|
HC MICRO EXAM/CRYSTALS
|
Facility
|
OP
|
$27.00
|
|
|
Service Code
|
CPT 89060
|
| Hospital Charge Code |
900910153
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.40 |
| Max. Negotiated Rate |
$63.38 |
| Rate for Payer: Adventist Health Medi-Cal |
$7.33
|
| Rate for Payer: Aetna of CA HMO/PPO |
$52.46
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.06
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7.33
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$51.96
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$63.38
|
| Rate for Payer: Blue Distinction Transplant |
$16.20
|
| Rate for Payer: Blue Shield of California Commercial |
$16.69
|
| Rate for Payer: Blue Shield of California EPN |
$13.12
|
| Rate for Payer: Caremore Medicare Advantage |
$7.33
|
| Rate for Payer: Cash Price |
$12.15
|
| Rate for Payer: Cash Price |
$12.15
|
| Rate for Payer: Central Health Plan Commercial |
$21.60
|
| Rate for Payer: Cigna of CA HMO |
$17.28
|
| Rate for Payer: Cigna of CA PPO |
$19.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11.00
|
| Rate for Payer: Dignity Health Media |
$7.33
|
| Rate for Payer: Dignity Health Medi-Cal |
$8.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.90
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$7.33
|
| Rate for Payer: EPIC Health Plan Transplant |
$7.33
|
| Rate for Payer: Galaxy Health WC |
$22.95
|
| Rate for Payer: Global Benefits Group Commercial |
$16.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$24.30
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$20.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$12.02
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$12.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7.33
|
| Rate for Payer: InnovAge PACE Commercial |
$11.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$18.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12.08
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9.82
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9.82
|
| Rate for Payer: Multiplan Commercial |
$20.25
|
| Rate for Payer: Networks By Design Commercial |
$17.55
|
| Rate for Payer: Prime Health Services Commercial |
$22.95
|
| Rate for Payer: Prime Health Services Medicare |
$7.77
|
| Rate for Payer: Riverside University Health System MISP |
$8.06
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$16.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$16.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.94
|
| Rate for Payer: United Healthcare All Other HMO |
$5.94
|
| Rate for Payer: United Healthcare HMO Rider |
$5.94
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.94
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.06
|
| Rate for Payer: Vantage Medical Group Senior |
$7.33
|
|
|
HC MICRO EXAM/CRYSTALS
|
Facility
|
IP
|
$194.00
|
|
|
Service Code
|
CPT 89060
|
| Hospital Charge Code |
900910153
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$38.80 |
| Max. Negotiated Rate |
$174.60 |
| Rate for Payer: Cash Price |
$87.30
|
| Rate for Payer: Central Health Plan Commercial |
$155.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$77.60
|
| Rate for Payer: Galaxy Health WC |
$164.90
|
| Rate for Payer: Global Benefits Group Commercial |
$116.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$174.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$129.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$73.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$38.80
|
| Rate for Payer: Multiplan Commercial |
$145.50
|
| Rate for Payer: Networks By Design Commercial |
$126.10
|
| Rate for Payer: Prime Health Services Commercial |
$164.90
|
|
|
HC MICRO EXAM/SPERM
|
Facility
|
OP
|
$36.00
|
|
|
Service Code
|
CPT 89321
|
| Hospital Charge Code |
900910155
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$7.20 |
| Max. Negotiated Rate |
$106.87 |
| Rate for Payer: Adventist Health Medi-Cal |
$12.05
|
| Rate for Payer: Aetna of CA HMO/PPO |
$88.48
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$18.08
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12.05
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$87.62
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$106.87
|
| Rate for Payer: Blue Distinction Transplant |
$21.60
|
| Rate for Payer: Blue Shield of California Commercial |
$22.25
|
| Rate for Payer: Blue Shield of California EPN |
$17.50
|
| Rate for Payer: Caremore Medicare Advantage |
$12.05
|
| Rate for Payer: Cash Price |
$16.20
|
| Rate for Payer: Cash Price |
$16.20
|
| Rate for Payer: Central Health Plan Commercial |
$28.80
|
| Rate for Payer: Cigna of CA HMO |
$23.04
|
| Rate for Payer: Cigna of CA PPO |
$26.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$18.08
|
| Rate for Payer: Dignity Health Media |
$12.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.27
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$12.05
|
| Rate for Payer: EPIC Health Plan Transplant |
$12.05
|
| Rate for Payer: Galaxy Health WC |
$30.60
|
| Rate for Payer: Global Benefits Group Commercial |
$21.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$32.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$27.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$19.76
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$19.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$12.05
|
| Rate for Payer: InnovAge PACE Commercial |
$18.08
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$24.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13.72
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16.15
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16.15
|
| Rate for Payer: Multiplan Commercial |
$27.00
|
| Rate for Payer: Networks By Design Commercial |
$23.40
|
| Rate for Payer: Prime Health Services Commercial |
$30.60
|
| Rate for Payer: Prime Health Services Medicare |
$12.77
|
| Rate for Payer: Riverside University Health System MISP |
$13.26
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$21.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$21.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.76
|
| Rate for Payer: United Healthcare All Other HMO |
$9.76
|
| Rate for Payer: United Healthcare HMO Rider |
$9.76
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.76
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$18.08
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.26
|
| Rate for Payer: Vantage Medical Group Senior |
$12.05
|
|
|
HC MICRO EXAM/SPERM
|
Facility
|
IP
|
$164.00
|
|
|
Service Code
|
CPT 89321
|
| Hospital Charge Code |
900910155
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$32.80 |
| Max. Negotiated Rate |
$147.60 |
| Rate for Payer: Cash Price |
$73.80
|
| Rate for Payer: Central Health Plan Commercial |
$131.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$65.60
|
| Rate for Payer: Galaxy Health WC |
$139.40
|
| Rate for Payer: Global Benefits Group Commercial |
$98.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$147.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$109.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$62.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$32.80
|
| Rate for Payer: Multiplan Commercial |
$123.00
|
| Rate for Payer: Networks By Design Commercial |
$106.60
|
| Rate for Payer: Prime Health Services Commercial |
$139.40
|
|
|
HC MICRO EXAM/TRICHOMONAS
|
Facility
|
OP
|
$17.00
|
|
|
Service Code
|
CPT 87210
|
| Hospital Charge Code |
900910156
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$3.40 |
| Max. Negotiated Rate |
$37.88 |
| Rate for Payer: Adventist Health Medi-Cal |
$5.82
|
| Rate for Payer: Aetna of CA HMO/PPO |
$31.35
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$8.73
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.82
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$31.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$37.88
|
| Rate for Payer: Blue Distinction Transplant |
$10.20
|
| Rate for Payer: Blue Shield of California Commercial |
$10.51
|
| Rate for Payer: Blue Shield of California EPN |
$8.26
|
| Rate for Payer: Caremore Medicare Advantage |
$5.82
|
| Rate for Payer: Cash Price |
$7.65
|
| Rate for Payer: Cash Price |
$7.65
|
| Rate for Payer: Central Health Plan Commercial |
$13.60
|
| Rate for Payer: Cigna of CA HMO |
$10.88
|
| Rate for Payer: Cigna of CA PPO |
$12.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8.73
|
| Rate for Payer: Dignity Health Media |
$5.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$6.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.86
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$5.82
|
| Rate for Payer: EPIC Health Plan Transplant |
$5.82
|
| Rate for Payer: Galaxy Health WC |
$14.45
|
| Rate for Payer: Global Benefits Group Commercial |
$10.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$15.30
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$12.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$9.54
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$9.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.82
|
| Rate for Payer: InnovAge PACE Commercial |
$8.73
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$7.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$7.80
|
| Rate for Payer: Multiplan Commercial |
$12.75
|
| Rate for Payer: Networks By Design Commercial |
$11.05
|
| Rate for Payer: Prime Health Services Commercial |
$14.45
|
| Rate for Payer: Prime Health Services Medicare |
$6.17
|
| Rate for Payer: Riverside University Health System MISP |
$6.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$10.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.72
|
| Rate for Payer: United Healthcare All Other HMO |
$4.72
|
| Rate for Payer: United Healthcare HMO Rider |
$4.72
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.72
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$8.73
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6.40
|
| Rate for Payer: Vantage Medical Group Senior |
$5.82
|
|
|
HC MICRO EXAM/TRICHOMONAS
|
Facility
|
IP
|
$160.00
|
|
|
Service Code
|
CPT 87210
|
| Hospital Charge Code |
900910156
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$32.00 |
| Max. Negotiated Rate |
$144.00 |
| Rate for Payer: Cash Price |
$72.00
|
| Rate for Payer: Central Health Plan Commercial |
$128.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$64.00
|
| Rate for Payer: Galaxy Health WC |
$136.00
|
| Rate for Payer: Global Benefits Group Commercial |
$96.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$144.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$106.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$60.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$32.00
|
| Rate for Payer: Multiplan Commercial |
$120.00
|
| Rate for Payer: Networks By Design Commercial |
$104.00
|
| Rate for Payer: Prime Health Services Commercial |
$136.00
|
|
|
HC MICROFIL LARVA
|
Facility
|
IP
|
$200.00
|
|
|
Service Code
|
CPT 87207
|
| Hospital Charge Code |
900911659
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$40.00 |
| Max. Negotiated Rate |
$180.00 |
| Rate for Payer: Cash Price |
$90.00
|
| Rate for Payer: Central Health Plan Commercial |
$160.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$80.00
|
| Rate for Payer: Galaxy Health WC |
$170.00
|
| Rate for Payer: Global Benefits Group Commercial |
$120.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$180.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$133.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$76.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$40.00
|
| Rate for Payer: Multiplan Commercial |
$150.00
|
| Rate for Payer: Networks By Design Commercial |
$130.00
|
| Rate for Payer: Prime Health Services Commercial |
$170.00
|
|
|
HC MICROFIL LARVA
|
Facility
|
OP
|
$22.00
|
|
|
Service Code
|
CPT 87207
|
| Hospital Charge Code |
900911659
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$4.40 |
| Max. Negotiated Rate |
$53.17 |
| Rate for Payer: Adventist Health Medi-Cal |
$5.99
|
| Rate for Payer: Aetna of CA HMO/PPO |
$43.99
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$8.98
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6.59
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.99
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$43.59
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$53.17
|
| 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 |
$5.99
|
| 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 |
$8.98
|
| Rate for Payer: Dignity Health Media |
$5.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$6.59
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.09
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$5.99
|
| Rate for Payer: EPIC Health Plan Transplant |
$5.99
|
| 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 |
$9.82
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$9.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.99
|
| Rate for Payer: InnovAge PACE Commercial |
$8.98
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$14.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10.13
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8.03
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8.03
|
| 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 |
$6.35
|
| Rate for Payer: Riverside University Health System MISP |
$6.59
|
| 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 |
$4.85
|
| Rate for Payer: United Healthcare All Other HMO |
$4.85
|
| Rate for Payer: United Healthcare HMO Rider |
$4.85
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.85
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$8.98
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6.59
|
| Rate for Payer: Vantage Medical Group Senior |
$5.99
|
|
|
HC MICROGLOBULIN
|
Facility
|
OP
|
$62.00
|
|
|
Service Code
|
CPT 82232
|
| Hospital Charge Code |
900912121
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.40 |
| Max. Negotiated Rate |
$143.61 |
| Rate for Payer: Adventist Health Medi-Cal |
$16.18
|
| Rate for Payer: Aetna of CA HMO/PPO |
$118.73
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$24.27
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$17.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$16.18
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$117.74
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$143.61
|
| Rate for Payer: Blue Distinction Transplant |
$37.20
|
| Rate for Payer: Blue Shield of California Commercial |
$38.32
|
| Rate for Payer: Blue Shield of California EPN |
$30.13
|
| Rate for Payer: Caremore Medicare Advantage |
$16.18
|
| Rate for Payer: Cash Price |
$27.90
|
| Rate for Payer: Cash Price |
$27.90
|
| Rate for Payer: Central Health Plan Commercial |
$49.60
|
| Rate for Payer: Cigna of CA HMO |
$39.68
|
| Rate for Payer: Cigna of CA PPO |
$45.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$24.27
|
| Rate for Payer: Dignity Health Media |
$16.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$17.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$21.84
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$16.18
|
| Rate for Payer: EPIC Health Plan Transplant |
$16.18
|
| Rate for Payer: Galaxy Health WC |
$52.70
|
| Rate for Payer: Global Benefits Group Commercial |
$37.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$55.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$46.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$26.54
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$26.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$16.18
|
| Rate for Payer: InnovAge PACE Commercial |
$24.27
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$41.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$27.32
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$21.68
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$21.68
|
| Rate for Payer: Multiplan Commercial |
$46.50
|
| Rate for Payer: Networks By Design Commercial |
$40.30
|
| Rate for Payer: Prime Health Services Commercial |
$52.70
|
| Rate for Payer: Prime Health Services Medicare |
$17.15
|
| Rate for Payer: Riverside University Health System MISP |
$17.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$37.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$37.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$13.10
|
| Rate for Payer: United Healthcare All Other HMO |
$13.10
|
| Rate for Payer: United Healthcare HMO Rider |
$13.10
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$13.10
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$24.27
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$17.80
|
| Rate for Payer: Vantage Medical Group Senior |
$16.18
|
|
|
HC MICROGLOBULIN
|
Facility
|
IP
|
$194.00
|
|
|
Service Code
|
CPT 82232
|
| Hospital Charge Code |
900912121
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$38.80 |
| Max. Negotiated Rate |
$174.60 |
| Rate for Payer: Cash Price |
$87.30
|
| Rate for Payer: Central Health Plan Commercial |
$155.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$77.60
|
| Rate for Payer: Galaxy Health WC |
$164.90
|
| Rate for Payer: Global Benefits Group Commercial |
$116.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$174.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$129.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$73.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$38.80
|
| Rate for Payer: Multiplan Commercial |
$145.50
|
| Rate for Payer: Networks By Design Commercial |
$126.10
|
| Rate for Payer: Prime Health Services Commercial |
$164.90
|
|
|
HC MICROGUIDEWIRE
|
Facility
|
IP
|
$594.00
|
|
|
Service Code
|
CPT C1769
|
| Hospital Charge Code |
909081801
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$118.80 |
| Max. Negotiated Rate |
$534.60 |
| Rate for Payer: Cash Price |
$267.30
|
| Rate for Payer: Central Health Plan Commercial |
$475.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$237.60
|
| Rate for Payer: Galaxy Health WC |
$504.90
|
| Rate for Payer: Global Benefits Group Commercial |
$356.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$534.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$396.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$226.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$118.80
|
| Rate for Payer: Multiplan Commercial |
$445.50
|
| Rate for Payer: Networks By Design Commercial |
$386.10
|
| Rate for Payer: Prime Health Services Commercial |
$504.90
|
|
|
HC MICROGUIDEWIRE
|
Facility
|
OP
|
$594.00
|
|
|
Service Code
|
CPT C1769
|
| Hospital Charge Code |
909081801
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$118.80 |
| Max. Negotiated Rate |
$534.60 |
| Rate for Payer: Aetna of CA HMO/PPO |
$396.30
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$504.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$326.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$326.70
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$287.61
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$350.94
|
| Rate for Payer: Blue Distinction Transplant |
$356.40
|
| Rate for Payer: Blue Shield of California Commercial |
$373.63
|
| Rate for Payer: Blue Shield of California EPN |
$290.47
|
| Rate for Payer: Cash Price |
$267.30
|
| Rate for Payer: Cash Price |
$267.30
|
| Rate for Payer: Central Health Plan Commercial |
$475.20
|
| Rate for Payer: Cigna of CA HMO |
$380.16
|
| Rate for Payer: Cigna of CA PPO |
$439.56
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$504.90
|
| Rate for Payer: Dignity Health Media |
$504.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$504.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$237.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$237.60
|
| Rate for Payer: Galaxy Health WC |
$504.90
|
| Rate for Payer: Global Benefits Group Commercial |
$356.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$534.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$445.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$207.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$396.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$226.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$118.80
|
| Rate for Payer: Multiplan Commercial |
$445.50
|
| Rate for Payer: Networks By Design Commercial |
$386.10
|
| Rate for Payer: Prime Health Services Commercial |
$504.90
|
| Rate for Payer: Riverside University Health System MISP |
$237.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$356.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$356.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$297.00
|
| Rate for Payer: United Healthcare All Other HMO |
$297.00
|
| Rate for Payer: United Healthcare HMO Rider |
$297.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$297.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$504.90
|
| Rate for Payer: Vantage Medical Group Senior |
$504.90
|
|
|
HC MICROHEMATOCRIT SPUN
|
Facility
|
OP
|
$11.00
|
|
|
Service Code
|
CPT 85013
|
| Hospital Charge Code |
900910790
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$2.20 |
| Max. Negotiated Rate |
$20.97 |
| Rate for Payer: Adventist Health Medi-Cal |
$7.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$17.36
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$17.19
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$20.97
|
| Rate for Payer: Blue Distinction Transplant |
$6.60
|
| Rate for Payer: Blue Shield of California Commercial |
$6.80
|
| Rate for Payer: Blue Shield of California EPN |
$5.35
|
| Rate for Payer: Caremore Medicare Advantage |
$7.00
|
| Rate for Payer: Cash Price |
$4.95
|
| Rate for Payer: Cash Price |
$4.95
|
| Rate for Payer: Central Health Plan Commercial |
$8.80
|
| Rate for Payer: Cigna of CA HMO |
$7.04
|
| Rate for Payer: Cigna of CA PPO |
$8.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.50
|
| Rate for Payer: Dignity Health Media |
$7.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.45
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$7.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$7.00
|
| Rate for Payer: Galaxy Health WC |
$9.35
|
| Rate for Payer: Global Benefits Group Commercial |
$6.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$9.90
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$8.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$11.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$11.55
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7.00
|
| Rate for Payer: InnovAge PACE Commercial |
$10.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.86
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9.38
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9.38
|
| Rate for Payer: Multiplan Commercial |
$8.25
|
| Rate for Payer: Networks By Design Commercial |
$7.15
|
| Rate for Payer: Prime Health Services Commercial |
$9.35
|
| Rate for Payer: Prime Health Services Medicare |
$7.42
|
| Rate for Payer: Riverside University Health System MISP |
$7.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.67
|
| Rate for Payer: United Healthcare All Other HMO |
$5.67
|
| Rate for Payer: United Healthcare HMO Rider |
$5.67
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.67
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.70
|
| Rate for Payer: Vantage Medical Group Senior |
$7.00
|
|
|
HC MICROHEMATOCRIT SPUN
|
Facility
|
IP
|
$116.00
|
|
|
Service Code
|
CPT 85013
|
| Hospital Charge Code |
900910790
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$23.20 |
| Max. Negotiated Rate |
$104.40 |
| Rate for Payer: Cash Price |
$52.20
|
| Rate for Payer: Central Health Plan Commercial |
$92.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$46.40
|
| Rate for Payer: Galaxy Health WC |
$98.60
|
| Rate for Payer: Global Benefits Group Commercial |
$69.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$104.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$77.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$44.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23.20
|
| Rate for Payer: Multiplan Commercial |
$87.00
|
| Rate for Payer: Networks By Design Commercial |
$75.40
|
| Rate for Payer: Prime Health Services Commercial |
$98.60
|
|
|
HC MICROHEMATOCRIT SPUN BODY FLUID
|
Facility
|
IP
|
$140.00
|
|
|
Service Code
|
CPT 85013
|
| Hospital Charge Code |
900910159
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$28.00 |
| Max. Negotiated Rate |
$126.00 |
| Rate for Payer: Cash Price |
$63.00
|
| Rate for Payer: Central Health Plan Commercial |
$112.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$56.00
|
| Rate for Payer: Galaxy Health WC |
$119.00
|
| Rate for Payer: Global Benefits Group Commercial |
$84.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$126.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$93.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$53.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$28.00
|
| Rate for Payer: Multiplan Commercial |
$105.00
|
| Rate for Payer: Networks By Design Commercial |
$91.00
|
| Rate for Payer: Prime Health Services Commercial |
$119.00
|
|
|
HC MICROHEMATOCRIT SPUN BODY FLUID
|
Facility
|
OP
|
$15.00
|
|
|
Service Code
|
CPT 85013
|
| Hospital Charge Code |
900910159
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$3.00 |
| Max. Negotiated Rate |
$20.97 |
| Rate for Payer: Adventist Health Medi-Cal |
$7.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$17.36
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$17.19
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$20.97
|
| Rate for Payer: Blue Distinction Transplant |
$9.00
|
| Rate for Payer: Blue Shield of California Commercial |
$9.27
|
| Rate for Payer: Blue Shield of California EPN |
$7.29
|
| Rate for Payer: Caremore Medicare Advantage |
$7.00
|
| Rate for Payer: Cash Price |
$6.75
|
| Rate for Payer: Cash Price |
$6.75
|
| Rate for Payer: Central Health Plan Commercial |
$12.00
|
| Rate for Payer: Cigna of CA HMO |
$9.60
|
| Rate for Payer: Cigna of CA PPO |
$11.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.50
|
| Rate for Payer: Dignity Health Media |
$7.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.45
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$7.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$7.00
|
| Rate for Payer: Galaxy Health WC |
$12.75
|
| Rate for Payer: Global Benefits Group Commercial |
$9.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$13.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$11.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$11.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$11.55
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7.00
|
| Rate for Payer: InnovAge PACE Commercial |
$10.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.86
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9.38
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9.38
|
| Rate for Payer: Multiplan Commercial |
$11.25
|
| Rate for Payer: Networks By Design Commercial |
$9.75
|
| Rate for Payer: Prime Health Services Commercial |
$12.75
|
| Rate for Payer: Prime Health Services Medicare |
$7.42
|
| Rate for Payer: Riverside University Health System MISP |
$7.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.67
|
| Rate for Payer: United Healthcare All Other HMO |
$5.67
|
| Rate for Payer: United Healthcare HMO Rider |
$5.67
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.67
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.70
|
| Rate for Payer: Vantage Medical Group Senior |
$7.00
|
|
|
HC MICROPRO CNTRL FEATURE ADDN UE
|
Facility
|
IP
|
$5,230.00
|
|
|
Service Code
|
CPT L6882
|
| Hospital Charge Code |
905356882
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$1,046.00 |
| Max. Negotiated Rate |
$4,707.00 |
| Rate for Payer: Blue Shield of California EPN |
$2,792.82
|
| Rate for Payer: Cash Price |
$2,353.50
|
| Rate for Payer: Central Health Plan Commercial |
$4,184.00
|
| Rate for Payer: Cigna of CA HMO |
$3,661.00
|
| Rate for Payer: Cigna of CA PPO |
$3,661.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,092.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,092.00
|
| Rate for Payer: Galaxy Health WC |
$4,445.50
|
| Rate for Payer: Global Benefits Group Commercial |
$3,138.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,707.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,488.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,992.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,046.00
|
| Rate for Payer: Multiplan Commercial |
$3,922.50
|
| Rate for Payer: Networks By Design Commercial |
$2,615.00
|
| Rate for Payer: Prime Health Services Commercial |
$4,445.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,974.85
|
| Rate for Payer: United Healthcare All Other HMO |
$1,928.82
|
| Rate for Payer: United Healthcare HMO Rider |
$1,886.98
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,725.90
|
|
|
HC MICROPRO CNTRL FEATURE ADDN UE
|
Facility
|
OP
|
$5,230.00
|
|
|
Service Code
|
CPT L6882
|
| Hospital Charge Code |
905356882
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$1,830.50 |
| Max. Negotiated Rate |
$4,707.00 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4,445.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,876.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,876.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,532.37
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,089.88
|
| Rate for Payer: Blue Distinction Transplant |
$3,138.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,922.50
|
| Rate for Payer: Blue Shield of California EPN |
$2,845.12
|
| Rate for Payer: Cash Price |
$2,353.50
|
| Rate for Payer: Central Health Plan Commercial |
$4,184.00
|
| Rate for Payer: Cigna of CA HMO |
$3,661.00
|
| Rate for Payer: Cigna of CA PPO |
$3,661.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,445.50
|
| Rate for Payer: Dignity Health Media |
$4,445.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,445.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,092.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,092.00
|
| Rate for Payer: Galaxy Health WC |
$4,445.50
|
| Rate for Payer: Global Benefits Group Commercial |
$3,138.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,707.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$3,922.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,830.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,488.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,144.30
|
| Rate for Payer: Multiplan Commercial |
$3,922.50
|
| Rate for Payer: Networks By Design Commercial |
$2,615.00
|
| Rate for Payer: Prime Health Services Commercial |
$4,445.50
|
| Rate for Payer: Riverside University Health System MISP |
$2,092.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,138.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,138.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,615.00
|
| Rate for Payer: United Healthcare All Other HMO |
$2,615.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,615.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,615.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,445.50
|
| Rate for Payer: Vantage Medical Group Senior |
$4,445.50
|
|
|
HC MICROWIRE MIRAGE
|
Facility
|
OP
|
$2,254.00
|
|
|
Service Code
|
CPT C1769
|
| Hospital Charge Code |
909000025
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$396.30 |
| Max. Negotiated Rate |
$2,028.60 |
| Rate for Payer: Aetna of CA HMO/PPO |
$396.30
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,915.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,239.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,239.70
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,091.39
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,331.66
|
| Rate for Payer: Blue Distinction Transplant |
$1,352.40
|
| Rate for Payer: Blue Shield of California Commercial |
$1,417.77
|
| Rate for Payer: Blue Shield of California EPN |
$1,102.21
|
| Rate for Payer: Cash Price |
$1,014.30
|
| Rate for Payer: Cash Price |
$1,014.30
|
| Rate for Payer: Central Health Plan Commercial |
$1,803.20
|
| Rate for Payer: Cigna of CA HMO |
$1,442.56
|
| Rate for Payer: Cigna of CA PPO |
$1,667.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,915.90
|
| Rate for Payer: Dignity Health Media |
$1,915.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,915.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$901.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$901.60
|
| Rate for Payer: Galaxy Health WC |
$1,915.90
|
| Rate for Payer: Global Benefits Group Commercial |
$1,352.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,028.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,690.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$788.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,503.42
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$858.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$450.80
|
| Rate for Payer: Multiplan Commercial |
$1,690.50
|
| Rate for Payer: Networks By Design Commercial |
$1,465.10
|
| Rate for Payer: Prime Health Services Commercial |
$1,915.90
|
| Rate for Payer: Riverside University Health System MISP |
$901.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,352.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,352.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,127.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,127.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,127.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,127.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,915.90
|
| Rate for Payer: Vantage Medical Group Senior |
$1,915.90
|
|
|
HC MICROWIRE MIRAGE
|
Facility
|
IP
|
$2,254.00
|
|
|
Service Code
|
CPT C1769
|
| Hospital Charge Code |
909000025
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$450.80 |
| Max. Negotiated Rate |
$2,028.60 |
| Rate for Payer: Cash Price |
$1,014.30
|
| Rate for Payer: Central Health Plan Commercial |
$1,803.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$901.60
|
| Rate for Payer: Galaxy Health WC |
$1,915.90
|
| Rate for Payer: Global Benefits Group Commercial |
$1,352.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,028.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,503.42
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$858.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$450.80
|
| Rate for Payer: Multiplan Commercial |
$1,690.50
|
| Rate for Payer: Networks By Design Commercial |
$1,465.10
|
| Rate for Payer: Prime Health Services Commercial |
$1,915.90
|
|
|
HC MISC CD FLOW MARKER (EA)
|
Facility
|
OP
|
$150.00
|
|
|
Service Code
|
CPT 88184
|
| Hospital Charge Code |
903901917
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$30.00 |
| Max. Negotiated Rate |
$741.03 |
| Rate for Payer: Adventist Health Medi-Cal |
$449.11
|
| Rate for Payer: Aetna of CA HMO/PPO |
$470.85
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$673.66
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$494.02
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$449.11
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$283.77
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$346.13
|
| Rate for Payer: Blue Distinction Transplant |
$90.00
|
| Rate for Payer: Blue Shield of California Commercial |
$92.70
|
| Rate for Payer: Blue Shield of California EPN |
$72.90
|
| Rate for Payer: Caremore Medicare Advantage |
$449.11
|
| Rate for Payer: Cash Price |
$67.50
|
| Rate for Payer: Cash Price |
$67.50
|
| Rate for Payer: Central Health Plan Commercial |
$120.00
|
| Rate for Payer: Cigna of CA HMO |
$96.00
|
| Rate for Payer: Cigna of CA PPO |
$111.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$673.66
|
| Rate for Payer: Dignity Health Media |
$449.11
|
| Rate for Payer: Dignity Health Medi-Cal |
$494.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$606.30
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$449.11
|
| Rate for Payer: EPIC Health Plan Transplant |
$449.11
|
| Rate for Payer: Galaxy Health WC |
$127.50
|
| Rate for Payer: Global Benefits Group Commercial |
$90.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$135.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$112.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$736.54
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$741.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$449.11
|
| Rate for Payer: InnovAge PACE Commercial |
$673.66
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$100.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$80.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$449.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$30.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$601.81
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$601.81
|
| Rate for Payer: Multiplan Commercial |
$112.50
|
| Rate for Payer: Networks By Design Commercial |
$97.50
|
| Rate for Payer: Prime Health Services Commercial |
$127.50
|
| Rate for Payer: Prime Health Services Medicare |
$476.06
|
| Rate for Payer: Riverside University Health System MISP |
$494.02
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$90.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$90.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$240.94
|
| Rate for Payer: United Healthcare All Other HMO |
$240.94
|
| Rate for Payer: United Healthcare HMO Rider |
$240.94
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$240.94
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$673.66
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$494.02
|
| Rate for Payer: Vantage Medical Group Senior |
$449.11
|
|
|
HC MISC CD FLOW MARKER (EA)
|
Facility
|
IP
|
$292.00
|
|
|
Service Code
|
CPT 88184
|
| Hospital Charge Code |
903901917
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$58.40 |
| Max. Negotiated Rate |
$262.80 |
| Rate for Payer: Cash Price |
$131.40
|
| Rate for Payer: Central Health Plan Commercial |
$233.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$116.80
|
| Rate for Payer: Galaxy Health WC |
$248.20
|
| Rate for Payer: Global Benefits Group Commercial |
$175.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$262.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$194.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$111.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$58.40
|
| Rate for Payer: Multiplan Commercial |
$219.00
|
| Rate for Payer: Networks By Design Commercial |
$189.80
|
| Rate for Payer: Prime Health Services Commercial |
$248.20
|
|
|
HC MISC CYTOPLAMIC FLOW MARKER EA
|
Facility
|
IP
|
$292.00
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
903901998
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$58.40 |
| Max. Negotiated Rate |
$262.80 |
| Rate for Payer: Cash Price |
$131.40
|
| Rate for Payer: Central Health Plan Commercial |
$233.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$116.80
|
| Rate for Payer: Galaxy Health WC |
$248.20
|
| Rate for Payer: Global Benefits Group Commercial |
$175.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$262.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$194.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$111.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$58.40
|
| Rate for Payer: Multiplan Commercial |
$219.00
|
| Rate for Payer: Networks By Design Commercial |
$189.80
|
| Rate for Payer: Prime Health Services Commercial |
$248.20
|
|
|
HC MISC CYTOPLAMIC FLOW MARKER EA
|
Facility
|
OP
|
$147.00
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
903901998
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$17.95 |
| Max. Negotiated Rate |
$281.75 |
| Rate for Payer: Aetna of CA HMO/PPO |
$281.75
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$124.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$80.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$80.85
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$139.44
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$170.08
|
| Rate for Payer: Blue Distinction Transplant |
$88.20
|
| Rate for Payer: Blue Shield of California Commercial |
$90.85
|
| Rate for Payer: Blue Shield of California EPN |
$71.44
|
| Rate for Payer: Cash Price |
$66.15
|
| Rate for Payer: Cash Price |
$66.15
|
| Rate for Payer: Central Health Plan Commercial |
$117.60
|
| Rate for Payer: Cigna of CA HMO |
$94.08
|
| Rate for Payer: Cigna of CA PPO |
$108.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$124.95
|
| Rate for Payer: Dignity Health Media |
$124.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$124.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$58.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$58.80
|
| Rate for Payer: Galaxy Health WC |
$124.95
|
| Rate for Payer: Global Benefits Group Commercial |
$88.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$132.30
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$110.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$51.45
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$98.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$39.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$29.40
|
| Rate for Payer: Multiplan Commercial |
$110.25
|
| Rate for Payer: Networks By Design Commercial |
$95.55
|
| Rate for Payer: Prime Health Services Commercial |
$124.95
|
| Rate for Payer: Riverside University Health System MISP |
$58.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$88.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$88.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$17.95
|
| Rate for Payer: United Healthcare All Other HMO |
$17.95
|
| Rate for Payer: United Healthcare HMO Rider |
$17.95
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$17.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$124.95
|
| Rate for Payer: Vantage Medical Group Senior |
$124.95
|
|
|
HC MMR ADMINISTRATION
|
Facility
|
OP
|
$23.00
|
|
| Hospital Charge Code |
902890244
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$4.60 |
| Max. Negotiated Rate |
$2,356.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$13.97
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$12.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12.65
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: Blue Distinction Transplant |
$13.80
|
| Rate for Payer: Blue Shield of California Commercial |
$14.47
|
| Rate for Payer: Blue Shield of California EPN |
$11.25
|
| Rate for Payer: Cash Price |
$10.35
|
| Rate for Payer: Cash Price |
$10.35
|
| Rate for Payer: Central Health Plan Commercial |
$18.40
|
| Rate for Payer: Cigna of CA HMO |
$14.72
|
| Rate for Payer: Cigna of CA PPO |
$17.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.55
|
| Rate for Payer: Dignity Health Media |
$19.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$19.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$9.20
|
| Rate for Payer: Galaxy Health WC |
$19.55
|
| Rate for Payer: Global Benefits Group Commercial |
$13.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$20.70
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$17.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$8.05
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.60
|
| Rate for Payer: Multiplan Commercial |
$17.25
|
| Rate for Payer: Networks By Design Commercial |
$14.95
|
| Rate for Payer: Prime Health Services Commercial |
$19.55
|
| Rate for Payer: Riverside University Health System MISP |
$9.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$13.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$13.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$11.50
|
| Rate for Payer: United Healthcare All Other HMO |
$11.50
|
| Rate for Payer: United Healthcare HMO Rider |
$11.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.55
|
| Rate for Payer: Vantage Medical Group Senior |
$19.55
|
|
