|
HC K PLST SKT JOINT&THIGH LAC SAC
|
Facility
|
IP
|
$9,945.00
|
|
|
Service Code
|
CPT L5105
|
| Hospital Charge Code |
905355105
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$1,989.00 |
| Max. Negotiated Rate |
$8,950.50 |
| Rate for Payer: Blue Shield of California EPN |
$5,310.63
|
| Rate for Payer: Cash Price |
$4,475.25
|
| Rate for Payer: Central Health Plan Commercial |
$7,956.00
|
| Rate for Payer: Cigna of CA HMO |
$6,961.50
|
| Rate for Payer: Cigna of CA PPO |
$6,961.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,978.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$3,978.00
|
| Rate for Payer: Galaxy Health WC |
$8,453.25
|
| Rate for Payer: Global Benefits Group Commercial |
$5,967.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,950.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,633.32
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,789.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,989.00
|
| Rate for Payer: Multiplan Commercial |
$7,458.75
|
| Rate for Payer: Networks By Design Commercial |
$4,972.50
|
| Rate for Payer: Prime Health Services Commercial |
$8,453.25
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,755.23
|
| Rate for Payer: United Healthcare All Other HMO |
$3,667.72
|
| Rate for Payer: United Healthcare HMO Rider |
$3,588.16
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,281.85
|
|
|
HC KRAS EXON 2
|
Facility
|
IP
|
$302.00
|
|
|
Service Code
|
CPT 81275
|
| Hospital Charge Code |
903800316
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$60.40 |
| Max. Negotiated Rate |
$271.80 |
| Rate for Payer: Cash Price |
$135.90
|
| Rate for Payer: Central Health Plan Commercial |
$241.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$120.80
|
| Rate for Payer: Galaxy Health WC |
$256.70
|
| Rate for Payer: Global Benefits Group Commercial |
$181.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$271.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$201.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$115.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$60.40
|
| Rate for Payer: Multiplan Commercial |
$226.50
|
| Rate for Payer: Networks By Design Commercial |
$196.30
|
| Rate for Payer: Prime Health Services Commercial |
$256.70
|
|
|
HC KRAS EXON 2
|
Facility
|
OP
|
$218.00
|
|
|
Service Code
|
CPT 81275
|
| Hospital Charge Code |
903800316
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$43.60 |
| Max. Negotiated Rate |
$1,000.76 |
| Rate for Payer: Adventist Health Medi-Cal |
$193.25
|
| Rate for Payer: Aetna of CA HMO/PPO |
$554.12
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$289.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$212.58
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$193.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$820.46
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,000.76
|
| Rate for Payer: Blue Distinction Transplant |
$130.80
|
| Rate for Payer: Blue Shield of California Commercial |
$134.72
|
| Rate for Payer: Blue Shield of California EPN |
$105.95
|
| Rate for Payer: Caremore Medicare Advantage |
$193.25
|
| Rate for Payer: Cash Price |
$98.10
|
| Rate for Payer: Cash Price |
$98.10
|
| Rate for Payer: Central Health Plan Commercial |
$174.40
|
| Rate for Payer: Cigna of CA HMO |
$139.52
|
| Rate for Payer: Cigna of CA PPO |
$161.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$289.88
|
| Rate for Payer: Dignity Health Media |
$193.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$212.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$260.89
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$193.25
|
| Rate for Payer: EPIC Health Plan Transplant |
$193.25
|
| Rate for Payer: Galaxy Health WC |
$185.30
|
| Rate for Payer: Global Benefits Group Commercial |
$130.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$196.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$163.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$316.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$318.86
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$193.25
|
| Rate for Payer: InnovAge PACE Commercial |
$289.88
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$145.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$293.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$193.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$43.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$258.96
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$258.96
|
| Rate for Payer: Multiplan Commercial |
$163.50
|
| Rate for Payer: Networks By Design Commercial |
$141.70
|
| Rate for Payer: Prime Health Services Commercial |
$185.30
|
| Rate for Payer: Prime Health Services Medicare |
$204.84
|
| Rate for Payer: Riverside University Health System MISP |
$212.58
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$130.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$130.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$156.54
|
| Rate for Payer: United Healthcare All Other HMO |
$156.54
|
| Rate for Payer: United Healthcare HMO Rider |
$156.54
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$156.54
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$289.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$212.58
|
| Rate for Payer: Vantage Medical Group Senior |
$193.25
|
|
|
HC KRAS EXON VARIANTS
|
Facility
|
OP
|
$218.00
|
|
|
Service Code
|
CPT 81276
|
| Hospital Charge Code |
903800317
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$43.60 |
| Max. Negotiated Rate |
$1,364.46 |
| Rate for Payer: Adventist Health Medi-Cal |
$193.25
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,028.40
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$289.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$212.58
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$193.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,118.63
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,364.46
|
| Rate for Payer: Blue Distinction Transplant |
$130.80
|
| Rate for Payer: Blue Shield of California Commercial |
$134.72
|
| Rate for Payer: Blue Shield of California EPN |
$105.95
|
| Rate for Payer: Caremore Medicare Advantage |
$193.25
|
| Rate for Payer: Cash Price |
$98.10
|
| Rate for Payer: Cash Price |
$98.10
|
| Rate for Payer: Central Health Plan Commercial |
$174.40
|
| Rate for Payer: Cigna of CA HMO |
$139.52
|
| Rate for Payer: Cigna of CA PPO |
$161.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$289.88
|
| Rate for Payer: Dignity Health Media |
$193.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$212.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$260.89
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$193.25
|
| Rate for Payer: EPIC Health Plan Transplant |
$193.25
|
| Rate for Payer: Galaxy Health WC |
$185.30
|
| Rate for Payer: Global Benefits Group Commercial |
$130.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$196.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$163.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$316.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$318.86
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$193.25
|
| Rate for Payer: InnovAge PACE Commercial |
$289.88
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$145.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$293.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$193.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$43.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$258.96
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$258.96
|
| Rate for Payer: Multiplan Commercial |
$163.50
|
| Rate for Payer: Networks By Design Commercial |
$141.70
|
| Rate for Payer: Prime Health Services Commercial |
$185.30
|
| Rate for Payer: Prime Health Services Medicare |
$204.84
|
| Rate for Payer: Riverside University Health System MISP |
$212.58
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$130.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$130.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$156.54
|
| Rate for Payer: United Healthcare All Other HMO |
$156.54
|
| Rate for Payer: United Healthcare HMO Rider |
$156.54
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$156.54
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$289.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$212.58
|
| Rate for Payer: Vantage Medical Group Senior |
$193.25
|
|
|
HC KRAS EXON VARIANTS
|
Facility
|
IP
|
$302.00
|
|
|
Service Code
|
CPT 81276
|
| Hospital Charge Code |
903800317
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$60.40 |
| Max. Negotiated Rate |
$271.80 |
| Rate for Payer: Cash Price |
$135.90
|
| Rate for Payer: Central Health Plan Commercial |
$241.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$120.80
|
| Rate for Payer: Galaxy Health WC |
$256.70
|
| Rate for Payer: Global Benefits Group Commercial |
$181.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$271.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$201.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$115.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$60.40
|
| Rate for Payer: Multiplan Commercial |
$226.50
|
| Rate for Payer: Networks By Design Commercial |
$196.30
|
| Rate for Payer: Prime Health Services Commercial |
$256.70
|
|
|
HC LAA PERI DEVICE LEAK CLOSURE
|
Facility
|
IP
|
$47,157.00
|
|
|
Service Code
|
CPT 93799
|
| Hospital Charge Code |
906820299
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$9,431.40 |
| Max. Negotiated Rate |
$42,441.30 |
| Rate for Payer: Cash Price |
$21,220.65
|
| Rate for Payer: Central Health Plan Commercial |
$37,725.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$18,862.80
|
| Rate for Payer: Galaxy Health WC |
$40,083.45
|
| Rate for Payer: Global Benefits Group Commercial |
$28,294.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$42,441.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$31,453.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$17,966.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9,431.40
|
| Rate for Payer: Multiplan Commercial |
$35,367.75
|
| Rate for Payer: Networks By Design Commercial |
$30,652.05
|
| Rate for Payer: Prime Health Services Commercial |
$40,083.45
|
|
|
HC LAA PERI DEVICE LEAK CLOSURE
|
Facility
|
IP
|
$47,157.00
|
|
|
Service Code
|
CPT 93799
|
| Hospital Charge Code |
906819768
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$9,431.40 |
| Max. Negotiated Rate |
$42,441.30 |
| Rate for Payer: Cash Price |
$21,220.65
|
| Rate for Payer: Central Health Plan Commercial |
$37,725.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$18,862.80
|
| Rate for Payer: Galaxy Health WC |
$40,083.45
|
| Rate for Payer: Global Benefits Group Commercial |
$28,294.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$42,441.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$31,453.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$17,966.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9,431.40
|
| Rate for Payer: Multiplan Commercial |
$35,367.75
|
| Rate for Payer: Networks By Design Commercial |
$30,652.05
|
| Rate for Payer: Prime Health Services Commercial |
$40,083.45
|
|
|
HC LAA PERI DEVICE LEAK CLOSURE
|
Facility
|
OP
|
$47,157.00
|
|
|
Service Code
|
CPT 93799
|
| Hospital Charge Code |
906820299
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$195.17 |
| Max. Negotiated Rate |
$42,441.30 |
| Rate for Payer: Adventist Health Medi-Cal |
$195.17
|
| Rate for Payer: Aetna of CA HMO/PPO |
$28,638.45
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$292.76
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$214.69
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$195.17
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$22,833.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$27,860.36
|
| Rate for Payer: Blue Distinction Transplant |
$28,294.20
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Caremore Medicare Advantage |
$195.17
|
| Rate for Payer: Cash Price |
$21,220.65
|
| Rate for Payer: Cash Price |
$21,220.65
|
| Rate for Payer: Cash Price |
$21,220.65
|
| Rate for Payer: Central Health Plan Commercial |
$37,725.60
|
| Rate for Payer: Cigna of CA HMO |
$30,180.48
|
| Rate for Payer: Cigna of CA PPO |
$34,896.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$292.76
|
| Rate for Payer: Dignity Health Media |
$195.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$214.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$263.48
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$195.17
|
| Rate for Payer: EPIC Health Plan Transplant |
$195.17
|
| Rate for Payer: Galaxy Health WC |
$40,083.45
|
| Rate for Payer: Global Benefits Group Commercial |
$28,294.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$42,441.30
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$35,367.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$320.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$322.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$195.17
|
| Rate for Payer: InnovAge PACE Commercial |
$292.76
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$31,453.72
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$195.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9,431.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$261.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$261.53
|
| Rate for Payer: Multiplan Commercial |
$35,367.75
|
| Rate for Payer: Networks By Design Commercial |
$30,652.05
|
| Rate for Payer: Prime Health Services Commercial |
$40,083.45
|
| Rate for Payer: Prime Health Services Medicare |
$206.88
|
| Rate for Payer: Riverside University Health System MISP |
$214.69
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$28,294.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$28,294.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,078.00
|
| Rate for Payer: United Healthcare All Other HMO |
$827.00
|
| Rate for Payer: United Healthcare HMO Rider |
$702.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$643.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$292.76
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$214.69
|
| Rate for Payer: Vantage Medical Group Senior |
$195.17
|
|
|
HC LAA PERI DEVICE LEAK CLOSURE
|
Facility
|
OP
|
$47,157.00
|
|
|
Service Code
|
CPT 93799
|
| Hospital Charge Code |
906819768
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$195.17 |
| Max. Negotiated Rate |
$42,441.30 |
| Rate for Payer: Adventist Health Medi-Cal |
$195.17
|
| Rate for Payer: Aetna of CA HMO/PPO |
$28,638.45
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$292.76
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$214.69
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$195.17
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$22,833.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$27,860.36
|
| Rate for Payer: Blue Distinction Transplant |
$28,294.20
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Caremore Medicare Advantage |
$195.17
|
| Rate for Payer: Cash Price |
$21,220.65
|
| Rate for Payer: Cash Price |
$21,220.65
|
| Rate for Payer: Cash Price |
$21,220.65
|
| Rate for Payer: Central Health Plan Commercial |
$37,725.60
|
| Rate for Payer: Cigna of CA HMO |
$30,180.48
|
| Rate for Payer: Cigna of CA PPO |
$34,896.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$292.76
|
| Rate for Payer: Dignity Health Media |
$195.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$214.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$263.48
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$195.17
|
| Rate for Payer: EPIC Health Plan Transplant |
$195.17
|
| Rate for Payer: Galaxy Health WC |
$40,083.45
|
| Rate for Payer: Global Benefits Group Commercial |
$28,294.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$42,441.30
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$35,367.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$320.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$322.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$195.17
|
| Rate for Payer: InnovAge PACE Commercial |
$292.76
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$31,453.72
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$195.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9,431.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$261.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$261.53
|
| Rate for Payer: Multiplan Commercial |
$35,367.75
|
| Rate for Payer: Networks By Design Commercial |
$30,652.05
|
| Rate for Payer: Prime Health Services Commercial |
$40,083.45
|
| Rate for Payer: Prime Health Services Medicare |
$206.88
|
| Rate for Payer: Riverside University Health System MISP |
$214.69
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$28,294.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$28,294.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,078.00
|
| Rate for Payer: United Healthcare All Other HMO |
$827.00
|
| Rate for Payer: United Healthcare HMO Rider |
$702.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$643.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$292.76
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$214.69
|
| Rate for Payer: Vantage Medical Group Senior |
$195.17
|
|
|
HC LAB REF ACH RECEPTOR MODULATING ABS
|
Facility
|
OP
|
$22.00
|
|
|
Service Code
|
CPT 83519
|
| Hospital Charge Code |
900912584
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.40 |
| Max. Negotiated Rate |
$119.90 |
| Rate for Payer: Adventist Health Medi-Cal |
$18.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$99.15
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$27.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$20.24
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$18.40
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$98.30
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$119.90
|
| Rate for Payer: Blue Distinction Transplant |
$13.20
|
| Rate for Payer: Blue Shield of California Commercial |
$13.60
|
| Rate for Payer: Blue Shield of California EPN |
$10.69
|
| Rate for Payer: Caremore Medicare Advantage |
$18.40
|
| Rate for Payer: Cash Price |
$9.90
|
| Rate for Payer: Cash Price |
$9.90
|
| Rate for Payer: Central Health Plan Commercial |
$17.60
|
| Rate for Payer: Cigna of CA HMO |
$14.08
|
| Rate for Payer: Cigna of CA PPO |
$16.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$27.60
|
| Rate for Payer: Dignity Health Media |
$18.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$20.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$24.84
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$18.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$18.40
|
| Rate for Payer: Galaxy Health WC |
$18.70
|
| Rate for Payer: Global Benefits Group Commercial |
$13.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$19.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$16.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$30.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$30.36
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$18.40
|
| Rate for Payer: InnovAge PACE Commercial |
$27.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$14.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$23.31
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$24.66
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$24.66
|
| Rate for Payer: Multiplan Commercial |
$16.50
|
| Rate for Payer: Networks By Design Commercial |
$14.30
|
| Rate for Payer: Prime Health Services Commercial |
$18.70
|
| Rate for Payer: Prime Health Services Medicare |
$19.50
|
| Rate for Payer: Riverside University Health System MISP |
$20.24
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$13.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$13.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.90
|
| Rate for Payer: United Healthcare All Other HMO |
$14.90
|
| Rate for Payer: United Healthcare HMO Rider |
$14.90
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.90
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$27.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$20.24
|
| Rate for Payer: Vantage Medical Group Senior |
$18.40
|
|
|
HC LAB REF ACH RECEPTOR MODULATING ABS
|
Facility
|
IP
|
$22.00
|
|
|
Service Code
|
CPT 83519
|
| Hospital Charge Code |
900912584
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.40 |
| Max. Negotiated Rate |
$19.80 |
| Rate for Payer: Cash Price |
$9.90
|
| Rate for Payer: Central Health Plan Commercial |
$17.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.80
|
| Rate for Payer: Galaxy Health WC |
$18.70
|
| Rate for Payer: Global Benefits Group Commercial |
$13.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$19.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$14.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.40
|
| Rate for Payer: Multiplan Commercial |
$16.50
|
| Rate for Payer: Networks By Design Commercial |
$14.30
|
| Rate for Payer: Prime Health Services Commercial |
$18.70
|
|
|
HC LAB REF ACOMPARATIVE GENE HYBRIDIZATIO
|
Facility
|
OP
|
$1,025.00
|
|
|
Service Code
|
CPT 81228
|
| Hospital Charge Code |
900912780
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$205.00 |
| Max. Negotiated Rate |
$2,409.61 |
| Rate for Payer: Adventist Health Medi-Cal |
$900.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,126.51
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,350.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$990.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$900.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,975.49
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,409.61
|
| Rate for Payer: Blue Distinction Transplant |
$615.00
|
| Rate for Payer: Blue Shield of California Commercial |
$633.45
|
| Rate for Payer: Blue Shield of California EPN |
$498.15
|
| Rate for Payer: Caremore Medicare Advantage |
$900.00
|
| Rate for Payer: Cash Price |
$461.25
|
| Rate for Payer: Cash Price |
$461.25
|
| Rate for Payer: Central Health Plan Commercial |
$820.00
|
| Rate for Payer: Cigna of CA HMO |
$656.00
|
| Rate for Payer: Cigna of CA PPO |
$758.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,350.00
|
| Rate for Payer: Dignity Health Media |
$900.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$990.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,215.00
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$900.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$900.00
|
| Rate for Payer: Galaxy Health WC |
$871.25
|
| Rate for Payer: Global Benefits Group Commercial |
$615.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$922.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$768.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,476.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,485.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$900.00
|
| Rate for Payer: InnovAge PACE Commercial |
$1,350.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$683.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$390.52
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$900.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$205.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,206.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,206.00
|
| Rate for Payer: Multiplan Commercial |
$768.75
|
| Rate for Payer: Networks By Design Commercial |
$666.25
|
| Rate for Payer: Prime Health Services Commercial |
$871.25
|
| Rate for Payer: Prime Health Services Medicare |
$954.00
|
| Rate for Payer: Riverside University Health System MISP |
$990.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$615.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$615.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$729.00
|
| Rate for Payer: United Healthcare All Other HMO |
$729.00
|
| Rate for Payer: United Healthcare HMO Rider |
$729.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$729.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,350.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$990.00
|
| Rate for Payer: Vantage Medical Group Senior |
$900.00
|
|
|
HC LAB REF ACOMPARATIVE GENE HYBRIDIZATIO
|
Facility
|
IP
|
$1,025.00
|
|
|
Service Code
|
CPT 81228
|
| Hospital Charge Code |
900912780
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$205.00 |
| Max. Negotiated Rate |
$922.50 |
| Rate for Payer: Cash Price |
$461.25
|
| Rate for Payer: Central Health Plan Commercial |
$820.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$410.00
|
| Rate for Payer: Galaxy Health WC |
$871.25
|
| Rate for Payer: Global Benefits Group Commercial |
$615.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$922.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$683.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$390.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$205.00
|
| Rate for Payer: Multiplan Commercial |
$768.75
|
| Rate for Payer: Networks By Design Commercial |
$666.25
|
| Rate for Payer: Prime Health Services Commercial |
$871.25
|
|
|
HC LAB REF ADDITION KARYOTYPE
|
Facility
|
OP
|
$40.00
|
|
|
Service Code
|
CPT 88280
|
| Hospital Charge Code |
900910745
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$8.00 |
| Max. Negotiated Rate |
$222.71 |
| Rate for Payer: Adventist Health Medi-Cal |
$33.47
|
| Rate for Payer: Aetna of CA HMO/PPO |
$184.19
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$50.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$36.82
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$33.47
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$182.59
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$222.71
|
| Rate for Payer: Blue Distinction Transplant |
$24.00
|
| Rate for Payer: Blue Shield of California Commercial |
$24.72
|
| Rate for Payer: Blue Shield of California EPN |
$19.44
|
| Rate for Payer: Caremore Medicare Advantage |
$33.47
|
| Rate for Payer: Cash Price |
$18.00
|
| Rate for Payer: Cash Price |
$18.00
|
| Rate for Payer: Central Health Plan Commercial |
$32.00
|
| Rate for Payer: Cigna of CA HMO |
$25.60
|
| Rate for Payer: Cigna of CA PPO |
$29.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$50.20
|
| Rate for Payer: Dignity Health Media |
$33.47
|
| Rate for Payer: Dignity Health Medi-Cal |
$36.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$45.18
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$33.47
|
| Rate for Payer: EPIC Health Plan Transplant |
$33.47
|
| Rate for Payer: Galaxy Health WC |
$34.00
|
| Rate for Payer: Global Benefits Group Commercial |
$24.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$36.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$30.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$54.89
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$55.23
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$33.47
|
| Rate for Payer: InnovAge PACE Commercial |
$50.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$26.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$36.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$33.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$44.85
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$44.85
|
| Rate for Payer: Multiplan Commercial |
$30.00
|
| Rate for Payer: Networks By Design Commercial |
$26.00
|
| Rate for Payer: Prime Health Services Commercial |
$34.00
|
| Rate for Payer: Prime Health Services Medicare |
$35.48
|
| Rate for Payer: Riverside University Health System MISP |
$36.82
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$24.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$24.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$27.11
|
| Rate for Payer: United Healthcare All Other HMO |
$27.11
|
| Rate for Payer: United Healthcare HMO Rider |
$27.11
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$27.11
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$50.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$36.82
|
| Rate for Payer: Vantage Medical Group Senior |
$33.47
|
|
|
HC LAB REF ADDITION KARYOTYPE
|
Facility
|
IP
|
$40.00
|
|
|
Service Code
|
CPT 88280
|
| Hospital Charge Code |
900910745
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$8.00 |
| Max. Negotiated Rate |
$36.00 |
| Rate for Payer: Cash Price |
$18.00
|
| Rate for Payer: Central Health Plan Commercial |
$32.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.00
|
| Rate for Payer: Galaxy Health WC |
$34.00
|
| Rate for Payer: Global Benefits Group Commercial |
$24.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$36.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$26.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$15.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.00
|
| Rate for Payer: Multiplan Commercial |
$30.00
|
| Rate for Payer: Networks By Design Commercial |
$26.00
|
| Rate for Payer: Prime Health Services Commercial |
$34.00
|
|
|
HC LAB REF AEROBIC ROUTINE MIC PANEL
|
Facility
|
IP
|
$14.00
|
|
|
Service Code
|
CPT 87186
|
| Hospital Charge Code |
900911299
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$12.60 |
| Rate for Payer: Cash Price |
$6.30
|
| Rate for Payer: Central Health Plan Commercial |
$11.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.60
|
| Rate for Payer: Galaxy Health WC |
$11.90
|
| Rate for Payer: Global Benefits Group Commercial |
$8.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$12.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.80
|
| Rate for Payer: Multiplan Commercial |
$10.50
|
| Rate for Payer: Networks By Design Commercial |
$9.10
|
| Rate for Payer: Prime Health Services Commercial |
$11.90
|
|
|
HC LAB REF AEROBIC ROUTINE MIC PANEL
|
Facility
|
OP
|
$14.00
|
|
|
Service Code
|
CPT 87186
|
| Hospital Charge Code |
900911299
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$225.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$8.65
|
| Rate for Payer: Aetna of CA HMO/PPO |
$63.44
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.98
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9.52
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.65
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$62.89
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$76.71
|
| Rate for Payer: Blue Distinction Transplant |
$8.40
|
| Rate for Payer: Blue Shield of California Commercial |
$8.65
|
| Rate for Payer: Blue Shield of California EPN |
$6.80
|
| Rate for Payer: Caremore Medicare Advantage |
$8.65
|
| Rate for Payer: Cash Price |
$6.30
|
| Rate for Payer: Cash Price |
$6.30
|
| Rate for Payer: Cash Price |
$6.30
|
| Rate for Payer: Central Health Plan Commercial |
$11.20
|
| Rate for Payer: Cigna of CA HMO |
$8.96
|
| Rate for Payer: Cigna of CA PPO |
$10.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.98
|
| Rate for Payer: Dignity Health Media |
$8.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.68
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$8.65
|
| Rate for Payer: EPIC Health Plan Transplant |
$8.65
|
| Rate for Payer: Galaxy Health WC |
$11.90
|
| Rate for Payer: Global Benefits Group Commercial |
$8.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$12.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$10.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$14.19
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$14.27
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.65
|
| Rate for Payer: InnovAge PACE Commercial |
$12.98
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14.27
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11.59
|
| Rate for Payer: Multiplan Commercial |
$10.50
|
| Rate for Payer: Networks By Design Commercial |
$9.10
|
| Rate for Payer: Prime Health Services Commercial |
$11.90
|
| Rate for Payer: Prime Health Services Medicare |
$9.17
|
| Rate for Payer: Riverside University Health System MISP |
$9.52
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$225.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.01
|
| Rate for Payer: United Healthcare All Other HMO |
$7.01
|
| Rate for Payer: United Healthcare HMO Rider |
$7.01
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.01
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.98
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.52
|
| Rate for Payer: Vantage Medical Group Senior |
$8.65
|
|
|
HC LAB REF ALBUMIN CHARGE - SO
|
Facility
|
OP
|
$8.00
|
|
|
Service Code
|
CPT 82040
|
| Hospital Charge Code |
900910549
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$1.60 |
| Max. Negotiated Rate |
$43.97 |
| Rate for Payer: Adventist Health Medi-Cal |
$4.95
|
| Rate for Payer: Aetna of CA HMO/PPO |
$36.32
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.42
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.44
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4.95
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$36.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$43.97
|
| Rate for Payer: Blue Distinction Transplant |
$4.80
|
| Rate for Payer: Blue Shield of California Commercial |
$4.94
|
| Rate for Payer: Blue Shield of California EPN |
$3.89
|
| Rate for Payer: Caremore Medicare Advantage |
$4.95
|
| Rate for Payer: Cash Price |
$3.60
|
| Rate for Payer: Cash Price |
$3.60
|
| Rate for Payer: Central Health Plan Commercial |
$6.40
|
| Rate for Payer: Cigna of CA HMO |
$5.12
|
| Rate for Payer: Cigna of CA PPO |
$5.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.42
|
| Rate for Payer: Dignity Health Media |
$4.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.68
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4.95
|
| Rate for Payer: EPIC Health Plan Transplant |
$4.95
|
| Rate for Payer: Galaxy Health WC |
$6.80
|
| Rate for Payer: Global Benefits Group Commercial |
$4.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$7.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$6.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$8.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$8.17
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4.95
|
| Rate for Payer: InnovAge PACE Commercial |
$7.42
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7.64
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.63
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.63
|
| Rate for Payer: Multiplan Commercial |
$6.00
|
| Rate for Payer: Networks By Design Commercial |
$5.20
|
| Rate for Payer: Prime Health Services Commercial |
$6.80
|
| Rate for Payer: Prime Health Services Medicare |
$5.25
|
| Rate for Payer: Riverside University Health System MISP |
$5.44
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.01
|
| Rate for Payer: United Healthcare All Other HMO |
$4.01
|
| Rate for Payer: United Healthcare HMO Rider |
$4.01
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.01
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.42
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.44
|
| Rate for Payer: Vantage Medical Group Senior |
$4.95
|
|
|
HC LAB REF ALBUMIN CHARGE - SO
|
Facility
|
IP
|
$8.00
|
|
|
Service Code
|
CPT 82040
|
| Hospital Charge Code |
900910549
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$1.60 |
| Max. Negotiated Rate |
$7.20 |
| Rate for Payer: Cash Price |
$3.60
|
| Rate for Payer: Central Health Plan Commercial |
$6.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.20
|
| Rate for Payer: Galaxy Health WC |
$6.80
|
| Rate for Payer: Global Benefits Group Commercial |
$4.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$7.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.60
|
| Rate for Payer: Multiplan Commercial |
$6.00
|
| Rate for Payer: Networks By Design Commercial |
$5.20
|
| Rate for Payer: Prime Health Services Commercial |
$6.80
|
|
|
HC LAB REF ALCOHOL METHYL
|
Facility
|
OP
|
$79.00
|
|
|
Service Code
|
CPT 80320
|
| Hospital Charge Code |
900910716
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$0.06 |
| Max. Negotiated Rate |
$92.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$0.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$67.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$43.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$43.45
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$75.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$92.00
|
| Rate for Payer: Blue Distinction Transplant |
$47.40
|
| Rate for Payer: Blue Shield of California Commercial |
$48.82
|
| Rate for Payer: Blue Shield of California EPN |
$38.39
|
| Rate for Payer: Cash Price |
$35.55
|
| Rate for Payer: Cash Price |
$35.55
|
| Rate for Payer: Central Health Plan Commercial |
$63.20
|
| Rate for Payer: Cigna of CA HMO |
$50.56
|
| Rate for Payer: Cigna of CA PPO |
$58.46
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$67.15
|
| Rate for Payer: Dignity Health Media |
$67.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$67.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$31.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$31.60
|
| Rate for Payer: Galaxy Health WC |
$67.15
|
| Rate for Payer: Global Benefits Group Commercial |
$47.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$71.10
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$59.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$27.65
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$52.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$30.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.80
|
| Rate for Payer: Multiplan Commercial |
$59.25
|
| Rate for Payer: Networks By Design Commercial |
$51.35
|
| Rate for Payer: Prime Health Services Commercial |
$67.15
|
| Rate for Payer: Riverside University Health System MISP |
$31.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$47.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$47.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$39.50
|
| Rate for Payer: United Healthcare All Other HMO |
$39.50
|
| Rate for Payer: United Healthcare HMO Rider |
$39.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$39.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$67.15
|
| Rate for Payer: Vantage Medical Group Senior |
$67.15
|
|
|
HC LAB REF ALCOHOL METHYL
|
Facility
|
IP
|
$79.00
|
|
|
Service Code
|
CPT 80320
|
| Hospital Charge Code |
900910716
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.80 |
| Max. Negotiated Rate |
$71.10 |
| Rate for Payer: Cash Price |
$35.55
|
| Rate for Payer: Central Health Plan Commercial |
$63.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$31.60
|
| Rate for Payer: Galaxy Health WC |
$67.15
|
| Rate for Payer: Global Benefits Group Commercial |
$47.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$71.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$52.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$30.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.80
|
| Rate for Payer: Multiplan Commercial |
$59.25
|
| Rate for Payer: Networks By Design Commercial |
$51.35
|
| Rate for Payer: Prime Health Services Commercial |
$67.15
|
|
|
HC LAB REF ALLERGEN INDIVIDUAL (RAST)
|
Facility
|
OP
|
$8.00
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
900911010
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$1.60 |
| Max. Negotiated Rate |
$140.27 |
| Rate for Payer: Adventist Health Medi-Cal |
$5.22
|
| Rate for Payer: Aetna of CA HMO/PPO |
$38.29
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.83
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.74
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.22
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$115.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$140.27
|
| Rate for Payer: Blue Distinction Transplant |
$4.80
|
| Rate for Payer: Blue Shield of California Commercial |
$4.94
|
| Rate for Payer: Blue Shield of California EPN |
$3.89
|
| Rate for Payer: Caremore Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$3.60
|
| Rate for Payer: Cash Price |
$3.60
|
| Rate for Payer: Central Health Plan Commercial |
$6.40
|
| Rate for Payer: Cigna of CA HMO |
$5.12
|
| Rate for Payer: Cigna of CA PPO |
$5.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.83
|
| Rate for Payer: Dignity Health Media |
$5.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.05
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$5.22
|
| Rate for Payer: EPIC Health Plan Transplant |
$5.22
|
| Rate for Payer: Galaxy Health WC |
$6.80
|
| Rate for Payer: Global Benefits Group Commercial |
$4.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$7.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$6.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$8.56
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$8.61
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.22
|
| Rate for Payer: InnovAge PACE Commercial |
$7.83
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.99
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.99
|
| Rate for Payer: Multiplan Commercial |
$6.00
|
| Rate for Payer: Networks By Design Commercial |
$5.20
|
| Rate for Payer: Prime Health Services Commercial |
$6.80
|
| Rate for Payer: Prime Health Services Medicare |
$5.53
|
| Rate for Payer: Riverside University Health System MISP |
$5.74
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.23
|
| Rate for Payer: United Healthcare All Other HMO |
$4.23
|
| Rate for Payer: United Healthcare HMO Rider |
$4.23
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.23
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.74
|
| Rate for Payer: Vantage Medical Group Senior |
$5.22
|
|
|
HC LAB REF ALLERGEN INDIVIDUAL (RAST)
|
Facility
|
IP
|
$8.00
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
900911010
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$1.60 |
| Max. Negotiated Rate |
$7.20 |
| Rate for Payer: Cash Price |
$3.60
|
| Rate for Payer: Central Health Plan Commercial |
$6.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.20
|
| Rate for Payer: Galaxy Health WC |
$6.80
|
| Rate for Payer: Global Benefits Group Commercial |
$4.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$7.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.60
|
| Rate for Payer: Multiplan Commercial |
$6.00
|
| Rate for Payer: Networks By Design Commercial |
$5.20
|
| Rate for Payer: Prime Health Services Commercial |
$6.80
|
|
|
HC LAB REF AMPHOTERICIN B
|
Facility
|
OP
|
$101.00
|
|
|
Service Code
|
CPT 84999
|
| Hospital Charge Code |
900911105
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$20.20 |
| Max. Negotiated Rate |
$90.90 |
| Rate for Payer: Aetna of CA HMO/PPO |
$61.34
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$85.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$55.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$55.55
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$48.90
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$59.67
|
| Rate for Payer: Blue Distinction Transplant |
$60.60
|
| Rate for Payer: Blue Shield of California Commercial |
$62.42
|
| Rate for Payer: Blue Shield of California EPN |
$49.09
|
| Rate for Payer: Cash Price |
$45.45
|
| Rate for Payer: Central Health Plan Commercial |
$80.80
|
| Rate for Payer: Cigna of CA HMO |
$64.64
|
| Rate for Payer: Cigna of CA PPO |
$74.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$85.85
|
| Rate for Payer: Dignity Health Media |
$85.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$85.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$40.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$40.40
|
| Rate for Payer: Galaxy Health WC |
$85.85
|
| Rate for Payer: Global Benefits Group Commercial |
$60.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$90.90
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$75.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$35.35
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$67.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.20
|
| Rate for Payer: Multiplan Commercial |
$75.75
|
| Rate for Payer: Networks By Design Commercial |
$65.65
|
| Rate for Payer: Prime Health Services Commercial |
$85.85
|
| Rate for Payer: Riverside University Health System MISP |
$40.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$60.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$60.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$50.50
|
| Rate for Payer: United Healthcare All Other HMO |
$50.50
|
| Rate for Payer: United Healthcare HMO Rider |
$50.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$50.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$85.85
|
| Rate for Payer: Vantage Medical Group Senior |
$85.85
|
|
|
HC LAB REF AMPHOTERICIN B
|
Facility
|
IP
|
$101.00
|
|
|
Service Code
|
CPT 84999
|
| Hospital Charge Code |
900911105
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$20.20 |
| Max. Negotiated Rate |
$90.90 |
| Rate for Payer: Cash Price |
$45.45
|
| Rate for Payer: Central Health Plan Commercial |
$80.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$40.40
|
| Rate for Payer: Galaxy Health WC |
$85.85
|
| Rate for Payer: Global Benefits Group Commercial |
$60.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$90.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$67.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$38.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.20
|
| Rate for Payer: Multiplan Commercial |
$75.75
|
| Rate for Payer: Networks By Design Commercial |
$65.65
|
| Rate for Payer: Prime Health Services Commercial |
$85.85
|
|
