|
HC LAB REF STRYCHNINE
|
Facility
|
IP
|
$143.00
|
|
|
Service Code
|
CPT 80323
|
| Hospital Charge Code |
900911075
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$28.60 |
| Max. Negotiated Rate |
$128.70 |
| Rate for Payer: Cash Price |
$64.35
|
| Rate for Payer: Central Health Plan Commercial |
$114.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$57.20
|
| Rate for Payer: Galaxy Health WC |
$121.55
|
| Rate for Payer: Global Benefits Group Commercial |
$85.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$128.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$95.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$54.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$28.60
|
| Rate for Payer: Multiplan Commercial |
$107.25
|
| Rate for Payer: Networks By Design Commercial |
$92.95
|
| Rate for Payer: Prime Health Services Commercial |
$121.55
|
|
|
HC LAB REF SULFHEMOGLOBIN
|
Facility
|
OP
|
$10.00
|
|
|
Service Code
|
CPT 83060
|
| Hospital Charge Code |
900910299
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.00 |
| Max. Negotiated Rate |
$73.36 |
| Rate for Payer: Adventist Health Medi-Cal |
$8.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$60.68
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9.68
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.80
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$60.14
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$73.36
|
| Rate for Payer: Blue Distinction Transplant |
$6.00
|
| Rate for Payer: Blue Shield of California Commercial |
$6.18
|
| Rate for Payer: Blue Shield of California EPN |
$4.86
|
| Rate for Payer: Caremore Medicare Advantage |
$8.80
|
| Rate for Payer: Cash Price |
$4.50
|
| Rate for Payer: Cash Price |
$4.50
|
| 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 |
$13.20
|
| Rate for Payer: Dignity Health Media |
$8.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.88
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$8.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$8.80
|
| 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: Health Plan of Nevada (Sierra) Other |
$7.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$14.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$14.52
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.80
|
| Rate for Payer: InnovAge PACE Commercial |
$13.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13.96
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11.79
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11.79
|
| 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
|
| Rate for Payer: Prime Health Services Medicare |
$9.33
|
| Rate for Payer: Riverside University Health System MISP |
$9.68
|
| 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 |
$7.13
|
| Rate for Payer: United Healthcare All Other HMO |
$7.13
|
| Rate for Payer: United Healthcare HMO Rider |
$7.13
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.13
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.68
|
| Rate for Payer: Vantage Medical Group Senior |
$8.80
|
|
|
HC LAB REF SULFHEMOGLOBIN
|
Facility
|
IP
|
$10.00
|
|
|
Service Code
|
CPT 83060
|
| Hospital Charge Code |
900910299
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.00 |
| Max. Negotiated Rate |
$9.00 |
| Rate for Payer: Cash Price |
$4.50
|
| Rate for Payer: Central Health Plan Commercial |
$8.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$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: 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 T3 UPTAKE
|
Facility
|
IP
|
$10.00
|
|
|
Service Code
|
CPT 84479
|
| Hospital Charge Code |
900910792
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.00 |
| Max. Negotiated Rate |
$9.00 |
| Rate for Payer: Cash Price |
$4.50
|
| Rate for Payer: Central Health Plan Commercial |
$8.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$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: 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 T3 UPTAKE
|
Facility
|
OP
|
$10.00
|
|
|
Service Code
|
CPT 84479
|
| Hospital Charge Code |
900910792
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.00 |
| Max. Negotiated Rate |
$57.41 |
| Rate for Payer: Adventist Health Medi-Cal |
$6.47
|
| Rate for Payer: Aetna of CA HMO/PPO |
$47.49
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$9.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6.47
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$47.07
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$57.41
|
| Rate for Payer: Blue Distinction Transplant |
$6.00
|
| Rate for Payer: Blue Shield of California Commercial |
$6.18
|
| Rate for Payer: Blue Shield of California EPN |
$4.86
|
| Rate for Payer: Caremore Medicare Advantage |
$6.47
|
| Rate for Payer: Cash Price |
$4.50
|
| Rate for Payer: Cash Price |
$4.50
|
| 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 |
$9.70
|
| Rate for Payer: Dignity Health Media |
$6.47
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.73
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$6.47
|
| Rate for Payer: EPIC Health Plan Transplant |
$6.47
|
| 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: Health Plan of Nevada (Sierra) Other |
$7.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$10.61
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$10.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6.47
|
| Rate for Payer: InnovAge PACE Commercial |
$9.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10.79
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8.67
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8.67
|
| 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
|
| Rate for Payer: Prime Health Services Medicare |
$6.86
|
| Rate for Payer: Riverside University Health System MISP |
$7.12
|
| 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 |
$5.24
|
| Rate for Payer: United Healthcare All Other HMO |
$5.24
|
| Rate for Payer: United Healthcare HMO Rider |
$5.24
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.24
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$9.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.12
|
| Rate for Payer: Vantage Medical Group Senior |
$6.47
|
|
|
HC LAB REF TALWIN (PENTAZ)
|
Facility
|
IP
|
$92.00
|
|
|
Service Code
|
CPT 82542
|
| Hospital Charge Code |
900911096
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$18.40 |
| Max. Negotiated Rate |
$82.80 |
| Rate for Payer: Cash Price |
$41.40
|
| Rate for Payer: Central Health Plan Commercial |
$73.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$36.80
|
| Rate for Payer: Galaxy Health WC |
$78.20
|
| Rate for Payer: Global Benefits Group Commercial |
$55.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$82.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$61.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$35.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18.40
|
| Rate for Payer: Multiplan Commercial |
$69.00
|
| Rate for Payer: Networks By Design Commercial |
$59.80
|
| Rate for Payer: Prime Health Services Commercial |
$78.20
|
|
|
HC LAB REF TALWIN (PENTAZ)
|
Facility
|
OP
|
$92.00
|
|
|
Service Code
|
CPT 82542
|
| Hospital Charge Code |
900911096
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$18.40 |
| Max. Negotiated Rate |
$159.57 |
| Rate for Payer: Adventist Health Medi-Cal |
$24.09
|
| Rate for Payer: Aetna of CA HMO/PPO |
$132.53
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$36.14
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$26.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$24.09
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$130.82
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$159.57
|
| Rate for Payer: Blue Distinction Transplant |
$55.20
|
| Rate for Payer: Blue Shield of California Commercial |
$56.86
|
| Rate for Payer: Blue Shield of California EPN |
$44.71
|
| Rate for Payer: Caremore Medicare Advantage |
$24.09
|
| Rate for Payer: Cash Price |
$41.40
|
| Rate for Payer: Cash Price |
$41.40
|
| Rate for Payer: Central Health Plan Commercial |
$73.60
|
| Rate for Payer: Cigna of CA HMO |
$58.88
|
| Rate for Payer: Cigna of CA PPO |
$68.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$36.14
|
| Rate for Payer: Dignity Health Media |
$24.09
|
| Rate for Payer: Dignity Health Medi-Cal |
$26.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$32.52
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$24.09
|
| Rate for Payer: EPIC Health Plan Transplant |
$24.09
|
| Rate for Payer: Galaxy Health WC |
$78.20
|
| Rate for Payer: Global Benefits Group Commercial |
$55.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$82.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$69.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$39.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$39.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$24.09
|
| Rate for Payer: InnovAge PACE Commercial |
$36.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$61.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$29.16
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$24.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$32.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$32.28
|
| Rate for Payer: Multiplan Commercial |
$69.00
|
| Rate for Payer: Networks By Design Commercial |
$59.80
|
| Rate for Payer: Prime Health Services Commercial |
$78.20
|
| Rate for Payer: Prime Health Services Medicare |
$25.54
|
| Rate for Payer: Riverside University Health System MISP |
$26.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$55.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$55.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$19.51
|
| Rate for Payer: United Healthcare All Other HMO |
$19.51
|
| Rate for Payer: United Healthcare HMO Rider |
$19.51
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$19.51
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$36.14
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$26.50
|
| Rate for Payer: Vantage Medical Group Senior |
$24.09
|
|
|
HC LAB REF THIOPENTAL (PENTOTHAL)
|
Facility
|
OP
|
$143.00
|
|
|
Service Code
|
CPT 80345
|
| Hospital Charge Code |
900910555
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$0.06 |
| Max. Negotiated Rate |
$128.70 |
| Rate for Payer: Aetna of CA HMO/PPO |
$0.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$121.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$78.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$78.65
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$79.93
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$97.50
|
| Rate for Payer: Blue Distinction Transplant |
$85.80
|
| Rate for Payer: Blue Shield of California Commercial |
$88.37
|
| Rate for Payer: Blue Shield of California EPN |
$69.50
|
| Rate for Payer: Cash Price |
$64.35
|
| Rate for Payer: Cash Price |
$64.35
|
| Rate for Payer: Central Health Plan Commercial |
$114.40
|
| Rate for Payer: Cigna of CA HMO |
$91.52
|
| Rate for Payer: Cigna of CA PPO |
$105.82
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$121.55
|
| Rate for Payer: Dignity Health Media |
$121.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$121.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$57.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$57.20
|
| Rate for Payer: Galaxy Health WC |
$121.55
|
| Rate for Payer: Global Benefits Group Commercial |
$85.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$128.70
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$107.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$50.05
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$95.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$54.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$28.60
|
| Rate for Payer: Multiplan Commercial |
$107.25
|
| Rate for Payer: Networks By Design Commercial |
$92.95
|
| Rate for Payer: Prime Health Services Commercial |
$121.55
|
| Rate for Payer: Riverside University Health System MISP |
$57.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$85.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$85.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$71.50
|
| Rate for Payer: United Healthcare All Other HMO |
$71.50
|
| Rate for Payer: United Healthcare HMO Rider |
$71.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$71.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$121.55
|
| Rate for Payer: Vantage Medical Group Senior |
$121.55
|
|
|
HC LAB REF THIOPENTAL (PENTOTHAL)
|
Facility
|
IP
|
$143.00
|
|
|
Service Code
|
CPT 80345
|
| Hospital Charge Code |
900910555
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$28.60 |
| Max. Negotiated Rate |
$128.70 |
| Rate for Payer: Cash Price |
$64.35
|
| Rate for Payer: Central Health Plan Commercial |
$114.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$57.20
|
| Rate for Payer: Galaxy Health WC |
$121.55
|
| Rate for Payer: Global Benefits Group Commercial |
$85.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$128.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$95.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$54.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$28.60
|
| Rate for Payer: Multiplan Commercial |
$107.25
|
| Rate for Payer: Networks By Design Commercial |
$92.95
|
| Rate for Payer: Prime Health Services Commercial |
$121.55
|
|
|
HC LAB REF TIAGABINE LEVEL
|
Facility
|
IP
|
$99.00
|
|
|
Service Code
|
CPT 80199
|
| Hospital Charge Code |
900912716
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$19.80 |
| Max. Negotiated Rate |
$89.10 |
| Rate for Payer: Cash Price |
$44.55
|
| Rate for Payer: Central Health Plan Commercial |
$79.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$39.60
|
| Rate for Payer: Galaxy Health WC |
$84.15
|
| Rate for Payer: Global Benefits Group Commercial |
$59.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$89.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$66.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$37.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.80
|
| Rate for Payer: Multiplan Commercial |
$74.25
|
| Rate for Payer: Networks By Design Commercial |
$64.35
|
| Rate for Payer: Prime Health Services Commercial |
$84.15
|
|
|
HC LAB REF TIAGABINE LEVEL
|
Facility
|
OP
|
$99.00
|
|
|
Service Code
|
CPT 80199
|
| Hospital Charge Code |
900912716
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$19.80 |
| Max. Negotiated Rate |
$128.48 |
| Rate for Payer: Adventist Health Medi-Cal |
$27.11
|
| Rate for Payer: Aetna of CA HMO/PPO |
$128.48
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$40.66
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$29.82
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$27.11
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$79.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$96.36
|
| Rate for Payer: Blue Distinction Transplant |
$59.40
|
| Rate for Payer: Blue Shield of California Commercial |
$61.18
|
| Rate for Payer: Blue Shield of California EPN |
$48.11
|
| Rate for Payer: Caremore Medicare Advantage |
$27.11
|
| Rate for Payer: Cash Price |
$44.55
|
| Rate for Payer: Cash Price |
$44.55
|
| Rate for Payer: Central Health Plan Commercial |
$79.20
|
| Rate for Payer: Cigna of CA HMO |
$63.36
|
| Rate for Payer: Cigna of CA PPO |
$73.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$40.66
|
| Rate for Payer: Dignity Health Media |
$27.11
|
| Rate for Payer: Dignity Health Medi-Cal |
$29.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$36.60
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$27.11
|
| Rate for Payer: EPIC Health Plan Transplant |
$27.11
|
| Rate for Payer: Galaxy Health WC |
$84.15
|
| Rate for Payer: Global Benefits Group Commercial |
$59.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$89.10
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$74.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$44.46
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$44.73
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$27.11
|
| Rate for Payer: InnovAge PACE Commercial |
$40.66
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$66.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$37.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$27.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$36.33
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$36.33
|
| Rate for Payer: Multiplan Commercial |
$74.25
|
| Rate for Payer: Networks By Design Commercial |
$64.35
|
| Rate for Payer: Prime Health Services Commercial |
$84.15
|
| Rate for Payer: Prime Health Services Medicare |
$28.74
|
| Rate for Payer: Riverside University Health System MISP |
$29.82
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$59.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$59.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$21.96
|
| Rate for Payer: United Healthcare All Other HMO |
$21.96
|
| Rate for Payer: United Healthcare HMO Rider |
$21.96
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$21.96
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$40.66
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$29.82
|
| Rate for Payer: Vantage Medical Group Senior |
$27.11
|
|
|
HC LAB REF TISSUE CULT OTHER SOLID TISSUE
|
Facility
|
IP
|
$75.00
|
|
|
Service Code
|
CPT 88291
|
| Hospital Charge Code |
900910776
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$15.00 |
| Max. Negotiated Rate |
$67.50 |
| Rate for Payer: Cash Price |
$33.75
|
| Rate for Payer: Central Health Plan Commercial |
$60.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$30.00
|
| Rate for Payer: Galaxy Health WC |
$63.75
|
| Rate for Payer: Global Benefits Group Commercial |
$45.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$67.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$50.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$28.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.00
|
| Rate for Payer: Multiplan Commercial |
$56.25
|
| Rate for Payer: Networks By Design Commercial |
$48.75
|
| Rate for Payer: Prime Health Services Commercial |
$63.75
|
|
|
HC LAB REF TISSUE CULT OTHER SOLID TISSUE
|
Facility
|
OP
|
$75.00
|
|
|
Service Code
|
CPT 88291
|
| Hospital Charge Code |
900910776
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$15.00 |
| Max. Negotiated Rate |
$165.78 |
| Rate for Payer: Aetna of CA HMO/PPO |
$155.72
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$63.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$41.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$41.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$135.91
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$165.78
|
| Rate for Payer: Blue Distinction Transplant |
$45.00
|
| Rate for Payer: Blue Shield of California Commercial |
$46.35
|
| Rate for Payer: Blue Shield of California EPN |
$36.45
|
| Rate for Payer: Cash Price |
$33.75
|
| Rate for Payer: Cash Price |
$33.75
|
| Rate for Payer: Central Health Plan Commercial |
$60.00
|
| Rate for Payer: Cigna of CA HMO |
$48.00
|
| Rate for Payer: Cigna of CA PPO |
$55.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$63.75
|
| Rate for Payer: Dignity Health Media |
$63.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$63.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$30.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$30.00
|
| Rate for Payer: Galaxy Health WC |
$63.75
|
| Rate for Payer: Global Benefits Group Commercial |
$45.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$67.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$56.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$26.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$50.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$25.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.00
|
| Rate for Payer: Multiplan Commercial |
$56.25
|
| Rate for Payer: Networks By Design Commercial |
$48.75
|
| Rate for Payer: Prime Health Services Commercial |
$63.75
|
| Rate for Payer: Riverside University Health System MISP |
$30.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$45.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$45.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$27.19
|
| Rate for Payer: United Healthcare All Other HMO |
$27.19
|
| Rate for Payer: United Healthcare HMO Rider |
$27.19
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$27.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$63.75
|
| Rate for Payer: Vantage Medical Group Senior |
$63.75
|
|
|
HC LAB REF TISSUE CULTURE LYMPHOCYTE NON
|
Facility
|
IP
|
$101.00
|
|
|
Service Code
|
CPT 88230
|
| Hospital Charge Code |
900910686
|
|
Hospital Revenue Code
|
310
|
| 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
|
|
|
HC LAB REF TISSUE CULTURE LYMPHOCYTE NON
|
Facility
|
OP
|
$101.00
|
|
|
Service Code
|
CPT 88230
|
| Hospital Charge Code |
900910686
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$20.20 |
| Max. Negotiated Rate |
$877.64 |
| Rate for Payer: Adventist Health Medi-Cal |
$116.49
|
| Rate for Payer: Aetna of CA HMO/PPO |
$855.01
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$174.74
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$128.14
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$116.49
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$719.52
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$877.64
|
| 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: Caremore Medicare Advantage |
$116.49
|
| Rate for Payer: Cash Price |
$45.45
|
| 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 |
$174.74
|
| Rate for Payer: Dignity Health Media |
$116.49
|
| Rate for Payer: Dignity Health Medi-Cal |
$128.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$157.26
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$116.49
|
| Rate for Payer: EPIC Health Plan Transplant |
$116.49
|
| 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: Heritage Provider Network Commercial/Senior |
$191.04
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$192.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$116.49
|
| Rate for Payer: InnovAge PACE Commercial |
$174.74
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$67.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$191.86
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$116.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$156.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$156.10
|
| 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: Prime Health Services Medicare |
$123.48
|
| Rate for Payer: Riverside University Health System MISP |
$128.14
|
| 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 |
$94.36
|
| Rate for Payer: United Healthcare All Other HMO |
$94.36
|
| Rate for Payer: United Healthcare HMO Rider |
$94.36
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$94.36
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$174.74
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$128.14
|
| Rate for Payer: Vantage Medical Group Senior |
$116.49
|
|
|
HC LAB REF TISSUE CULTURE NEO BLOOD/BONE
|
Facility
|
IP
|
$203.00
|
|
|
Service Code
|
CPT 88237
|
| Hospital Charge Code |
900912791
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$40.60 |
| Max. Negotiated Rate |
$182.70 |
| Rate for Payer: Cash Price |
$91.35
|
| Rate for Payer: Central Health Plan Commercial |
$162.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$81.20
|
| Rate for Payer: Galaxy Health WC |
$172.55
|
| Rate for Payer: Global Benefits Group Commercial |
$121.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$182.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$135.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$77.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$40.60
|
| Rate for Payer: Multiplan Commercial |
$152.25
|
| Rate for Payer: Networks By Design Commercial |
$131.95
|
| Rate for Payer: Prime Health Services Commercial |
$172.55
|
|
|
HC LAB REF TISSUE CULTURE NEO BLOOD/BONE
|
Facility
|
OP
|
$203.00
|
|
|
Service Code
|
CPT 88237
|
| Hospital Charge Code |
900912791
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$40.60 |
| Max. Negotiated Rate |
$951.48 |
| Rate for Payer: Adventist Health Medi-Cal |
$143.75
|
| Rate for Payer: Aetna of CA HMO/PPO |
$926.98
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$215.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$158.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$143.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$780.06
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$951.48
|
| Rate for Payer: Blue Distinction Transplant |
$121.80
|
| Rate for Payer: Blue Shield of California Commercial |
$125.45
|
| Rate for Payer: Blue Shield of California EPN |
$98.66
|
| Rate for Payer: Caremore Medicare Advantage |
$143.75
|
| Rate for Payer: Cash Price |
$91.35
|
| Rate for Payer: Cash Price |
$91.35
|
| Rate for Payer: Central Health Plan Commercial |
$162.40
|
| Rate for Payer: Cigna of CA HMO |
$129.92
|
| Rate for Payer: Cigna of CA PPO |
$150.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$215.62
|
| Rate for Payer: Dignity Health Media |
$143.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$158.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$194.06
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$143.75
|
| Rate for Payer: EPIC Health Plan Transplant |
$143.75
|
| Rate for Payer: Galaxy Health WC |
$172.55
|
| Rate for Payer: Global Benefits Group Commercial |
$121.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$182.70
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$152.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$235.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$237.19
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$143.75
|
| Rate for Payer: InnovAge PACE Commercial |
$215.62
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$135.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$189.32
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$143.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$40.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$192.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$192.62
|
| Rate for Payer: Multiplan Commercial |
$152.25
|
| Rate for Payer: Networks By Design Commercial |
$131.95
|
| Rate for Payer: Prime Health Services Commercial |
$172.55
|
| Rate for Payer: Prime Health Services Medicare |
$152.38
|
| Rate for Payer: Riverside University Health System MISP |
$158.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$121.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$121.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$116.44
|
| Rate for Payer: United Healthcare All Other HMO |
$116.44
|
| Rate for Payer: United Healthcare HMO Rider |
$116.44
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$116.44
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$215.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$158.12
|
| Rate for Payer: Vantage Medical Group Senior |
$143.75
|
|
|
HC LAB REF TISSUE CULTURE NEO SOLID TUMOR
|
Facility
|
IP
|
$237.00
|
|
|
Service Code
|
CPT 88239
|
| Hospital Charge Code |
900912792
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$47.40 |
| Max. Negotiated Rate |
$213.30 |
| Rate for Payer: Cash Price |
$106.65
|
| Rate for Payer: Central Health Plan Commercial |
$189.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$94.80
|
| Rate for Payer: Galaxy Health WC |
$201.45
|
| Rate for Payer: Global Benefits Group Commercial |
$142.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$213.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$158.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$90.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$47.40
|
| Rate for Payer: Multiplan Commercial |
$177.75
|
| Rate for Payer: Networks By Design Commercial |
$154.05
|
| Rate for Payer: Prime Health Services Commercial |
$201.45
|
|
|
HC LAB REF TISSUE CULTURE NEO SOLID TUMOR
|
Facility
|
OP
|
$237.00
|
|
|
Service Code
|
CPT 88239
|
| Hospital Charge Code |
900912792
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$47.40 |
| Max. Negotiated Rate |
$1,266.73 |
| Rate for Payer: Adventist Health Medi-Cal |
$147.52
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,082.71
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$221.28
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$162.27
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$147.52
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,038.51
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,266.73
|
| Rate for Payer: Blue Distinction Transplant |
$142.20
|
| Rate for Payer: Blue Shield of California Commercial |
$146.47
|
| Rate for Payer: Blue Shield of California EPN |
$115.18
|
| Rate for Payer: Caremore Medicare Advantage |
$147.52
|
| Rate for Payer: Cash Price |
$106.65
|
| Rate for Payer: Cash Price |
$106.65
|
| Rate for Payer: Central Health Plan Commercial |
$189.60
|
| Rate for Payer: Cigna of CA HMO |
$151.68
|
| Rate for Payer: Cigna of CA PPO |
$175.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$221.28
|
| Rate for Payer: Dignity Health Media |
$147.52
|
| Rate for Payer: Dignity Health Medi-Cal |
$162.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$199.15
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$147.52
|
| Rate for Payer: EPIC Health Plan Transplant |
$147.52
|
| Rate for Payer: Galaxy Health WC |
$201.45
|
| Rate for Payer: Global Benefits Group Commercial |
$142.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$213.30
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$177.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$241.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$243.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$147.52
|
| Rate for Payer: InnovAge PACE Commercial |
$221.28
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$158.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$249.13
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$147.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$47.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$197.68
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$197.68
|
| Rate for Payer: Multiplan Commercial |
$177.75
|
| Rate for Payer: Networks By Design Commercial |
$154.05
|
| Rate for Payer: Prime Health Services Commercial |
$201.45
|
| Rate for Payer: Prime Health Services Medicare |
$156.37
|
| Rate for Payer: Riverside University Health System MISP |
$162.27
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$142.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$142.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$119.49
|
| Rate for Payer: United Healthcare All Other HMO |
$119.49
|
| Rate for Payer: United Healthcare HMO Rider |
$119.49
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$119.49
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$221.28
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$162.27
|
| Rate for Payer: Vantage Medical Group Senior |
$147.52
|
|
|
HC LAB REF TISSUE CULTURE SKIN/SOLID TISS
|
Facility
|
OP
|
$151.00
|
|
|
Service Code
|
CPT 88233
|
| Hospital Charge Code |
900912790
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$30.20 |
| Max. Negotiated Rate |
$1,060.09 |
| Rate for Payer: Adventist Health Medi-Cal |
$140.73
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,032.82
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$211.10
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$154.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$140.73
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$869.10
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,060.09
|
| Rate for Payer: Blue Distinction Transplant |
$90.60
|
| Rate for Payer: Blue Shield of California Commercial |
$93.32
|
| Rate for Payer: Blue Shield of California EPN |
$73.39
|
| Rate for Payer: Caremore Medicare Advantage |
$140.73
|
| Rate for Payer: Cash Price |
$67.95
|
| Rate for Payer: Cash Price |
$67.95
|
| Rate for Payer: Central Health Plan Commercial |
$120.80
|
| Rate for Payer: Cigna of CA HMO |
$96.64
|
| Rate for Payer: Cigna of CA PPO |
$111.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$211.10
|
| Rate for Payer: Dignity Health Media |
$140.73
|
| Rate for Payer: Dignity Health Medi-Cal |
$154.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$189.99
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$140.73
|
| Rate for Payer: EPIC Health Plan Transplant |
$140.73
|
| Rate for Payer: Galaxy Health WC |
$128.35
|
| Rate for Payer: Global Benefits Group Commercial |
$90.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$135.90
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$113.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$230.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$232.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$140.73
|
| Rate for Payer: InnovAge PACE Commercial |
$211.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$100.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$237.65
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$140.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$30.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$188.58
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$188.58
|
| Rate for Payer: Multiplan Commercial |
$113.25
|
| Rate for Payer: Networks By Design Commercial |
$98.15
|
| Rate for Payer: Prime Health Services Commercial |
$128.35
|
| Rate for Payer: Prime Health Services Medicare |
$149.17
|
| Rate for Payer: Riverside University Health System MISP |
$154.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$90.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$90.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$113.99
|
| Rate for Payer: United Healthcare All Other HMO |
$113.99
|
| Rate for Payer: United Healthcare HMO Rider |
$113.99
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$113.99
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$211.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$154.80
|
| Rate for Payer: Vantage Medical Group Senior |
$140.73
|
|
|
HC LAB REF TISSUE CULTURE SKIN/SOLID TISS
|
Facility
|
IP
|
$151.00
|
|
|
Service Code
|
CPT 88233
|
| Hospital Charge Code |
900912790
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$30.20 |
| Max. Negotiated Rate |
$135.90 |
| Rate for Payer: Cash Price |
$67.95
|
| Rate for Payer: Central Health Plan Commercial |
$120.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$60.40
|
| Rate for Payer: Galaxy Health WC |
$128.35
|
| Rate for Payer: Global Benefits Group Commercial |
$90.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$135.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$100.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$57.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$30.20
|
| Rate for Payer: Multiplan Commercial |
$113.25
|
| Rate for Payer: Networks By Design Commercial |
$98.15
|
| Rate for Payer: Prime Health Services Commercial |
$128.35
|
|
|
HC LAB REF TISSUE INSITU INTERP & REPORT
|
Facility
|
IP
|
$54.00
|
|
|
Service Code
|
CPT 88365
|
| Hospital Charge Code |
900910703
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$10.80 |
| Max. Negotiated Rate |
$48.60 |
| Rate for Payer: Cash Price |
$24.30
|
| Rate for Payer: Central Health Plan Commercial |
$43.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$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: 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 TISSUE INSITU INTERP & REPORT
|
Facility
|
OP
|
$54.00
|
|
|
Service Code
|
CPT 88365
|
| Hospital Charge Code |
900910703
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$10.80 |
| Max. Negotiated Rate |
$608.42 |
| Rate for Payer: Adventist Health Medi-Cal |
$213.41
|
| Rate for Payer: Aetna of CA HMO/PPO |
$608.42
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$320.12
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$234.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$213.41
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$70.38
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$85.85
|
| Rate for Payer: Blue Distinction Transplant |
$32.40
|
| Rate for Payer: Blue Shield of California Commercial |
$33.37
|
| Rate for Payer: Blue Shield of California EPN |
$26.24
|
| Rate for Payer: Caremore Medicare Advantage |
$213.41
|
| Rate for Payer: Cash Price |
$24.30
|
| Rate for Payer: Cash Price |
$24.30
|
| 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 |
$320.12
|
| Rate for Payer: Dignity Health Media |
$213.41
|
| Rate for Payer: Dignity Health Medi-Cal |
$234.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$288.10
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$213.41
|
| Rate for Payer: EPIC Health Plan Transplant |
$213.41
|
| 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: Health Plan of Nevada (Sierra) Other |
$40.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$349.99
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$352.13
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$213.41
|
| Rate for Payer: InnovAge PACE Commercial |
$320.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$36.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$166.40
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$213.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$285.97
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$285.97
|
| 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
|
| Rate for Payer: Prime Health Services Medicare |
$226.21
|
| Rate for Payer: Riverside University Health System MISP |
$234.75
|
| 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 |
$123.38
|
| Rate for Payer: United Healthcare All Other HMO |
$123.38
|
| Rate for Payer: United Healthcare HMO Rider |
$123.38
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$123.38
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$320.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$234.75
|
| Rate for Payer: Vantage Medical Group Senior |
$213.41
|
|
|
HC LAB REF TRYPSINOGEN
|
Facility
|
OP
|
$70.00
|
|
|
Service Code
|
CPT 83519
|
| Hospital Charge Code |
900910733
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.00 |
| 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 |
$42.00
|
| Rate for Payer: Blue Shield of California Commercial |
$43.26
|
| Rate for Payer: Blue Shield of California EPN |
$34.02
|
| Rate for Payer: Caremore Medicare Advantage |
$18.40
|
| Rate for Payer: Cash Price |
$31.50
|
| Rate for Payer: Cash Price |
$31.50
|
| Rate for Payer: Central Health Plan Commercial |
$56.00
|
| Rate for Payer: Cigna of CA HMO |
$44.80
|
| Rate for Payer: Cigna of CA PPO |
$51.80
|
| 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 |
$59.50
|
| Rate for Payer: Global Benefits Group Commercial |
$42.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$63.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$52.50
|
| 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 |
$46.69
|
| 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 |
$14.00
|
| 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 |
$52.50
|
| Rate for Payer: Networks By Design Commercial |
$45.50
|
| Rate for Payer: Prime Health Services Commercial |
$59.50
|
| 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 |
$42.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$42.00
|
| 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 TRYPSINOGEN
|
Facility
|
IP
|
$70.00
|
|
|
Service Code
|
CPT 83519
|
| Hospital Charge Code |
900910733
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.00 |
| Max. Negotiated Rate |
$63.00 |
| Rate for Payer: Cash Price |
$31.50
|
| Rate for Payer: Central Health Plan Commercial |
$56.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$28.00
|
| Rate for Payer: Galaxy Health WC |
$59.50
|
| Rate for Payer: Global Benefits Group Commercial |
$42.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$63.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$46.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$26.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.00
|
| Rate for Payer: Multiplan Commercial |
$52.50
|
| Rate for Payer: Networks By Design Commercial |
$45.50
|
| Rate for Payer: Prime Health Services Commercial |
$59.50
|
|
