|
HC LAB REF MERCURY URINE
|
Facility
|
IP
|
$23.00
|
|
|
Service Code
|
CPT 83830
|
| Hospital Charge Code |
900911144
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.60 |
| Max. Negotiated Rate |
$20.70 |
| Rate for Payer: Adventist Health Commercial |
$4.60
|
| Rate for Payer: Cash Price |
$12.65
|
| Rate for Payer: Central Health Plan Commercial |
$18.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.20
|
| Rate for Payer: EPIC Health Plan Senior |
$9.20
|
| Rate for Payer: Galaxy Health WC |
$19.55
|
| Rate for Payer: Global Benefits Group Commercial |
$13.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$20.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.60
|
| Rate for Payer: Multiplan Commercial |
$17.25
|
| Rate for Payer: Networks By Design Commercial |
$14.95
|
| Rate for Payer: Prime Health Services Commercial |
$19.55
|
|
|
HC LAB REF METHEMALBUMIN
|
Facility
|
IP
|
$115.00
|
|
|
Service Code
|
CPT 83857
|
| Hospital Charge Code |
900911067
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$23.00 |
| Max. Negotiated Rate |
$103.50 |
| Rate for Payer: Adventist Health Commercial |
$23.00
|
| Rate for Payer: Cash Price |
$63.25
|
| Rate for Payer: Central Health Plan Commercial |
$92.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$46.00
|
| Rate for Payer: EPIC Health Plan Senior |
$46.00
|
| Rate for Payer: Galaxy Health WC |
$97.75
|
| Rate for Payer: Global Benefits Group Commercial |
$69.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$103.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$76.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$43.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$71.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23.00
|
| Rate for Payer: Multiplan Commercial |
$86.25
|
| Rate for Payer: Networks By Design Commercial |
$74.75
|
| Rate for Payer: Prime Health Services Commercial |
$97.75
|
|
|
HC LAB REF METHEMALBUMIN
|
Facility
|
OP
|
$115.00
|
|
|
Service Code
|
CPT 83857
|
| Hospital Charge Code |
900911067
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.70 |
| Max. Negotiated Rate |
$103.50 |
| Rate for Payer: Adventist Health Commercial |
$23.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$10.74
|
| Rate for Payer: Aetna of CA HMO/PPO |
$69.84
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$16.11
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11.81
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10.74
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$78.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15.85
|
| Rate for Payer: Blue Shield of California Commercial |
$69.81
|
| Rate for Payer: Blue Shield of California EPN |
$45.66
|
| Rate for Payer: Cash Price |
$63.25
|
| Rate for Payer: Cash Price |
$63.25
|
| Rate for Payer: Central Health Plan Commercial |
$92.00
|
| Rate for Payer: Cigna of CA HMO |
$73.60
|
| Rate for Payer: Cigna of CA PPO |
$85.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$16.11
|
| Rate for Payer: Dignity Health Medi-Cal |
$11.81
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.50
|
| Rate for Payer: EPIC Health Plan Senior |
$10.74
|
| Rate for Payer: Galaxy Health WC |
$97.75
|
| Rate for Payer: Global Benefits Group Commercial |
$69.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$103.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$17.61
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$16.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10.74
|
| Rate for Payer: InnovAge PACE Commercial |
$16.11
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$76.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$18.13
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$14.39
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14.39
|
| Rate for Payer: Multiplan Commercial |
$86.25
|
| Rate for Payer: Networks By Design Commercial |
$74.75
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$10.74
|
| Rate for Payer: Prime Health Services Commercial |
$97.75
|
| Rate for Payer: Prime Health Services Medicare |
$11.38
|
| Rate for Payer: Riverside University Health System MISP |
$11.81
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$69.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$69.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$8.70
|
| Rate for Payer: United Healthcare All Other HMO |
$8.70
|
| Rate for Payer: United Healthcare HMO Rider |
$8.70
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8.70
|
| Rate for Payer: Upland Medical Group Pediatric |
$10.74
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$16.11
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11.81
|
| Rate for Payer: Vantage Medical Group Senior |
$10.74
|
|
|
HC LAB REF METHEMOGLOBIN
|
Facility
|
OP
|
$10.00
|
|
|
Service Code
|
CPT 83050
|
| Hospital Charge Code |
900910295
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.00 |
| Max. Negotiated Rate |
$53.29 |
| Rate for Payer: Adventist Health Commercial |
$2.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$8.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6.07
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9.02
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.20
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$53.29
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10.81
|
| Rate for Payer: Blue Shield of California Commercial |
$6.07
|
| Rate for Payer: Blue Shield of California EPN |
$3.97
|
| Rate for Payer: Cash Price |
$5.50
|
| Rate for Payer: Cash Price |
$5.50
|
| Rate for Payer: Central Health Plan Commercial |
$8.00
|
| Rate for Payer: Cigna of CA HMO |
$6.40
|
| Rate for Payer: Cigna of CA PPO |
$7.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.02
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.07
|
| Rate for Payer: EPIC Health Plan Senior |
$8.20
|
| Rate for Payer: Galaxy Health WC |
$8.50
|
| Rate for Payer: Global Benefits Group Commercial |
$6.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$9.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$13.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$10.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.20
|
| Rate for Payer: InnovAge PACE Commercial |
$12.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12.05
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.99
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10.99
|
| Rate for Payer: Multiplan Commercial |
$7.50
|
| Rate for Payer: Networks By Design Commercial |
$6.50
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$8.20
|
| Rate for Payer: Prime Health Services Commercial |
$8.50
|
| Rate for Payer: Prime Health Services Medicare |
$8.69
|
| Rate for Payer: Riverside University Health System MISP |
$9.02
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.64
|
| Rate for Payer: United Healthcare All Other HMO |
$6.64
|
| Rate for Payer: United Healthcare HMO Rider |
$6.64
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.64
|
| Rate for Payer: Upland Medical Group Pediatric |
$8.20
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.02
|
| Rate for Payer: Vantage Medical Group Senior |
$8.20
|
|
|
HC LAB REF METHEMOGLOBIN
|
Facility
|
IP
|
$10.00
|
|
|
Service Code
|
CPT 83050
|
| Hospital Charge Code |
900910295
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.00 |
| Max. Negotiated Rate |
$9.00 |
| Rate for Payer: Adventist Health Commercial |
$2.00
|
| Rate for Payer: Cash Price |
$5.50
|
| Rate for Payer: Central Health Plan Commercial |
$8.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.00
|
| Rate for Payer: EPIC Health Plan Senior |
$4.00
|
| Rate for Payer: Galaxy Health WC |
$8.50
|
| Rate for Payer: Global Benefits Group Commercial |
$6.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$9.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.00
|
| Rate for Payer: Multiplan Commercial |
$7.50
|
| Rate for Payer: Networks By Design Commercial |
$6.50
|
| Rate for Payer: Prime Health Services Commercial |
$8.50
|
|
|
HC LAB REF MITOCHONDRIAL DNA
|
Facility
|
IP
|
$1,316.00
|
|
|
Service Code
|
CPT 84999
|
| Hospital Charge Code |
900911407
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$263.20 |
| Max. Negotiated Rate |
$1,184.40 |
| Rate for Payer: Adventist Health Commercial |
$263.20
|
| Rate for Payer: Cash Price |
$723.80
|
| Rate for Payer: Central Health Plan Commercial |
$1,052.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$526.40
|
| Rate for Payer: EPIC Health Plan Senior |
$526.40
|
| Rate for Payer: Galaxy Health WC |
$1,118.60
|
| Rate for Payer: Global Benefits Group Commercial |
$789.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,184.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$877.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$501.40
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$814.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$263.20
|
| Rate for Payer: Multiplan Commercial |
$987.00
|
| Rate for Payer: Networks By Design Commercial |
$855.40
|
| Rate for Payer: Prime Health Services Commercial |
$1,118.60
|
|
|
HC LAB REF MITOCHONDRIAL DNA
|
Facility
|
OP
|
$1,316.00
|
|
|
Service Code
|
CPT 84999
|
| Hospital Charge Code |
900911407
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$263.20 |
| Max. Negotiated Rate |
$1,184.40 |
| Rate for Payer: Adventist Health Commercial |
$263.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$799.21
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,118.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$723.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$987.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$637.21
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$772.89
|
| Rate for Payer: Blue Shield of California Commercial |
$798.81
|
| Rate for Payer: Blue Shield of California EPN |
$522.45
|
| Rate for Payer: Cash Price |
$723.80
|
| Rate for Payer: Central Health Plan Commercial |
$1,052.80
|
| Rate for Payer: Cigna of CA HMO |
$842.24
|
| Rate for Payer: Cigna of CA PPO |
$973.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,118.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,118.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,118.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$526.40
|
| Rate for Payer: EPIC Health Plan Senior |
$526.40
|
| Rate for Payer: Galaxy Health WC |
$1,118.60
|
| Rate for Payer: Global Benefits Group Commercial |
$789.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,184.40
|
| Rate for Payer: InnovAge PACE Commercial |
$658.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$877.77
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$814.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$263.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$921.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$921.20
|
| Rate for Payer: Multiplan Commercial |
$987.00
|
| Rate for Payer: Networks By Design Commercial |
$855.40
|
| Rate for Payer: Prime Health Services Commercial |
$1,118.60
|
| Rate for Payer: Riverside University Health System MISP |
$526.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$789.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$789.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$658.00
|
| Rate for Payer: United Healthcare All Other HMO |
$658.00
|
| Rate for Payer: United Healthcare HMO Rider |
$658.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$658.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,118.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,118.60
|
| Rate for Payer: Vantage Medical Group Senior |
$1,118.60
|
|
|
HC LAB REF MMR MUMPS IGG IFA
|
Facility
|
IP
|
$54.00
|
|
|
Service Code
|
CPT 86735
|
| Hospital Charge Code |
900912870
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.80 |
| Max. Negotiated Rate |
$48.60 |
| Rate for Payer: Adventist Health Commercial |
$10.80
|
| Rate for Payer: Cash Price |
$29.70
|
| Rate for Payer: Central Health Plan Commercial |
$43.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$21.60
|
| Rate for Payer: EPIC Health Plan Senior |
$21.60
|
| Rate for Payer: Galaxy Health WC |
$45.90
|
| Rate for Payer: Global Benefits Group Commercial |
$32.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$48.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$36.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$20.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$33.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.80
|
| Rate for Payer: Multiplan Commercial |
$40.50
|
| Rate for Payer: Networks By Design Commercial |
$35.10
|
| Rate for Payer: Prime Health Services Commercial |
$45.90
|
|
|
HC LAB REF MMR MUMPS IGG IFA
|
Facility
|
OP
|
$54.00
|
|
|
Service Code
|
CPT 86735
|
| Hospital Charge Code |
900912870
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.57 |
| Max. Negotiated Rate |
$95.95 |
| Rate for Payer: Adventist Health Commercial |
$10.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$13.05
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32.79
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.36
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13.05
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$95.95
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$19.47
|
| Rate for Payer: Blue Shield of California Commercial |
$32.78
|
| Rate for Payer: Blue Shield of California EPN |
$21.44
|
| Rate for Payer: Cash Price |
$29.70
|
| Rate for Payer: Cash Price |
$29.70
|
| Rate for Payer: Central Health Plan Commercial |
$43.20
|
| Rate for Payer: Cigna of CA HMO |
$34.56
|
| Rate for Payer: Cigna of CA PPO |
$39.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.57
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.36
|
| Rate for Payer: Dignity Health Medicare Advantage |
$13.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$17.62
|
| Rate for Payer: EPIC Health Plan Senior |
$13.05
|
| Rate for Payer: Galaxy Health WC |
$45.90
|
| Rate for Payer: Global Benefits Group Commercial |
$32.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$48.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$21.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$19.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13.05
|
| Rate for Payer: InnovAge PACE Commercial |
$19.57
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$36.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$22.02
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17.49
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17.49
|
| Rate for Payer: Multiplan Commercial |
$40.50
|
| Rate for Payer: Networks By Design Commercial |
$35.10
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$13.05
|
| Rate for Payer: Prime Health Services Commercial |
$45.90
|
| Rate for Payer: Prime Health Services Medicare |
$13.83
|
| Rate for Payer: Riverside University Health System MISP |
$14.36
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$32.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$32.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.57
|
| Rate for Payer: United Healthcare All Other HMO |
$10.57
|
| Rate for Payer: United Healthcare HMO Rider |
$10.57
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.57
|
| Rate for Payer: Upland Medical Group Pediatric |
$13.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.36
|
| Rate for Payer: Vantage Medical Group Senior |
$13.05
|
|
|
HC LAB REF MMR RUBELLA IGG ELISA
|
Facility
|
OP
|
$60.00
|
|
|
Service Code
|
CPT 86762
|
| Hospital Charge Code |
900912871
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.65 |
| Max. Negotiated Rate |
$104.37 |
| Rate for Payer: Adventist Health Commercial |
$12.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$14.39
|
| Rate for Payer: Aetna of CA HMO/PPO |
$36.44
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21.59
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15.83
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14.39
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$104.37
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$21.18
|
| Rate for Payer: Blue Shield of California Commercial |
$36.42
|
| Rate for Payer: Blue Shield of California EPN |
$23.82
|
| Rate for Payer: Cash Price |
$33.00
|
| Rate for Payer: Cash Price |
$33.00
|
| Rate for Payer: Central Health Plan Commercial |
$48.00
|
| Rate for Payer: Cigna of CA HMO |
$38.40
|
| Rate for Payer: Cigna of CA PPO |
$44.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21.59
|
| Rate for Payer: Dignity Health Medi-Cal |
$15.83
|
| Rate for Payer: Dignity Health Medicare Advantage |
$14.39
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.43
|
| Rate for Payer: EPIC Health Plan Senior |
$14.39
|
| Rate for Payer: Galaxy Health WC |
$51.00
|
| Rate for Payer: Global Benefits Group Commercial |
$36.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$54.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$23.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$22.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$14.39
|
| Rate for Payer: InnovAge PACE Commercial |
$21.59
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$40.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$24.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$19.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$19.28
|
| Rate for Payer: Multiplan Commercial |
$45.00
|
| Rate for Payer: Networks By Design Commercial |
$39.00
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$14.39
|
| Rate for Payer: Prime Health Services Commercial |
$51.00
|
| Rate for Payer: Prime Health Services Medicare |
$15.25
|
| Rate for Payer: Riverside University Health System MISP |
$15.83
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$36.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$36.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$11.65
|
| Rate for Payer: United Healthcare All Other HMO |
$11.65
|
| Rate for Payer: United Healthcare HMO Rider |
$11.65
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.65
|
| Rate for Payer: Upland Medical Group Pediatric |
$14.39
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21.59
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15.83
|
| Rate for Payer: Vantage Medical Group Senior |
$14.39
|
|
|
HC LAB REF MMR RUBELLA IGG ELISA
|
Facility
|
IP
|
$60.00
|
|
|
Service Code
|
CPT 86762
|
| Hospital Charge Code |
900912871
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.00 |
| Max. Negotiated Rate |
$54.00 |
| Rate for Payer: Adventist Health Commercial |
$12.00
|
| Rate for Payer: Cash Price |
$33.00
|
| Rate for Payer: Central Health Plan Commercial |
$48.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$24.00
|
| Rate for Payer: EPIC Health Plan Senior |
$24.00
|
| Rate for Payer: Galaxy Health WC |
$51.00
|
| Rate for Payer: Global Benefits Group Commercial |
$36.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$54.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$40.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$22.86
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$37.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.00
|
| Rate for Payer: Multiplan Commercial |
$45.00
|
| Rate for Payer: Networks By Design Commercial |
$39.00
|
| Rate for Payer: Prime Health Services Commercial |
$51.00
|
|
|
HC LAB REF MMR RUBEOLA IGG IFA
|
Facility
|
IP
|
$53.00
|
|
|
Service Code
|
CPT 86765
|
| Hospital Charge Code |
900912869
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.60 |
| Max. Negotiated Rate |
$47.70 |
| Rate for Payer: Adventist Health Commercial |
$10.60
|
| Rate for Payer: Cash Price |
$29.15
|
| Rate for Payer: Central Health Plan Commercial |
$42.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$21.20
|
| Rate for Payer: EPIC Health Plan Senior |
$21.20
|
| Rate for Payer: Galaxy Health WC |
$45.05
|
| Rate for Payer: Global Benefits Group Commercial |
$31.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$47.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$35.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$20.19
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$32.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.60
|
| Rate for Payer: Multiplan Commercial |
$39.75
|
| Rate for Payer: Networks By Design Commercial |
$34.45
|
| Rate for Payer: Prime Health Services Commercial |
$45.05
|
|
|
HC LAB REF MMR RUBEOLA IGG IFA
|
Facility
|
OP
|
$53.00
|
|
|
Service Code
|
CPT 86765
|
| Hospital Charge Code |
900912869
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.43 |
| Max. Negotiated Rate |
$93.74 |
| Rate for Payer: Adventist Health Commercial |
$10.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$12.88
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32.19
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19.32
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.17
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12.88
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$93.74
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$19.03
|
| Rate for Payer: Blue Shield of California Commercial |
$32.17
|
| Rate for Payer: Blue Shield of California EPN |
$21.04
|
| Rate for Payer: Cash Price |
$29.15
|
| Rate for Payer: Cash Price |
$29.15
|
| Rate for Payer: Central Health Plan Commercial |
$42.40
|
| Rate for Payer: Cigna of CA HMO |
$33.92
|
| Rate for Payer: Cigna of CA PPO |
$39.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.32
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.17
|
| Rate for Payer: Dignity Health Medicare Advantage |
$12.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$17.39
|
| Rate for Payer: EPIC Health Plan Senior |
$12.88
|
| Rate for Payer: Galaxy Health WC |
$45.05
|
| Rate for Payer: Global Benefits Group Commercial |
$31.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$47.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$21.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$19.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$12.88
|
| Rate for Payer: InnovAge PACE Commercial |
$19.32
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$35.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$21.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17.26
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17.26
|
| Rate for Payer: Multiplan Commercial |
$39.75
|
| Rate for Payer: Networks By Design Commercial |
$34.45
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$12.88
|
| Rate for Payer: Prime Health Services Commercial |
$45.05
|
| Rate for Payer: Prime Health Services Medicare |
$13.65
|
| Rate for Payer: Riverside University Health System MISP |
$14.17
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$31.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$31.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.43
|
| Rate for Payer: United Healthcare All Other HMO |
$10.43
|
| Rate for Payer: United Healthcare HMO Rider |
$10.43
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.43
|
| Rate for Payer: Upland Medical Group Pediatric |
$12.88
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.17
|
| Rate for Payer: Vantage Medical Group Senior |
$12.88
|
|
|
HC LAB REF MOLECULAR CYTOGENETICS,DNA PRO
|
Facility
|
OP
|
$34.00
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
900910683
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$6.80 |
| Max. Negotiated Rate |
$1,234.22 |
| Rate for Payer: Adventist Health Commercial |
$6.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$21.42
|
| Rate for Payer: Aetna of CA HMO/PPO |
$20.65
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$32.13
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$23.56
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$21.42
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,234.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$250.49
|
| Rate for Payer: Blue Shield of California Commercial |
$20.64
|
| Rate for Payer: Blue Shield of California EPN |
$13.50
|
| Rate for Payer: Cash Price |
$18.70
|
| Rate for Payer: Cash Price |
$18.70
|
| Rate for Payer: Central Health Plan Commercial |
$27.20
|
| Rate for Payer: Cigna of CA HMO |
$21.76
|
| Rate for Payer: Cigna of CA PPO |
$25.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$32.13
|
| Rate for Payer: Dignity Health Medi-Cal |
$23.56
|
| Rate for Payer: Dignity Health Medicare Advantage |
$21.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$28.92
|
| Rate for Payer: EPIC Health Plan Senior |
$21.42
|
| Rate for Payer: Galaxy Health WC |
$28.90
|
| Rate for Payer: Global Benefits Group Commercial |
$20.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$30.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$35.13
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$28.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$21.42
|
| Rate for Payer: InnovAge PACE Commercial |
$32.13
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$22.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$31.92
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$28.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$28.70
|
| Rate for Payer: Multiplan Commercial |
$25.50
|
| Rate for Payer: Networks By Design Commercial |
$22.10
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$21.42
|
| Rate for Payer: Prime Health Services Commercial |
$28.90
|
| Rate for Payer: Prime Health Services Medicare |
$22.71
|
| Rate for Payer: Riverside University Health System MISP |
$23.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$20.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$20.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$17.35
|
| Rate for Payer: United Healthcare All Other HMO |
$17.35
|
| Rate for Payer: United Healthcare HMO Rider |
$17.35
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$17.35
|
| Rate for Payer: Upland Medical Group Pediatric |
$21.42
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$32.13
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$23.56
|
| Rate for Payer: Vantage Medical Group Senior |
$21.42
|
|
|
HC LAB REF MOLECULAR CYTOGENETICS,DNA PRO
|
Facility
|
IP
|
$34.00
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
900910683
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$6.80 |
| Max. Negotiated Rate |
$30.60 |
| Rate for Payer: Adventist Health Commercial |
$6.80
|
| Rate for Payer: Cash Price |
$18.70
|
| Rate for Payer: Central Health Plan Commercial |
$27.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.60
|
| Rate for Payer: EPIC Health Plan Senior |
$13.60
|
| Rate for Payer: Galaxy Health WC |
$28.90
|
| Rate for Payer: Global Benefits Group Commercial |
$20.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$30.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$22.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12.95
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.80
|
| Rate for Payer: Multiplan Commercial |
$25.50
|
| Rate for Payer: Networks By Design Commercial |
$22.10
|
| Rate for Payer: Prime Health Services Commercial |
$28.90
|
|
|
HC LAB REF MOLECULAR CYTOGENTCS 100-300CE
|
Facility
|
OP
|
$64.00
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
900910679
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$12.80 |
| Max. Negotiated Rate |
$1,904.23 |
| Rate for Payer: Adventist Health Commercial |
$12.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$51.19
|
| Rate for Payer: Aetna of CA HMO/PPO |
$38.87
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$76.78
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$56.31
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$51.19
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,904.23
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$386.47
|
| Rate for Payer: Blue Shield of California Commercial |
$38.85
|
| Rate for Payer: Blue Shield of California EPN |
$25.41
|
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Central Health Plan Commercial |
$51.20
|
| Rate for Payer: Cigna of CA HMO |
$40.96
|
| Rate for Payer: Cigna of CA PPO |
$47.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$76.78
|
| Rate for Payer: Dignity Health Medi-Cal |
$56.31
|
| Rate for Payer: Dignity Health Medicare Advantage |
$51.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$69.11
|
| Rate for Payer: EPIC Health Plan Senior |
$51.19
|
| Rate for Payer: Galaxy Health WC |
$54.40
|
| Rate for Payer: Global Benefits Group Commercial |
$38.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$57.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$83.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$54.49
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$51.19
|
| Rate for Payer: InnovAge PACE Commercial |
$76.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$42.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$60.19
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$51.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$68.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$68.59
|
| Rate for Payer: Multiplan Commercial |
$48.00
|
| Rate for Payer: Networks By Design Commercial |
$41.60
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$51.19
|
| Rate for Payer: Prime Health Services Commercial |
$54.40
|
| Rate for Payer: Prime Health Services Medicare |
$54.26
|
| Rate for Payer: Riverside University Health System MISP |
$56.31
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$38.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$38.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$41.46
|
| Rate for Payer: United Healthcare All Other HMO |
$41.46
|
| Rate for Payer: United Healthcare HMO Rider |
$41.46
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$41.46
|
| Rate for Payer: Upland Medical Group Pediatric |
$51.19
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$76.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$56.31
|
| Rate for Payer: Vantage Medical Group Senior |
$51.19
|
|
|
HC LAB REF MOLECULAR CYTOGENTCS 100-300CE
|
Facility
|
IP
|
$64.00
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
900910679
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$12.80 |
| Max. Negotiated Rate |
$57.60 |
| Rate for Payer: Adventist Health Commercial |
$12.80
|
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Central Health Plan Commercial |
$51.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$25.60
|
| Rate for Payer: EPIC Health Plan Senior |
$25.60
|
| Rate for Payer: Galaxy Health WC |
$54.40
|
| Rate for Payer: Global Benefits Group Commercial |
$38.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$57.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$42.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$24.38
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$39.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.80
|
| Rate for Payer: Multiplan Commercial |
$48.00
|
| Rate for Payer: Networks By Design Commercial |
$41.60
|
| Rate for Payer: Prime Health Services Commercial |
$54.40
|
|
|
HC LAB REF MORPHOMETRIC ANALYSIS IN SITU
|
Facility
|
OP
|
$73.00
|
|
|
Service Code
|
CPT 88368
|
| Hospital Charge Code |
900912796
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$14.60 |
| Max. Negotiated Rate |
$749.58 |
| Rate for Payer: Adventist Health Commercial |
$14.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$457.06
|
| Rate for Payer: Aetna of CA HMO/PPO |
$44.33
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$685.59
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$502.77
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$457.06
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$626.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$127.09
|
| Rate for Payer: Blue Shield of California Commercial |
$44.31
|
| Rate for Payer: Blue Shield of California EPN |
$28.98
|
| Rate for Payer: Cash Price |
$40.15
|
| Rate for Payer: Cash Price |
$40.15
|
| Rate for Payer: Central Health Plan Commercial |
$58.40
|
| Rate for Payer: Cigna of CA HMO |
$46.72
|
| Rate for Payer: Cigna of CA PPO |
$54.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$685.59
|
| Rate for Payer: Dignity Health Medi-Cal |
$502.77
|
| Rate for Payer: Dignity Health Medicare Advantage |
$457.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$617.03
|
| Rate for Payer: EPIC Health Plan Senior |
$457.06
|
| Rate for Payer: Galaxy Health WC |
$62.05
|
| Rate for Payer: Global Benefits Group Commercial |
$43.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$65.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$749.58
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$129.71
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$457.06
|
| Rate for Payer: InnovAge PACE Commercial |
$685.59
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$48.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$143.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$457.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$612.46
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$612.46
|
| Rate for Payer: Multiplan Commercial |
$54.75
|
| Rate for Payer: Networks By Design Commercial |
$47.45
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$457.06
|
| Rate for Payer: Prime Health Services Commercial |
$62.05
|
| Rate for Payer: Prime Health Services Medicare |
$484.48
|
| Rate for Payer: Riverside University Health System MISP |
$502.77
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$43.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$43.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$240.94
|
| Rate for Payer: United Healthcare All Other HMO |
$240.94
|
| Rate for Payer: United Healthcare HMO Rider |
$240.94
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$240.94
|
| Rate for Payer: Upland Medical Group Pediatric |
$457.06
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$685.59
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$502.77
|
| Rate for Payer: Vantage Medical Group Senior |
$457.06
|
|
|
HC LAB REF MORPHOMETRIC ANALYSIS IN SITU
|
Facility
|
IP
|
$73.00
|
|
|
Service Code
|
CPT 88368
|
| Hospital Charge Code |
900912796
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$14.60 |
| Max. Negotiated Rate |
$65.70 |
| Rate for Payer: Adventist Health Commercial |
$14.60
|
| Rate for Payer: Cash Price |
$40.15
|
| Rate for Payer: Central Health Plan Commercial |
$58.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$29.20
|
| Rate for Payer: EPIC Health Plan Senior |
$29.20
|
| Rate for Payer: Galaxy Health WC |
$62.05
|
| Rate for Payer: Global Benefits Group Commercial |
$43.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$65.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$48.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$27.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$45.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.60
|
| Rate for Payer: Multiplan Commercial |
$54.75
|
| Rate for Payer: Networks By Design Commercial |
$47.45
|
| Rate for Payer: Prime Health Services Commercial |
$62.05
|
|
|
HC LAB REF MS PANEL IGG CSF
|
Facility
|
IP
|
$15.00
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
900910556
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.00 |
| Max. Negotiated Rate |
$13.50 |
| Rate for Payer: Adventist Health Commercial |
$3.00
|
| Rate for Payer: Cash Price |
$8.25
|
| Rate for Payer: Central Health Plan Commercial |
$12.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.00
|
| Rate for Payer: EPIC Health Plan Senior |
$6.00
|
| Rate for Payer: Galaxy Health WC |
$12.75
|
| Rate for Payer: Global Benefits Group Commercial |
$9.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$13.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.71
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.00
|
| Rate for Payer: Multiplan Commercial |
$11.25
|
| Rate for Payer: Networks By Design Commercial |
$9.75
|
| Rate for Payer: Prime Health Services Commercial |
$12.75
|
|
|
HC LAB REF MS PANEL IGG CSF
|
Facility
|
OP
|
$15.00
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
900910556
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.00 |
| Max. Negotiated Rate |
$56.37 |
| Rate for Payer: Adventist Health Commercial |
$3.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$9.30
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9.11
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9.30
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$56.37
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11.44
|
| Rate for Payer: Blue Shield of California Commercial |
$9.11
|
| Rate for Payer: Blue Shield of California EPN |
$5.96
|
| Rate for Payer: Cash Price |
$8.25
|
| Rate for Payer: Cash Price |
$8.25
|
| Rate for Payer: Central Health Plan Commercial |
$12.00
|
| Rate for Payer: Cigna of CA HMO |
$9.60
|
| Rate for Payer: Cigna of CA PPO |
$11.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$10.23
|
| Rate for Payer: Dignity Health Medicare Advantage |
$9.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.55
|
| Rate for Payer: EPIC Health Plan Senior |
$9.30
|
| Rate for Payer: Galaxy Health WC |
$12.75
|
| Rate for Payer: Global Benefits Group Commercial |
$9.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$13.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$15.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$10.46
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$9.30
|
| Rate for Payer: InnovAge PACE Commercial |
$13.95
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.55
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$12.46
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$12.46
|
| Rate for Payer: Multiplan Commercial |
$11.25
|
| Rate for Payer: Networks By Design Commercial |
$9.75
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$9.30
|
| Rate for Payer: Prime Health Services Commercial |
$12.75
|
| Rate for Payer: Prime Health Services Medicare |
$9.86
|
| Rate for Payer: Riverside University Health System MISP |
$10.23
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.53
|
| Rate for Payer: United Healthcare All Other HMO |
$7.53
|
| Rate for Payer: United Healthcare HMO Rider |
$7.53
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.53
|
| Rate for Payer: Upland Medical Group Pediatric |
$9.30
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.23
|
| Rate for Payer: Vantage Medical Group Senior |
$9.30
|
|
|
HC LAB REF MS PANEL IGG, SERUM
|
Facility
|
IP
|
$15.00
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
900912659
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.00 |
| Max. Negotiated Rate |
$13.50 |
| Rate for Payer: Adventist Health Commercial |
$3.00
|
| Rate for Payer: Cash Price |
$8.25
|
| Rate for Payer: Central Health Plan Commercial |
$12.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.00
|
| Rate for Payer: EPIC Health Plan Senior |
$6.00
|
| Rate for Payer: Galaxy Health WC |
$12.75
|
| Rate for Payer: Global Benefits Group Commercial |
$9.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$13.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.71
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.00
|
| Rate for Payer: Multiplan Commercial |
$11.25
|
| Rate for Payer: Networks By Design Commercial |
$9.75
|
| Rate for Payer: Prime Health Services Commercial |
$12.75
|
|
|
HC LAB REF MS PANEL IGG, SERUM
|
Facility
|
OP
|
$15.00
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
900912659
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.00 |
| Max. Negotiated Rate |
$56.37 |
| Rate for Payer: Adventist Health Commercial |
$3.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$9.30
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9.11
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9.30
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$56.37
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11.44
|
| Rate for Payer: Blue Shield of California Commercial |
$9.11
|
| Rate for Payer: Blue Shield of California EPN |
$5.96
|
| Rate for Payer: Cash Price |
$8.25
|
| Rate for Payer: Cash Price |
$8.25
|
| Rate for Payer: Central Health Plan Commercial |
$12.00
|
| Rate for Payer: Cigna of CA HMO |
$9.60
|
| Rate for Payer: Cigna of CA PPO |
$11.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$10.23
|
| Rate for Payer: Dignity Health Medicare Advantage |
$9.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.55
|
| Rate for Payer: EPIC Health Plan Senior |
$9.30
|
| Rate for Payer: Galaxy Health WC |
$12.75
|
| Rate for Payer: Global Benefits Group Commercial |
$9.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$13.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$15.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$10.46
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$9.30
|
| Rate for Payer: InnovAge PACE Commercial |
$13.95
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.55
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$12.46
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$12.46
|
| Rate for Payer: Multiplan Commercial |
$11.25
|
| Rate for Payer: Networks By Design Commercial |
$9.75
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$9.30
|
| Rate for Payer: Prime Health Services Commercial |
$12.75
|
| Rate for Payer: Prime Health Services Medicare |
$9.86
|
| Rate for Payer: Riverside University Health System MISP |
$10.23
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.53
|
| Rate for Payer: United Healthcare All Other HMO |
$7.53
|
| Rate for Payer: United Healthcare HMO Rider |
$7.53
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.53
|
| Rate for Payer: Upland Medical Group Pediatric |
$9.30
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.23
|
| Rate for Payer: Vantage Medical Group Senior |
$9.30
|
|
|
HC LAB REF MTHFR MUTATION
|
Facility
|
IP
|
$63.00
|
|
|
Service Code
|
CPT 81291
|
| Hospital Charge Code |
900912713
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$12.60 |
| Max. Negotiated Rate |
$56.70 |
| Rate for Payer: Adventist Health Commercial |
$12.60
|
| Rate for Payer: Cash Price |
$34.65
|
| Rate for Payer: Central Health Plan Commercial |
$50.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$25.20
|
| Rate for Payer: EPIC Health Plan Senior |
$25.20
|
| Rate for Payer: Galaxy Health WC |
$53.55
|
| Rate for Payer: Global Benefits Group Commercial |
$37.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$56.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$42.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$24.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$39.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.60
|
| Rate for Payer: Multiplan Commercial |
$47.25
|
| Rate for Payer: Networks By Design Commercial |
$40.95
|
| Rate for Payer: Prime Health Services Commercial |
$53.55
|
|
|
HC LAB REF MTHFR MUTATION
|
Facility
|
OP
|
$63.00
|
|
|
Service Code
|
CPT 81291
|
| Hospital Charge Code |
900912713
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$12.60 |
| Max. Negotiated Rate |
$332.60 |
| Rate for Payer: Adventist Health Commercial |
$12.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$65.34
|
| Rate for Payer: Aetna of CA HMO/PPO |
$38.26
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$98.01
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$71.87
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$65.34
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$332.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$67.50
|
| Rate for Payer: Blue Shield of California Commercial |
$38.24
|
| Rate for Payer: Blue Shield of California EPN |
$25.01
|
| Rate for Payer: Cash Price |
$34.65
|
| Rate for Payer: Cash Price |
$34.65
|
| Rate for Payer: Central Health Plan Commercial |
$50.40
|
| Rate for Payer: Cigna of CA HMO |
$40.32
|
| Rate for Payer: Cigna of CA PPO |
$46.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$98.01
|
| Rate for Payer: Dignity Health Medi-Cal |
$71.87
|
| Rate for Payer: Dignity Health Medicare Advantage |
$65.34
|
| Rate for Payer: EPIC Health Plan Commercial |
$88.21
|
| Rate for Payer: EPIC Health Plan Senior |
$65.34
|
| Rate for Payer: Galaxy Health WC |
$53.55
|
| Rate for Payer: Global Benefits Group Commercial |
$37.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$56.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$107.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$65.34
|
| Rate for Payer: InnovAge PACE Commercial |
$98.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$42.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$24.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$65.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$87.56
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$87.56
|
| Rate for Payer: Multiplan Commercial |
$47.25
|
| Rate for Payer: Networks By Design Commercial |
$40.95
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$65.34
|
| Rate for Payer: Prime Health Services Commercial |
$53.55
|
| Rate for Payer: Prime Health Services Medicare |
$69.26
|
| Rate for Payer: Riverside University Health System MISP |
$71.87
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$37.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$37.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$52.93
|
| Rate for Payer: United Healthcare All Other HMO |
$52.93
|
| Rate for Payer: United Healthcare HMO Rider |
$52.93
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$52.93
|
| Rate for Payer: Upland Medical Group Pediatric |
$65.34
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$98.01
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$71.87
|
| Rate for Payer: Vantage Medical Group Senior |
$65.34
|
|
