Rate for Payer: IEHP Medicare Advantage |
$16.85
|
| Rate for Payer: Innovage PACE Commercial |
$25.28
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$37.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$22.58
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$22.58
|
| Rate for Payer: Multiplan Commercial |
$42.00
|
| Rate for Payer: Networks By Design Commercial |
$36.40
|
| Rate for Payer: Prime Health Services Commercial |
$47.60
|
| Rate for Payer: Prime Health Services Medicare |
$17.86
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$33.60
|
| Rate for Payer: Riverside University Health MISP |
$18.54
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$33.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$33.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$13.65
|
| Rate for Payer: United Healthcare All Other HMO |
$13.65
|
| Rate for Payer: United Healthcare HMO Rider |
$13.65
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$13.65
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$25.28
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$18.54
|
| Rate for Payer: Vantage Medical Group Senior |
$16.85
|
|
